2012 Compliance: Fraud, Waste and Abuse (training - Ubhonline.com
2012 Compliance: Fraud, Waste and Abuse (training - Ubhonline.com
2012 Compliance: Fraud, Waste and Abuse (training - Ubhonline.com
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Pertinent Laws <strong>and</strong> Regulations<br />
• Federal Health Insurance Portability <strong>and</strong> Accountability Act of 1996<br />
(HIPAA)<br />
• HIPAA contains provisions <strong>and</strong> rules related to protecting the privacy <strong>and</strong><br />
security of protected health information (PHI) as well as provisions related to<br />
the prevention of health care fraud <strong>and</strong> abuse.<br />
– HIPAA Privacy<br />
• The Privacy Rule outlines specific protections for the use <strong>and</strong> disclosure of PHI. It<br />
also grants rights specific to members.<br />
– HIPAA Security<br />
• The Security Rule outlines specific protections <strong>and</strong> safeguards for electronic PHI.<br />
• If you be<strong>com</strong>e aware of a potential breach or inappropriate disclosure of<br />
protected information, you must <strong>com</strong>ply with the security breach <strong>and</strong> disclosure<br />
provisions under HIPAA <strong>and</strong>, if applicable, with any business associate<br />
agreement.<br />
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum.<br />
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