1 How HIPAA Violations Affect the Medical Billing Process Part Two

How HIPAA Violations Affect the Medical Billing Process Part Two

Amber Ball HCR/220 June 17, 2013

2 How HIPAA Violations Affect the Medical Billing Process Part Two

HIV/AIDS and HIPAA The Human Immunodeficiency Virus (HIV), and Acquired Immune Deficiency Syndrome (AIDS), are two vastly spreading diseases affected the globe. The disease was first discovered in the 1950s in the Congo, but did not surface in the United States until the 1980s. Since then, more than one million people have the virus. According to "Aids.gov" (2012), CDC estimates that more than one million people are living with HIV in the U.S. One in five (20%) of those people living with HIV is unaware of their infection. AIDS is caused by a retrovirus known as HIV, which infects and kills the T-cells of the bodys immune system. HIV destroys CD4 cells, which is a type of white blood cells that helps the body fight diseases. The more CD4 cells that die, the weaker your immune system will be. As the CD4 cells are destroyed by HIV, the body will begin to develop other infections that would not normally affect it therefore making those who suffer from AIDS unable to fight off infections. In order to become infected with HIV, vaginal secretions, semen, or infected blood must enter your body. A person cant catch HIV from ordinary contact such as hugging, kissing, or even shaking hands. HIV can also not be transmitted through, water, air, or even a mosquito bite. The Health Insurance Portability and Accountability Act (HIPAA), was established in 1996. When this document was initially passed, it had two main focuses. First, to ensure people could maintain insurance when between jobs. Second, to maintain privacy and security between the patient and the facility they are being treated at. Since 1996 when the HIPPA laws were passed, it has drastically changed the way medical facilities must handle, process, and store medical records.

3 How HIPAA Violations Affect the Medical Billing Process Part Two

There are four parts to HIPAA. Part one, transactions and codes sets are intended for the facility and insurance. HIPAA has named certain types of organizations as covered entities, including health plans, health care clearinghouses, and certain health care providers. HIPAA also adheres to a specific set of codes that all medical facilities must use known as the ICD 9 (International Classification of Diseases). These codes consist of three to five digit numbers that is used to describe the patients diagnosis and procedures performed on the patient. Part two, identifiers are used to put a patient with a chart. There are currently eighteen named identifiers. These identifiers, spelled out in HIPAA, contain personal information not allowed to be used to label a patients file. For instance, you would not be allowed to use a patients initials and date of birth, these things are personal to the particular patient and are on file with the office. Offices would also not be allowed to use account number as a filing system because it would be an easy way for an unauthorized person to access the patients file. Part three, privacy. This is the right to a patient to only allow the doctor to know what they want them to know, and the doctor must only share this information with the correct personnel. This allows the doctor to obtain the needed information without the patient feeling they have to release all information. In this section, there are forms that must be filled out in order for others to be allowed access to medical information. If the patient has not filled anything out on who is and is not allowed access, then no-one will be allowed access except proper medical personnel. Part four, security. Part four is the most important of all of the HIPAA rules. In order for security to be adequate, the facility must have proper training and re-training as much as the facility sees fit. Security measures should include passwords and or pass codes. A locked and secure area, where the patients chart and information are stored. Only correct personnel are allowed access to these files. Personnel should also be trained on the patients rights to privacy. With these four rules set

4 How HIPAA Violations Affect the Medical Billing Process Part Two

into place, it allows the patients to feel secure about their information, and it allows the doctors less room for lawsuits pertaining to the leak of patient information. When HIV/AIDS was introduced people were terrified of the disease. Doctors were not exactly sure how it was contracted, all they knew was they were unable to cure it. After ongoing testing was performed, they later realized it was only contracted through bodily fluid. The doctors attempted to inform as many people as they could of the risks and symptoms in attempts that people would get tested. Some people did receive testing, but once they found out they had it, they began receiving negative attention from everyone. People were evicted from their housing, lost their jobs, and were even denied professional medical care. This negative attention led to less people getting tested and allowed the virus to spread more rapidly. In 1990 the Americans with Disabilities Act (ADA) included the HIV infection to be included in the act. In 1996 HIPAA was introduced and turned out to be a positive turn point in the privacy of patients with HIV/AIDS. Since the HIPAA laws, it has become a big issue if someone is discriminated against for having HIV/AIDS. Ethically anyone that knows they have contracted the disease should tell anyone they are going to have intercourse with or may potentially become partners. However, do to social mockery, those infected are more than terrified to tell anyone. They are overwhelmed with fear at what others may say or think. On the other hand, we have those that find out they are infected and chose to infect tons of other people because they are upset with themselves. Due to legal bindings medical physicians have with their patients, they are unable to disclose anyone that may have or does have the virus. According to "Center for Disease Control and Prevention" (2013), 48 states plus D.C. now have HIV testing laws that are consistent with CDCs 2006 recommendations, nearly twice as many as when the recommendations were

5 How HIPAA Violations Affect the Medical Billing Process Part Two

released. 22 states have Medicaid programs that reimburse for routine HIV screening in all settings and populations. 32 states plus D.C. require laboratory reporting of CD4 and viral load data to HIV surveillance programs. According to "Texas Department of Health And Human Services" (2011), Texas law mandates the reporting of HIV/AIDS and STD by both healthcare providers and laboratories and Texas Administrative Code, Chapters 97.131-97.134 specifies the reporting process for HIV/AIDS, syphilis, gonorrhea, chancroid and Chlamydia. Communicable disease reporting is exempt from HIPAA (Health Insurance Portability and Accountability Act of 1996). Due to these laws, all cases must be filed, but with precaution by still allowing the patients security and confidentiality. We have come a long way since we first discovered the HIV virus. We have not figured out a complete cure yet, but doctors have figured out a way to put the virus in remission. With the cocktails of pills HIV and AIDS patients are prescribed, they are able to slow the process. However, not everyone is able to afford the medication they need. Some children are also born into this world with AIDS and HIV and are unable to defend their small bodies from the disease. Allowing more research, and with our technology rapidly advancing, will aide in finding a cure for AIDS and HIV. Schooling everyone on the importance of protection and how one can acquire the disease should also slow done and help prevent the spread of this infectious disease.

6 How HIPAA Violations Affect the Medical Billing Process Part Two

References

AIDS.gov. (2012). Retrieved from http://aids.gov/hiv-aids-basics/hiv-aids-101/statistics/

Centers for Disease Control and Prevention. (2013). Retrieved from http://www.cdc.gov/hiv/law/

Texas Department of Health and Human Services. (2011). Retrieved from http://www.dshs.state.tx.us/hivstd/healthcare/reporting.shtm