What does the Health Insurance Portability and Accountability Act of 1996 (HIPAA) criminalize?

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) establishes national standards for the protection of certain health information, but it specifically addresses issues related to the privacy and security of health information. The criminalization aspect of HIPAA focuses on unauthorized access to or disclosure of protected health information (PHI).

The correct answer highlights that submitting claims based on incorrect codes can lead to fraudulent activities that violate HIPAA regulations. This is because when healthcare providers submit claims, they must ensure the accuracy of the coding associated with diagnoses and treatments. If inaccurate codes are submitted—intentionally or with negligence—it might result in false claims to insurers, which is considered a serious violation of HIPAA and can lead to criminal charges.

In contrast, other options present scenarios that may be problematic but do not directly align with the specific criminal implications outlined in HIPAA. Providing inaccurate employee data, unauthorized use of employee information, and overcharging clients, while they may involve ethical concerns and potential violations of other regulations, do not have the same direct criminalization under HIPAA as fraudulent claim submissions do. Hence, the focus on coding inaccuracies aligns most closely with the intent and enforcement mechanisms of HIPAA.