Unit 9 Assignment: Complying with Law and Regulations in the Ethical Management of Health Information

Unit outcomes addressed in this Assignment:

• Explain corporate compliance programs.
• Differentiate between the concepts of fraud and abuse.
• Identify statutes, rules, and regulations that relate to compliance issues. 
• Evaluate policies and strategies to achieve data integrity.
• Recommend compliance of health record content across the health system.

Course outcome assessed in this Assignment:

HI135-4: Describe the regulations and requirements surrounding the release of information.

HI135-5: Analyze state and federal regulations which govern the release of protected health information. 

Instructions

As a compliance officer, you are required to manage and monitor security and integrity of medical information. You will demonstrate competence in information governance by completing all three of the scenarios in this assignment.

Scenario 1:
A patient has requested an amendment to their medical record. You recognize there is no policy in place to help facilitate requests such as this. You will develop an institutional policy and make recommendations for ensuring data integrity and quality of health information.

In your policy, include the following:
Interpret the guidelines from HIPAA legislation regarding patient amendments.
Recommend policy language to include timelines in response to a patient amendment request.
Ensure procedural compliance with HIPAA relating to the patient amendment process.

Scenario 2:
You have been tasked with recommending strategies to maintain compliance of health record content, documentation, and utilization across the health system. In order to accomplish this, you must do the following:

Interpret and evaluate the Joint Commission Standards pertaining to clinical documentation (acute care, behavioral health, and home health care). http://www.jointcommission.org/
Evaluate importance of compliance with documentation standards across the health system relating to patient care, reimbursement, quality improvement, and research.

Assignment Requirements:
Based on your interpretation and evaluation of the Joint Commission standards pertaining to clinical documentation, in a Word document, recommend 1 initiative in each of the following areas: patient care, reimbursement, quality improvement, and research to meet the compliance standards across the health system.

Tips for Success:
Visit http://www.jointcommission.org/, particularly the Information Management and Record of Care chapters, to gather necessary information as it relates to clinical documentation standards.
Evaluate the purpose of clinical documentation and how it is utilized in achieving quality patient care, ethical reimbursement, and research.

Scenario 3
A 16-year-old teen mother filed a complaint with a facility that refused to release her child’s records to her. The Release of Information (ROI) clerk indicated to the mother that by law, she is not allowed to have copies.
Compose a professional letter to the mother including whether the ROI clerk’s response was accurate based on federal and state laws by providing the summary of the law and informing her how this situation will be resolved.

Assignment Requirements:
Begin the letter by introducing yourself and your position within the facility.
Summarize the scenario provided
Provide an explanation to whether the ROI clerk’s response was accurate or not based on the research conducted of your state laws and HIPAA.
Conclude the letter by providing your contact information if any additional questions arise.

Tips for Success:
Visit your state’s ROI laws
Review the federal ROI laws under HIPAA