Discussion: Medicare, Medicaid, and HIPAA

Medicare, Medicaid, and the Health Insurance Portability and Accountability Act (HIPAA) have had significant impacts on the healthcare industry. Consider the most significant benefits that Medicare, Medicaid, and (HIPAA) have brought to the healthcare industry and the most significant challenges they have presented to decision making in the industry.

Research Medicare, Medicaid and HIPAA. Identify two benefits as well as two challenges.

Here is an example to get you started below:

(a) Offense

A person who knowingly and in violation of this part—

(1) uses or causes to be used a unique health identifier;

(2) obtains individually identifiable health information relating to an individual; or

(3) discloses individually identifiable health information to another person,
shall be punished as provided in subsection (b) of this section. For purposes of the previous sentence, a person (including an employee or other individual) shall be considered to have obtained or disclosed individually identifiable health information in violation of this part if the information is maintained by a covered entity (as defined in the HIPAA privacy regulation described in section 1320d–9 (b)(3) of this title) and the individual obtained or disclosed such information without authorization.

(b) Penalties

A person described in subsection (a) of this section shall—

(1) be fined not more than $50,000, imprisoned not more than 1 year, or both;

(2) if the offense is committed under false pretenses, be fined not more than $100,000, imprisoned not more than 5 years, or both; and

(3) if the offense is committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm, be fined not more than $250,000, imprisoned not more than 10 years, or both.

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