BHA FPX4006 Assessment 1 Health Care Regulation and Compliance Compliance Program Implementation and Ethical Decision
Place Your Order NowBHA FPX4006 Assessment 1 Health Care Regulation and Compliance Compliance Program Implementation and Ethical Decision
BHA FPX4006 Assessment 1 Health Care Regulation and Compliance was a recent issue at Vila healthcare where, under the direction of her supervisor, an employee was trying to get authorization for a procedure for a patient and shared protected health information (PHI) with the insurance company without a release of information (ROI) being obtained from the patient. The insurance company representative reached out to Vila Health department supe
Problem Summary: Privacy Breach—HIPAA Violation
| Briefly Explain the Law, Regulation, Standard, et cetera* | Briefly Explain How the Law, Regulation, Standard, et cetera Applies to the Privacy Breach/HIPAA Violation | |
| Applicable Law(s) | HIPAA Privacy Rule protect a patient’s protected health information. It gives them access to their own health information. Must have agreements with all entities to disclose PHI (Snell, 2020). | Applicable to Vila health situation because, apparently, the patient had not signed a release to discuss/disclose PHI with their insurance company. |
| Applicable Specific Regulation(s) | Omnibus rule states that any breach of PHI must be reported (Cascardo, 2014). | Applicable to Vila health because it identifies a potential process gap in obtaining authorization from patients. |
| Disclosure | Breach Notification Rule requires notification to affected patients and the department of Health and Human Services (HHS). Some cases may require media notification (CMS, 2021). | Applicable to Vila Health because they were notified of the error by the insurance company so they must report to the patient and HHS. |
| Applicable Human Resource Law(s) | Healthcare workers are responsible for adhering to requirements of HIPAA regulations which clearly state the requirements regarding protected health information. | It appears this Vila health worker violated their responsibility to the HIPAA law. Further investigation will determine intent/knowledge. |
| Applicable Industry Accrediting Body Standards | The department of Health and Human Services and the Civil Rights office, both have accrediting standards regarding HIPAA responsibilities. | Violation in this case, would be reported to the departments listed to determine next steps. BHA FPX4006 Assessment 1 Health Care Regulation and Compliance |
CMS. (2021). HIPAA Basics for Providers: Privacy, Security, & Breach Notification Rules. MLN Network.
Snell, E. (2020). What is a HIPAA Business Associate Agreement (BAA)? HealthIT Security.
Seven Essential Elements of an Effective Compliance Program
| Number | Element of an Effective Compliance Program (Federal Register)* | How Does This Element Apply to the Privacy Breach/HIPAA Violation? |
| 1. | Policies, procedures, and standards of conduct | Having a standard written release of information policy and form would be an initial step to ensuring proper process in obtaining appropriate consent from patients. Following up on training and monthly audits would also be appropriate ways to ensure proper compliance. |
| 2. | Oversight/Follow up | Having an auditor or compliance standard in place to inspect policies and their alignment with current laws. Having a compliance officer or team in place may be key to avoiding gaps in processes (Burton, 2014). |
| 3. | Education and Communication | Having a compliance team to lead this process is beneficial. Managers of each department educating and talking to their about necessary processes for compliance is a best practice for health care systems. The supervisor or department manager of the Vila health employee who made the error has responsibility to ensure their staff are knowledgeable of process and are following it (Burton, 2014). |
| 4. | Internal monitoring and auditing | Following up on education and process is vital to any organization. Having a new hire checklist can help ensure processes have been shared and aid with accountability of staff members. Monitoring operations to ensure adherence to the
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