PowerPoint® presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson

1. Chapter 3 LEGAL AND ETHICAL ISSUESin Medical Practice, Including HIPAA PowerPoint® presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson

2. Learning Outcomes 3.8 Discuss the impact that HIPAA regulations have in the medical office. 3.9 Explain how to protect patient confidentiality.

3. Introduction • Reasons to study medical law and ethics • Function at the highest professional level • Avoid legal problems Add clip art

4. Administrative Duties and the Law • Duties related to legal requirements • Insurance billing • Patient consent forms • Documentation in the medical record • Making appointments • Appointment books are a legal document • State reporting requirements • Births • Abuse • Certain diseases • Injuries from violent acts • Deaths • Phone calls • Maintain privacy

5. Clear and complete Referrals Missed appointments Dismissals Patient contact Medical record correction Medical records Property of facility or physician Retention and storage Based on state law Documentation

6. Confidentiality Issues • Legal obligation to maintain confidentiality of patient information • Discuss with patient privately • Share patient information only when appropriate • Do not discuss the case with anyone outside the medical office Confidential

7. HIPAA • Health Insurance Portability and Accountability Act (1996) • Improve efficiency and effectiveness of health-care delivery • Protect and enhance the rights of patients • Access to health-care information • Control inappropriate use or disclosure • Improve the quality of health care by restoring trust in the health-care system

8. Title I: Health Care Portability • Increases workers’ ability to get health-care coverage when starting a new job • Reduces workers’ probability of losing existing health-care coverage • Helps workers maintain continuous health-care coverage when changing jobs • Helps workers purchase health insurance on their own if they lose coverage under an employer’s group plan and have no other health-care coverage available

9. Title II: Prevention of Health Care Fraud and Abuse, Administrative Simplification and Medical Liability Reform • HIPAA privacy rules • Give patients more control over their health information • Set boundaries on the use and release of health-care records • Establish appropriate safeguards to protect the privacy of health information • Hold violators accountable if they violate patients’ privacy rights • Strike a balance when public responsibility supports disclosure of some forms of data

10. HIPAA (cont.) Providers are allowed to share information to provide care to patients. reatment ayment T P O perations HIPAA allows the provider to use health-care information for: Providers are allowed to share information to receive payment for the treatment provided. Providers are allowed to share information to conduct normal business activities, such as quality improvement.

11. HIPAA (cont.) • Protected health information (PHI) • Uses • Movement within an organization • Disclosure • Transmitted between or among organizations • Managing and storing • Sharing • Patient notification • Notice of privacy practices • Security measures • HIPAA Security Rule • Computer networks • The Internet • Disks, other storage media, and extranets • Chart • Reception area and clinical stations • Fax, copier, and printer

12. HIPAA (cont.) • Violations and penalties • Civil • Criminal • For knowing, wrongful misuse of health information • Administrative simplification • Standardizing patient information • Standardized codes

13. Apply Your Knowledge While you are documenting on the computer, you are called to a patient room for an emergency. What should you do before leaving the computer? ANSWER: You should close the patient record and log off the computer to protect the confidentiality of patient information. Good Answer!

14. Confidentiality Issues and MandatoryDisclosure Principles for preventing improper release of information • When in doubt, do not release information. • It is the patient’s right to keep patient information confidential or disclose it. • All patients should be treated with the same degree of confidentiality. • Be aware of all applicable laws and of the regulations.

15. Confidentiality Issues and MandatoryDisclosure (cont.) Principles for preventing improper release of information • When necessary to break confidentiality and when there is a conflict between ethics and confidentiality: • Discuss it with the patient. • If the law does not dictate what to do in the situation, the attending physician should make the judgment based on the urgency of the situation and any danger that might be posed to the patient or others. • Get written approval from the patient before releasing information.

16. Apply Your Knowledge A police officer enters the physician’s office where you work and requests information about a patient. May you release this information? What should you do? ANSWER: No, you should not be the person to release this information. You should refer the officer to the patient’s physician, who will make the judgment based on the urgency of the situation and any danger that might be posed to the patient or others. YES!

17. Code of Ethics • Principles of right and wrong • Laws are based on ethical considerations • Medical professionals are expected to act ethically • Will have a positive effect • On your reputation • Employer’s practice

18. End of Chapter 3 Let no one come to you without leaving better and happier. —Mother Theresa