HIPAA

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) will continue to have significant impact on individuals, physicians and other health care providers over the next several years. Compliance is the efforts you make to follow the principles and practices as identified by state and federal agencies. PCS can assist your practice with the professional elements of protecting individuals, streamlining processes, and increasing system-wide stability.

A compliance strategy provides your practice with a standardized process for handling business functions, leading to consistent and effective management and staff performance. PCS will:

ØAssess your current level of readiness, where you need to be,
            and how to get there

ØAssist with the develop of comprehensive and accurate Policies
            and Procedures

ØAssist with implementation and training

ØProvide customizable Word and Excel templates

ØProvide seminars and educational training

Failure to comply with mandates leads to sanctions and fines from state and federal agencies; failure to follow guidelines potentially results in more fraud and abuse in the claims reimbursement cycle.

Serious civil and criminal penalties apply for HIPAA non-compliance:

ØGeneral non-compliance with privacy, security and transaction
            regulations result in a $ 100 fine per violation and up to
            $25,000 per person

ØSpecific non-compliance with the Privacy rule is a $50,000 fine
            and imprisonment for one (1) year, if one knowingly obtains or
            discloses PHI.

    ØA person who obtains or discloses such health information
                    under false pretenses is subject to a $100,000 fine

    ØIf one obtains or discloses PHI with the intent to sell,
                    transfer, or use it for commercial advantage, personal gain
                    or malicious harm, a maximum fine of $250,000 and up to
                    ten (10) years imprisonment may be applied

Physicians, health care providers and organizations face challenges in implementing the HIPAA requirements - do not let these overwhelm you. Your practice is required to take “reasonable” steps to build protections specific to your health care practice/organization.

Compliance is an ongoing endeavor involving teamwork. Understand your practice’s established policies and procedures. Monitor your own activities to ensure you are following the required procedures. Do not take shortcuts when your actions involve patient privacy and security.