| Benefits |
Assessing the exact benefits of
such a tremendous change is difficult, especially since a mandate of
this magnitude has never been done in the history of
healthcare. However, the aggregate benefits of
HIPAA can be visualized in the expected outcomes of standardization and
simplification.
Despite initial implementation costs accrued the
first year, the estimated combined savings for healthcare providers is
16.7 billion dollars between the years 2002 to 2011.
Office efficiency will improve with standardization
of claim submissions and the requirement of standardized formats for
patient information transmittal.
Converting to an electronic format for claims
submission speeds information availability, and accrues long term
savings compared to paper submission.
Electronic data transfer will also significantly
improve customer service with reduced waiting for claim status,
eligibility, and referral information. |
| Penalties |
Noncompliance with any provision
is a $100 fine per occurrence, with a maximum accrued fine amount of
$25,000 per calendar year for an identical requirement or
prohibition. Each type of violation has its
own $25,000 maximum. Violate too many requirements, and you can be
looking at annual fines in the hundreds of thousands to
over a million dollars.
Individuals violating mandates may bear the burden
of fines up to $250,000 and imprisonment up to 10 years, if the offense
is committed with intent to sell, transfer, or use
individually identifiable information for commercial
advantage, personal gain, or malicious harm. HIPAA disclosure
mandates do not include the right of citizens to sue
providers. |
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