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Knowledge of HIPAA
Important for Medical Call Centers
By Luanne Sorenson
January, 2002
Call Centers interested in providing contracted services to health care
providers will have a competitive advantage if they are familiar with HIPAA
requirements.
What is HIPAA? HIPAA stands for "Health Insurance Portability and
Accountability Act." It is a federal law that went into effect on April
14, 2001. Passed in 1996, the law provides new safeguards to protect patient
privacy and confidentiality. In the past, some states have had extensive
privacy guidelines while others have had very little. In enacting HIPAA,
Congress mandated the establishment of comprehensive federal standards for the
"privacy of individually identifiable health information." The
Privacy Rule requires that covered entities "reasonably safeguard"
protected health information (PHI) - including electronic and oral
information.
According to a U.S. Department of Health and Human Services (HHS) fact sheet
dated July 6, 2001, most health plans, health care providers, and health care
clearinghouses must comply with the new requirements by April 14, 2003. The
law gives HHS authority to make appropriate changes to the rule prior to the
compliance date. The Office for Civil Rights (OCR) within HHS has been given
responsibility to ensure that HIPAA regulations are explained and enforced.
The OCR points out that "health care providers have a strong tradition of
safeguarding private health information. But in today's world, the old system
of paper records in locked filing cabinets is not enough. With information
broadly held and transmitted electronically, the rule provides clear standards
for all parties regarding protection of personal health information."
Across the country, health care organizations are working hard to ensure that
they are HIPAA compliant by the 2003 deadline. Under HIPAA, patients have
significant new rights to understand and control how their health information
is used. While final interpretations are still being worked on, all covered
entities are required to adopt written privacy procedures. According to HHS,
the privacy procedures must include who has access to protected information,
how it will be used within the entity, and when the information may be
disclosed. Covered entities also must educate employees on the new procedures
and designate a privacy officer. In addition, covered entities must take steps
to ensure that their business associates protect the privacy of health
information.
How does this impact call centers? Under the law, independent call centers are
considered business associates. As such the Privacy Rule requires providers
and health plans to obtain from their call center, satisfactory assurances,
typically through contract, that the center will use the information only for
clearly defined purposes, safeguard the information from misuse, and help the
covered entity meet HIPAA compliance obligations.
The Privacy Rule also is impacting call center operations. For example, some
call centers provide outbound services reminding patients of upcoming
appointments. Some interpretations of HIPAA maintain, that when such calls are
made, the calling agency cannot leave a message that includes the patient's
name and the nature of the appointment. Instead, verbiage such as, "this
is to remind you that someone in your household has an appointment at X clinic
on X date" must be used. In some cases, this change is causing confusion
among patients who have begun to question why the healthcare organization is
calling with a reminder when not enough useful information is provided.
In February of 2001, Secretary Tommy Thompson requested public comments on the
final rule to help HHS assess the real impact of HIPAA regulations on health
care delivery. During the 30-day comment period over 24,000 comments were
received. According to the OCR, it continues to review this input "to
determine what changes are appropriate to ensure that the rule protects
patient privacy as intended without harming consumers' access to care or the
quality of that care."
Keep yourself informed as new interpretations are released regarding HIPAA.
Initial guidance and other information about the new Privacy Rule are
available on the Web at http://www.hhs.gov/ocr/hipaa/.
Luanne Sorenson is the Director of Customer Relations at Gundersen
Lutheran Medical Center In La Crosse, WI
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