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Chapter 8

privacy, security, and fraud

TermDefinition
Privacy Freedom from unauthorized intrusion
State Preemption If a state's privacy laws are stricter than HIPPA privacy standards, the state laws take precedence.
Protected Health information (PHI) Information that contains one or more patient identifiers
De-identify To remove from health care transactions all information that identifies patients.
Permission A reason under HIPPA for disclosing patient information
Covered Entities Health care providers and clearinghouses that transmit HIPPA transactions electronically, and must comply with HIPPA standards and rules
Limited data set Protected health information from which certain patient identifiers have been removed.
Electronic medical record (EMR) contains all patient medical records for one practice
Electronic Health record (EHR) comprehensive record than the EMR, focusing on the total health of the patient and traveling with the patient.
Breach any unauthorized acquisition, access, use , or disclosure of personal health information which compromises the security or privacy of such information
Firewalls Hardware, software, or both designed to prevent unauthorized persons from accessing electronic information.
Encryption The scrambling or encoding of information before sending it electronically.
Health information technology for economic and clinical health act (HITECH) A section of the american recovery and reinvestment act (ARRA) that strengthened certain HIPPA privacy and security provisions.
American recovery and reinvestment act (ARRA) A 2009 act that made substantive change to HIPPA'S privacy and security regulations.
Federal false claims act a law that allows for individuals to bring civil actions on behalf of the U.S government, under a provision of the law called "qui tam" -"to bring an action for the king and for oneself"
Federal Anti-Kickback Law Prohibits knowingly and willfully receiving or paying anything of value to influence the referral of federal health care program business.
Stark Law prohibits physicians or their family members who own health care facilities from referring patients to those entities if the federal government, under medicare or medicaid, will pay for treatment.
Criminal Health care fraud statute a section of the united states code that prohibits fraud against any health care benefit program.
Created by: Chani1711