HIPAA Training Course – Fraud and Abuse
Our HIPAA Training Course – Fraud and Abuse offers a comprehensive overview of the Health Insurance Portability and Accountability Act (PL 104-191), Private Rule, Security Rule, Enforcement Rule, and Omnibus rule. This training provides critical information about General Administrative Requirements as well as administrative requirements regarding security and privacy regulations. Improve your knowledge in this area with our program!
Included In This Course
Closed Captions
Certificate of Completion
About HIPPA
U.S. Congress passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996, establishing rigorous requirements for maintaining patient data security and safeguarding individually identifiable health information beginning April 14th 2003. With HIPAA, medical providers are obligated to protect a patient’s private records while also allowing individuals access to their own health information. Each healthcare facility must provide sufficient documentation that all individuals with access to patients or their medical records have had adequate HIPAA training.
HIPAA was established to revolutionize the healthcare industry and bring down costs. It sought to streamline tedious administrative tasks and improve the confidentiality of patients’ health information, which continues to be one of its primary objectives today. As such, HIPAA compliance focuses largely on safeguarding patient data for total security and privacy.
About our course
This training provides critical information about General Administrative Requirements as well as administrative requirements regarding security and privacy regulations. Improve your knowledge in this area with our program!
This HIPAA Training Class is designed to educate participants on the essentials of Public Law 104-191, Private Rule, Security Rule, Enforcement Rule and Omnibus rule that are integral components of Health Insurance Portability and Accountability Act. Understanding these regulations will ensure compliance with privacy laws when it comes to protecting personal health information.
What you will learn:
This HIPPA training program presents essential information about the General Administrative Requirements, Administrative Requirements, and the Security and Privacy provisions of regulation text 45 CFR Parts 160, 162, and 164.
- Identify the mandatory laws governing Medicare fraud and abuse.
- Describe your part in preventing Medicare fraud, waste, and abuse.
- Summarize what you can do to detect, correct, and prevent fraud, waste, and abuse.
- Establish an effective compliance plan
Who is this HIPPA training course for?
This course is intended for any student or employer that requires annual required training or any student who wishes to enter a healthcare career while meeting federal guidelines. This includes all individuals and organizations associated with the healthcare industry or in possession of private health information must be mindful of their responsibility.
This includes:
- Medical Professionals
- Employer Group Health Plans
- Health insurance providers
- individuals who work in the Healthcare system
- Employees in administration within the healthcare system
Key Term Knowledge Base: Key Terms Related to HIPAA, Fraud, and Abuse in Healthcare
Understanding key terms related to HIPAA, fraud, and abuse is crucial for healthcare professionals and anyone involved in handling patient data. These terms form the foundation of compliance and legal understanding in the healthcare sector. Knowing them not only helps in adhering to legal requirements but also ensures the protection of patient rights and data security.
| Term | Definition |
|---|---|
| HIPAA | Health Insurance Portability and Accountability Act; U.S. legislation that provides data privacy and security provisions for safeguarding medical information. |
| PHI | Protected Health Information; any information in a medical record that can be used to identify an individual and that was created, used, or disclosed in the course of providing a healthcare service. |
| Privacy Rule | A HIPAA rule that establishes national standards to protect individuals’ medical records and other personal health information. |
| Security Rule | A HIPAA mandate that requires appropriate administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and security of electronic protected health information (ePHI). |
| Covered Entities | Under HIPAA, these include health plans, health care clearinghouses, and health care providers who electronically transmit any health information in connection with transactions for which HHS has adopted standards. |
| Business Associate | A person or entity, other than a member of the workforce of a covered entity, who performs functions or activities on behalf of, or provides certain services to, a covered entity that involve access to protected health information. |
| Compliance | Adherence to laws, regulations, guidelines, and specifications relevant to the business or organization. |
| Data Breach | An incident in which sensitive, protected, or confidential data is copied, transmitted, viewed, stolen, or used by an individual unauthorized to do so. |
| Enforcement Rule | A HIPAA rule that provides standards for the enforcement of HIPAA compliance, including investigations, penalties, and procedures for hearings. |
| Fraud | Wrongful or criminal deception intended to result in financial or personal gain. |
| Abuse | Practices that are inconsistent with accepted sound medical, business, or fiscal practices. |
| OCR | Office for Civil Rights; responsible for enforcing the HIPAA Privacy and Security Rules. |
| NPP | Notice of Privacy Practices; a document that must be provided by covered entities under HIPAA, informing patients about their rights and privacy practices. |
| HITECH Act | Health Information Technology for Economic and Clinical Health Act; promotes the adoption and meaningful use of health information technology, and addresses privacy and security concerns associated with electronic transmission of health information. |
| Breach Notification Rule | A HIPAA rule requiring covered entities to notify affected individuals, HHS, and in some cases, the media of a breach of unsecured PHI. |
| Minimum Necessary Standard | A key provision of the HIPAA Privacy Rule requiring covered entities to make reasonable efforts to use, disclose, and request only the minimum amount of protected health information needed to accomplish the intended purpose. |
| De-identification | The process of removing identifying information from data sets so that the remaining data cannot be linked with specific individuals. |
| Sanction Policy | A policy under HIPAA requiring covered entities to apply appropriate sanctions against workforce members who violate HIPAA Privacy and Security Rules. |
| Risk Analysis | Part of the HIPAA Security Rule, it involves a thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of electronic protected health information held by the covered entity or business associate. |
| TPO | Treatment, Payment, and Health Care Operations; the three primary purposes for which the disclosure of PHI is considered permissible under HIPAA without a patient’s express permission. |
These terms form a basic vocabulary for understanding HIPAA and the complexities surrounding fraud and abuse in the healthcare sector. They are essential for anyone seeking to ensure compliance and protect patient privacy in a healthcare setting.
Frequently Asked Questions About HIPAA Training Course – Fraud and Abuse
What is HIPAA Training?
HIPAA Training is an educational process that ensures that employees of organizations handling protected health information (PHI) understand the requirements and regulations set forth by the Health Insurance Portability and Accountability Act (HIPAA). This training typically covers privacy and security rules, patient rights, and the proper handling and sharing of PHI.
Who is Required to Undergo HIPAA Training?
HIPAA training is required for all employees, volunteers, interns, and contractors of covered entities (such as healthcare providers, health plans, and healthcare clearinghouses) and business associates who have access to PHI. This includes both clinical and non-clinical staff.
How Often Should HIPAA Training be Conducted?
HIPAA regulations do not specify an exact frequency for training. However, it is generally recommended that HIPAA training be conducted annually to ensure continuous compliance and awareness of any changes in HIPAA regulations. Additionally, new employees should receive training as part of their orientation.
What Topics are Typically Covered in HIPAA Training?
HIPAA training usually covers a range of topics, including an overview of HIPAA regulations, patient rights under HIPAA, the use and disclosure of PHI, safeguards for protecting health information, breach notification rules, and how to report potential violations.
What Happens if an Organization Fails to Provide HIPAA Training?
Failure to provide HIPAA training can result in significant consequences. Violations of HIPAA rules can lead to fines, penalties, and legal action. Additionally, lack of training can increase the risk of breaches of patient information and damage the organization’s reputation.
Proudly DisplayYour Achievement
Upon completion of your training, you’ll receive a personalized certificate of completion to help validate to others your new skills.
HIPAA, Fraud, and Abuse Course Content
Module 1: HIPAA and Privacy
- HIPAA and Privacy
- Security, Safeguards, and Controls
- Examples and Cases
Module 2: Fraud, Waste, and Abuse
- Fraud, Waste, and Abuse
- Case Examples and Law
Module 3: Compliance and Prevention
- Compliance and Prevention
| 5 star | 82% | |
| 4 star | 17% | |
| 3 star | 1% | |
| 2 star | 0% | |
| 1 star | 0% |
Your Training Instructor
Wendy Wendy is a certified coder with accreditation through AAPC. She has worded in healthcare for twenty plus years and has worked in multiple specialties such as Radiology, family practice, chiropractic, OB/ Gyn, Orthopedics and more. She has been an active member of her local AAPC chapter and served as Vice President and Member Education roles. Wendy not only educates; she continues to in the field daily as a consultant to help providers find cash flow problems and get them resolved quickly.
Personally, she lives in Naples, Maine during the summer months and Florida in the winter, giving her the best of both worlds. She has two grown daughters and a sweet granddaughter. In her free time she enjoys camping, travel and a giant Patriots fan .
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Smooth delivery and easy access to LMS. Good to see that the LMS offers progress tracking. Would be great if badges were offered on completion of courses to share via Credly to future employers.