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Who should attend HIPAA And Health Care Coverage Issues
This seminar is designed for human resource and payroll professionals, benefits managers, operations managers, business owners and managers, accountants, controllers and attorneys.
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HIPAA And Health Care Coverage Issues  

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This seminar is designed for human resource and payroll professionals, benefits managers, operations managers, business owners and managers, accountants, controllers and attorneys.

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Seminar Summary:

This program is intended to provide attendees with advanced information relevant to HIPAA, compliance with HIPAA regulations and the everyday implications of HIPAA. (see full course description)

 
 

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Training Course Syllabus:


This seminar is designed for human resource and payroll professionals, benefits managers, operations managers, business owners and managers, accountants, controllers and attorneys.

This program is intended to provide attendees with advanced information relevant to HIPAA, compliance with HIPAA regulations and the everyday implications of HIPAA. It will provide practical information and procedures for ensuring that entities meet the requirements imposed by HIPAA.

Topics to be discussed include:

• Disclosures Under HIPAA

• Current Status Of HIPAA Regulations

• Individual Rights

• State Law Preemption

• Privacy Notices, Consent Forms And Authorizations

• Business Associates

• Retention Of Medical Records Under HIPAA

• Group Health Plan And HIPAA Coverage Issues

• Electronic Transmission And Security Standards

• Non-Discrimination Rules For Health Status

• What Entities Need To Have Done By Now

• HIPAA’s Relationship To COBRA

8:30 a.m. - 9:15 a.m.

I. Overview Of HIPAA Requirements

A. Goal Of HIPAA

B. Compliance Deadline

C. Guidelines On Privacy Statements

D. Covered Entities

9:15 a.m. - 9:30 a.m.

II. Who Must Comply?

A. Definition

B. Covered Entities

C. Physician And Physician Practices

9:30 a.m. - 10:00 a.m.

III. Disclosures Under HIPAA

A. To Individuals

B. To Relatives

C. Prescriptions

D. Use Of PHI For Appointments And Scheduling

E. Oral Communications

F. Disclosures Required By Law

G. Parental Access To Children’s Records

H. Disclosure For Payment Purposes

I. Disclosure For Treatment, Payment Or Healthcare Operations By A Different Covered Entity

J. Physician Treating Patients For The First Time In A Hospital

10:00 a.m. - 10:15 a.m.

IV. The Current Status Of HIPAA Regulations

A. The August 14, 2002 Final Regulations

B. Future Rules And Guidance

C. The December 3, 2002 Standards

D. Gray Areas

10:15 a.m. - 10:30 a.m.

V. Individual Rights

A. Individual Rights

B. Denial Of Access

C. Disclosure Exceptions

D. Steps To Lessen The Burden Of Implementing The Privacy Rule

E. Accounting Of Disclosures

10:30 a.m. - 10:40 a.m.

Break

10:40 a.m. - 11:00 a.m.

VI. State Law Preemption

11:00 a.m. - 11:15 a.m.

VII. Nuts And Bolts: Privacy Notices, Consent Forms

And Authorizations

A. Notice Of Privacy Rights

B. Authorizations

11:15 a.m. - 11:30 a.m.

VIII. Business Associates

A. Business Associates

B. Business Associate Agreements

11:30 a.m. - 11:45 a.m.

IX. Retention Of Medical Records Under HIPAA

A. Medical Records: Health Facilities Generally

B. American Medical Association

C. Medicare Hospital Manual

D. JCAHO

E. Mental Health Services

F. Home Health Agency

G. Hospice

H. Long Term Care Facility

I. HIPAA: Specific Provisions

11:45 a.m. - 12:00 p.m.

X. Questions

12:00 p.m. - 1:00 p.m.

Lunch (On Your Own)

1:00 p.m. - 1:30 p.m.

XI. Group Health Plan And HIPAA Coverage Issues

A. Goal

B. Portability Of Health Coverage

C. Creditable Coverage

D. Preexisiting Conditions

E. Miscellaneous Provisions

F. HIPAA Nondiscrimination Requirements

G. Effective Dates

H. Plan Amendments

1:30 p.m. - 2:15 p.m.

XII. Electronic Transmission And Security Standards

A. Background

B. Rules

C. Specific Requirements

2:15 p.m. - 3:15 p.m.

XIII. Nondiscrimination Rules For Health Status

A. Physical Examination

B. Health History

C. Sports Participation

D. Preexisting Conditions, Which Existed Prior To Enrolling In The Plan

E. 12 Month Preexisting Condition

F. Excluding Coverage For Benefits For A Health Condition

G. Lifetime Limits On All Benefits Covered Under The Plan

H. Denial Of Benefits For An Injury Based On The Source Of That Injury

I. High Claims History

J. Higher Premiums For Group Health Plan That Cover Individuals, Some Of Whom Have Adverse Health Factors

K. Health Insurance Charges A Different Premium For Each Individual Within A Group Of Similarly Situated Individuals Based On Each Individual’s Health Status

L. Defining Groups Of Similarly Situated Individuals

M. Wellness Programs

N. Voluntary Testing To Group Health Plan Enrollees To Help Detect Early Health Problems

O. Premium Differential Between Smokers and Nonsmokers

P. Non-Confinement Provision

Q. 90-Day Waiting Period For Enrollment

R. Plan Provision Favoring Disabled Dependents

3:15 p.m. - 3:25 p.m.

Break

3:25 p.m. - 3:45 p.m.

XIV. What Entities Need To Have Done By Now

A. Designate A Privacy Official And Institute A Compliance Program

B. Designate A Contact Person

C. Train All Personnel On Policies/Procedures

D. Install Technology

E. Establish Complaint/Disciplinary Procedures

F. Mitigation Procedures

G. Begin Reviewing All Existing Contracts For

Compliance

H. Review Insurance Coverage

I. Review Consent And Authorization Forms

J. Administrative Requirements

3:45 p.m. - 4:15 p.m.

XV. HIPAA’S Relationship To COBRA

A. Background

B. Who Is Entitled To Benefits?

C. Notice And Election Procedures

D. Covered Benefits

E. Duration Of Coverage

F. Paying For COBRA Coverage

G. Claims Procedures

H. Coordination With Other Benefits

I. Conclusion

4:15 p.m. - 4:30 p.m.

XVI. Questions

Seminar Summary:

This program is intended to provide attendees with advanced information relevant to HIPAA, compliance with HIPAA regulations and the everyday implications of HIPAA. (see full course description)

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