Health & SafetyAnswer Key

Tpo Hipaa Definition

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QUESTION 1

Accounting of Disclosure (AOD)

ANSWER

HIPAA requirement to list, upon patient request, all disclosures that meet the criteria. Currently, this does not require accounting for disclosures for treatment, payment, and healthcare operations (TPO), but under ARRA this changes to include these disclosures; awaiting final regulations.

QUESTION 2

Authorization

ANSWER

The granting of permission to disclose confidential information; as defined in terms of the HIPAA Privacy Rule, an individual's formal, written permission to use or disclose his or her personally identifiable health information for purposes other than treatment, payment, or healthcare operations 2. A patient's consent to the disclosure of protected health information (PHI); the form by which a patient gives consent to release of information.

QUESTION 3

Behavioral/Mental Health

ANSWER

A broad array of psychiatric services provided in acute, long-term, and ambulatory care settings; includes treatment of mental disorders, chemical dependency, mental retardation, and developmental disabilities, as well as cognitive rehabilitation services.

QUESTION 4

Breach of Confidentiality

ANSWER

A violation of a formal or implied contract in which private information belonging to one party, but entrusted to another party, is disclosed by that individual without the consent of the party to whom the information pertains; an unauthorized disclosure of confidential information.

QUESTION 5

Continuum of Care

ANSWER

The range of healthcare services provided to patients, from routine ambulatory care to intensive acute care; the emphasis is on treating individual patients at the level of care required by their course of treatment with the assurance of communication between caregivers.

QUESTION 6

Disclosure:

ANSWER

The act of making information known; in the health information management context, the release of confidential health information about an identifiable person to another person or entity.

QUESTION 7

Electronic Health Record (EHR):

ANSWER

An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization.

QUESTION 8

Healthcare Operations:

ANSWER

Certain activities undertaken by or on behalf of, a covered entity, including: conducting quality assessment and improvement activities; reviewing the competence or qualifications of healthcare professionals, underwriting, premium rating, and other activities relating to the creation; renewal or replacement of a contract of health insurance or health benefits; conducting or arranging for medical review, legal services, and auditing functions; business planning and development; and business management and general administrative activities of the entity.

QUESTION 9

Health Information:

ANSWER

According to the HIPAA Privacy Rule, any information (verbal or written) created or received by a healthcare provider, health plan, public health authority, employer, life insurer, school or university, or healthcare clearinghouse that relates to the physical or mental health of an individual, provision of healthcare to an individual, or payment for provision of healthcare.

QUESTION 10

Health Insurance Portability and Accountability Act of 1996 (HIPAA):

ANSWER

The federal legislation enacted to provide continuity of health coverage, control fraud and abuse in healthcare, reduce healthcare costs, and guarantee the security and privacy of health information; limits exclusion for pre-existing medical conditions, prohibits discrimination against employees and dependents based on health status, guarantees availability of health insurance to small employers, and guarantees renewability of insurance to all employees regardless of size; requires covered entities (most healthcare providers and organizations) to transmit healthcare claims in a specific format and to develop, implement, and comply with the standards of the Privacy Rule and the Security Rule; and mandates that covered entities apply for and utilize national identifiers in HIPAA transactions

QUESTION 11

Minimum Necessary Standard:

ANSWER

A stipulation of the HIPAA Privacy Rule that requires healthcare facilities and other covered entities to make reasonable efforts to limit the patient-identifiable information they disclose to the least amount required to accomplish the intended purpose for which the information was requested.

QUESTION 12

Notice of Privacy Practices:

ANSWER

A statement (mandated by the HIPAA Privacy Rule) issued by a healthcare organization that informs individuals of the uses and disclosures of patient-identifiable health information that may be made by the organization, as well as the individual's rights and the organization's legal duties with respect to that information.

QUESTION 13

Privacy:

ANSWER

The quality or state of being hidden from, or undisturbed by, the observation or activities of other persons, or freedom from unauthorized intrusion; in healthcare-related contexts, the right of a patient to control disclosure of protected health information.

QUESTION 14

Privacy Rule:

ANSWER

The federal regulations created to implement the privacy requirements of the simplification subtitle of the Health Insurance Portability and Accountability Act of 1996; effective in 2002; afforded patients certain rights to and about their protected health information.

QUESTION 15

Protected Health Information (PHI):

ANSWER

Individually identifiable health information that is transmitted by electronic media, maintained in electronic form, or transmitted in any other form or medium; Under HIPAA, all individually identifiable information, whether oral or recorded in any form or medium, created or received by a healthcare provider or any other entity subject to HIPAA requirements; Under the HITECH Final Rule, decedent health information older than 50 years is no longer considered PHI.

QUESTION 16

Release of Information:

ANSWER

The process of disclosing protected health information from the health record to another party.

QUESTION 17

Retention:

ANSWER

1. Mechanisms for storing records, providing for timely retrieval, and establishing the length of times that various types of records will be retained by the healthcare organization 2. The ability to keep valuable employees from seeking employment elsewhere.

QUESTION 18

Security:

ANSWER

1.The means to control access and protect information from accidental or intentional disclosure to unauthorized persons and from unauthorized alteration, destruction, or loss. 2. The physical protection of facilities and equipment from theft, damage, or unauthorized access; collectively, the policies, procedures, and safeguards designed to protect the confidentiality of information, maintain the integrity and availability of information systems, and control access to the content of these systems.

QUESTION 19

Security Rule:

ANSWER

The federal regulations created to implement the security requirements of the Health Insurance Portability and Accountability Act of 1996.

QUESTION 20

Substance Abuse:

ANSWER

Defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period.

QUESTION 21

Treatment, Payment, Operations (TPO):

ANSWER

Term used in the HIPAA Privacy Rule pertaining to broad activities under normal treatment, payment, and operations activities, important because of the rule's many exceptions to the release and disclosure of personal health information. Collectively, these three actions are functions of a covered entity which are necessary for the covered entity to successfully conduct business.

QUESTION 22

Use, disclosures, and requests:

ANSWER

Three types of situations in which personal health information is handled: use, which is internal to a covered entity or its business associate; disclosure, which is the dissemination of PHI from a covered entity or its business associate; and requests for PHI made by a covered entity or its business associate.

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