Healthcare Compliance – Part 1

History of Healthcare Compliance

In part one of our healthcare compliance series we will discuss the transition that the healthcare industry has been in for the last few decades. The U.S. Department of Health and Human Services (HHS) has played an instrumental role instituting major changes in the medical field in last 20 or so years. These changes have shifted how medical practices run today. The Health Insurance Portability and Accountability Act (HIPAA) was passed in 1996 and has brought major modifications to the industry. Although HIPAA was implemented in the mid 90’s it has continued to be updated and revised in an effort to improve healthcare in the United States.

Early stages of HIPAA

HIPAA was enacted for 2 primary purposes:

  1. One was to ensure the protection of an individual’s identifiable healthcare records. As more technology has entered the scene, there has been a greater effort to focus on how to best protect individual records. A move has been made from only managing paper records to managing privacy and safety of paper and electronic records.
  2. The second purpose was to serve patients by providing higher quality healthcare in order to promote public health and well-being. To meet these objectives HHS delegated the control and enforcement to the Office for Civil Rights (OCR) for HIPAA covered entities.

Present State of HIPAA:

  1. The Health Information Technology for Economic and Clinical Act (HITECH), which was passed in 2009 as part of the American Investment and Recovery and Reinvestment Act and implemented to encourage providers to adopt meaningful use in health information technology.
  2. In 2013 the “Omnibus rule” was added to give patients more control over personal healthcare information. This new legislation has cause health providers to change the way they run their practice. Specific legal documents such as authorization forms and notice of privacy are required documents to meet meaningful use criteria, which has increased the importance of these requirements.

In order to understand how HIPAA affects decisions today we needed to go back and explain the history and what has progressed up to the point. Regulations and rules that were put in place in the 90’s are impacting decisions today. If you want more information on the history of healthcare compliance please click here.