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The Health Insurance Portability and Accountability act (HIPAA)

The Health Insurance Portability and Accountability act (HIPAA)

The Health Insurance Portability and Accountability act (HIPAA)

QUESTION
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
Walden University
Nurs 6051: Transforming Nursing and Healthcare through Technology
August 9, 2019

 The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a dual-party regulation “signed into law on April 16, 2015” (Centers for Medicare and Medicaid Services, 2019, June 14).
 Initiated due to fears of poor-quality care and from the “failure of the traditional fee-for-service model” (Jones et al., 2019).
 (MACRA) abolished the inconsistent “Sustainable Growth Rate used in Medicare Billing and initiated the transformation of Medicare billing and reimbursement to a value-based system” (American Association of Nurse Practitioners, 2012-2019).
 For regulation purposes, my healthcare organization will create policies and procedures based on the option that MACRA provides participating clinicians with selections “based on your practice size, specialty, location, or patient population, and regardless of the model you select,” allowing for adequate tracking and reporting to The Centers for Medicare & Medicaid Services (CMS) (HealthIT.gov, 2019, February 12).
 According to HealthIT.gov, additional clinician payment choices include
• Advanced Alternative Payment Models (APMs)- regulate Medicare Part B reimbursement
• Merit-based Incentive Payment System (MIPS)-regulate payment based on performance
(2019, June 4)
References
American Association of Nurse Practitioners. (2012-2019). Advanced Payment Models: The transition from fee-for-service to quality-based reimbursement. Retrieved August 8, 2019, from https://www.aanp.org/practice/practice-management/quality-improvement/macra-mips
Centers for Medicare & Medicaid Services. (2019, June 14). MACRA. Retrieved August 9, 2019, from https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/value-based-programs/macra-mips-and-apms/macra-mips-and-apms.html
HealthIT.gov. (2019, June 4). Health IT Legislation. Retrieved August 10, 2019, from https://www.healthit.gov/topic/laws-regulation-and-policy/health-it-legislation
HealthIT.gov. (2019, February 12). Meaningful use and MACRA. Retrieved August 10, 2019, from https://www.healthit.gov/topic/meaningful-use-and-macra/meaningful-use-and-macra
Jones, R. T., Helm, B., Parris, D., Grubbs, S. S., Choy, H., & Kapetanovic, K. (2019). The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Made Simple for Medical and Radiation Oncologists: A Narrative Review. JAMA Oncology, 5(5), 723–727. https://doi-org.ezp.waldenulibrary.org/10.1001/jamaoncol.2018.5631
Northern New England Clinical Oncology Society (Photographer). (2017). Are you Ready for MACRA [digital image]. Retrieved August 9, 2019, from http://www.nnecos.org/MACRA
SSI (Photographer). (n.d.). MACRA, APM, MIPS [digital image]. Retrieved August 9, 2019, from http://thessigroup.com/macra-challenges-for-hospitals-in-2018/
The Health Insurance Portability and Accountability act (HIPAA)

ANSWER
The Health Insurance Portability and Accountability act (HIPAA)
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• HIPAA, often referred to as the health insurance portability and accountability act of 1996, is a policy which advocates for the creation of national standards to protect vital patient data from leaking without the patients consent.

• The HIPAA was established to fill in the void that existed in the healthcare industry regarding the issue of protecting health information and records. The secretary of U.S Department of Health and Human Services (HHS) was tasked in developing regulations to ensure that delicate health information was properly handled (Cohen et al., 2018).
• The major shift from paper-based records to electronic records, especially in the healthcare industry, was what facilitated the rapid need to implement HIPAA.
• The immediate implementation of the policy has facilitated the management of modern EHR systems, hence minimizing the access to vital patient records, to authorized medical personnel only.

• Another notable impact of the policy on system implementation is that it streamlines clinical and administrative functions, therefore, ensuring that they are in congruence with the policy provisions (Bergren et al., 2020).
• The implementation of the HIPAA act is beneficial to patients in that they have unlimited access to their care plans, hence, facilitating increased transparency and, therefore, subsequently improving the overall quality of patient care.
• An example of an organizational policy that is necessary to ensure the implementation of HIPAA act, is the establishment of mandatory training for all clinicians who have access to patient electronic health records (Wilburn, 2018).
• Another necessary organizational policy is one which stipulates on who has authorized access to patient data to ensure easier follow up in the event of a data breach and the loss of essential patient information.

References
Bergren, M. D., Maughan, E. D., Vandenbrink, R., Foster, B., & Carveth, L. (2020). Nursing Informatics and School Nursing: Specialists Wanted. NASN School Nurse, 1942602X20928347.
Cohen, I. G., & Mello, M. M. (2018). HIPAA and protecting health information in the 21st century. Jama, 320(3), 231-232.
Wilburn, A. (2018). Nursing informatics: Ethical considerations for adopting electronic records. NASN School Nurse, 33(3), 150-153.

The Health Insurance Portability and Accountability act (HIPAA)

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