Health Insurance Portability and Accountability Act (HIPAA):
The HIPAA Act of 1996 amended Section XI of the Social Security Act by adding Part F, “Administrative Simplification.” The new regulations issued under Part F establish a national standard for health care related transactions that involve the use of identifiable personal health information. In short, HIPAA is a new medical privacy regulation. Ambulance providers are included under this new law which regulates the privacy of electronic, oral and paper records relating to authorizations, treatment and payment of medical services. This law has a considerable impact on the way in which medical transportation organizations conduct business. ABBA Medical Transportation, LLC is considered a direct provider under this law, and has implemented policy, procedure and required training to comply.
Currently Medicare Compliance for Ambulance Services is not required, however it is strongly encouraged for Billing Agencies (OIG News Release November 30,1998). Medicare Compliance programs are viewed favorably by the Office of Inspector General when they are actually implemented and in place. There are seven essential elements of a Medicare Compliance Program all of which have been addressed by ABBA Medical Transportation, LLC, they are:
- Implementation of written policies and procedures regarding Medicare Practices
- Standards of Conduct
- Designation of a high-level compliance officer and other appropriate officials
- Development of training and education programs
- Creation of hotlines or other measures for receiving complaints and procedures for protecting callers from retaliation
- Enforcement of standards through well-publicized disciplinary directives
- Performance of internal audits and prompt response to detected offenses through corrective action.
Occupational Safety and Health (OSHA):
ABBA Medical Transportation, LLC has internal policies and procedures to address the various OSHA issues including bloodborne pathogens, vaccinations, and personal protective equipment. ABBA Medical Transportation, LLC goes to great efforts to ensure the compliance and safety of the workplace. Employees receive regular training regarding OSHA compliance.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We are required by law to maintain the privacy of Protected Health Information and to provide you with this Notice of our legal duties and privacy practices with respect to Protected Health Information. Protected Health Information is information maintained in any form that identifies any individual and relates to the physical or mental condition of that individual, the provision of health care or the payment for health care for that individual. We may use and disclose your Protected Health Information, without your consent or authorization, for purposes of your treatment, obtaining payment for services rendered to you, to another health care provider for it to obtain payment for services, and for our health care operations, and for the health care operations of another health care provider in certain limited circumstances. For example, we may disclose: a. Information to the hospital where we transport you concerning your medical condition and other information necessary to facilitate the transport; b. Information including medical reasons for your transport to obtain payment from your insurance company or other third party payor; c. Information to our billing company to process payment; d. Information to an auditor about services rendered to you for purposes of determining the quality of care provided. We may use the information we obtain about you to contact you to provide information concerning health-related services that may be of interest to you and to remind you about transports that have been scheduled for you. We also may use or disclose your Protected Health Information without your written consent or authorization, in accordance with and as otherwise restricted or limited by law or regulation, in the following circumstances:
- If we inform you in advance verbally and you have the opportunity to agree, prohibit or restrict verbally, we may make disclosures to your family member, other relative, close personal friend or other person identified by you directly relevant to such person’s involvement with your care or payment for your care, or we may disclose Protected Health Information to notify a family member, personal representative or other person responsible for your care of your location, general condition or health. If you are unavailable or incapacitated, we may exercise our professional judgment and disclose your Protected Health Information to the above named Individual or Individuals, if we determine it to be in your best interest. We may similarly make disclosures to entities involved in disaster relief activities who are involved in notification of family members;
- To your personal representative, i.e. the person who under state law has authority to act on your behalf in making decisions related to health care;
- To the extent required by law;
- For public health and oversight activities;
- For certain law enforcement activities;
- To the extent required by law;
- For judicial and administrative proceedings;
- To the coroner, medical examiner, or funeral director consistent with applicable law or as authorized by law;
- To prevent or lessen a serious and imminent threat to the health or safety of a person or the public;
- For specialized government functions including but not limited to national security;
- To comply with laws relating to workers’ compensation or other similar programs;
- For research in certain limited circumstances;
- If organ donation is elected, to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of cadaveric organs, eyes or tissues.
Any other uses and disclosures of your Protected Health Information will be made only with your written authorization. You may revoke any such authorization that you give, provided your revocation is in writing and we have not already taken any action in reliance on the authorization. If and to the extent New Jersey law may have more stringent requirements as to the use or disclosure of information, it is our policy to abide by the more stringent requirements of State law or regulation. You have the right to request restrictions to certain uses and disclosures of your Protected Health Information that are for purposes of carrying out treatment, payment or health care operations. You also have the right to request restrictions to certain permitted disclosures to family members, other relatives, close personal friends or individuals identified by you. We are not required to agree to such restrictions, but will advise you of our decision. We may nevertheless release restricted information in certain emergency situations.