Compliance Program Implementation and Ethical Decision Making
Compliance Program Implementation and Ethical Decision Making
I am assuming the role of an early careerist in risk management and quality improvement at Vila Health’s community-based hospitals. We are a medium-sized system of health care operating facilities in Minnesota and Wisconsin. I am working on a team-based initiative under the supervision of the Chief Compliance Officer. We have found an error has been made by one of the employees. The error was a compliance risk regarding a breach of privacy and a potential HIPAA violation. One of our employees has disclosed without prior written authorization a patient’s protected personal health information.
Privacy Break- HIPAA Violation
The employee in questioned was asked to obtain pre-authorization for an upcoming surgical procedure from a patient. The said employee submitted protected health care information about the patient to their insurance company. This in turned made the Member Services Representative from the insurance company to contact the supervisor at Vila Health. The representative from the insurance company stated that any further discussion of the matter without obtaining the prior written consent from the patient is prohibited. This is a big HIPAA violation that have could have severe impacts for both the employee and Vila Health care facility.
HIPAA stands for The Health Insurance Portability and Accountability Act which as created in 1996 to set the standard for sensitive patient data protection (Chen, J. Q., & Benusa, 2017). This law was created to ensure patients received safety and privacy regarding their health information. At Vila Health the patients PHI or personal health information wasn’t protected, therefore, making the facility noncompliant with HIPAA standards and rules. There are many different regulations, laws, and legislations that protect the rights of patients when it comes to their privacy and medical information.
