HIPAA Compliance for Medical Practices
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HIPAA Compliance for Medical Practices
HIPAA Compliance and HIPAA Risk management Articles, Tips and Updates for Medical Practices and Physicians
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HIPAA Media Access: Film Crews in Healthcare Facilities

HIPAA Media Access: Film Crews in Healthcare Facilities | HIPAA Compliance for Medical Practices | Scoop.it

The Department of Health and Human Services (HHS)’ Office for Civil Rights (OCR) has issued several Notices of Enforcement Discretion during the COVID-19 pandemic.

 

As such, OCR will not be imposing sanctions on covered entities for good-faith violations of certain rules. OCR will continue to impose sanctions for other violations.

 

One violation for which OCR will continue to apply sanctions is the violation of the HIPAA Media Access rule.

 

Under the HIPAA Privacy Rule, media and film crews may not access healthcare facilities where patient PHI is accessible, unless certain safeguards are in place.

HIPAA Media Access: When Can Film and Media Crews Access Healthcare Facilities?

Under the HIPAA Media Access rule, healthcare providers may permit media and film crews to access their facilities where PHI is accessible – but only if the facility first obtains written authorization from patients.

 

HIPAA does not permit covered health care providers to give the media, including film crews, access to any areas of their facilities where patients’ PHI will be accessible in any form (e.g., written, electronic, oral, or other visual or audio form), without

first obtaining a written HIPAA authorization from each patient whose PHI would be accessible to the media.

 

In addition, when film crews (after obtaining written patient authorization) access areas in which patients are present, the healthcare facility must put reasonable and appropriate safeguards in place to protect against unauthorized disclosure of PHI.

 

In the latest guidance on the topic, OCR explains that reasonable and appropriate safeguards include, among others, placing privacy screens on computer monitors to prevent electronic PHI (ePHI) from being viewed.

 

Safeguards also include using opaque barriers to ensure that patients who have not signed written authorizations are not filmed.

 

OCR has taken the matter of unauthorized filming of patients very seriously in recent years. In 2018, OCR initiated enforcement actions against Boston Medical Center, Brigham and Women’s Hospital, and Massachusetts General Hospital, after it was discovered they had given film crews access to their facilities without first obtaining authorization from patients.

 

They were fined a total of $999,000 for the HIPAA violations.

 

“The last thing hospital patients need to worry about during the COVID-19 crisis is a film crew walking around their bed shooting ‘B-roll,’” said Roger Severino, OCR Director.  “Hospitals and health care providers must get authorization from patients before giving the media access to their medical information; obscuring faces after the fact just doesn’t cut it.”

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What Is HIPAA And How To Comply With The HIPAA Security Rule

What Is HIPAA And How To Comply With The HIPAA Security Rule | HIPAA Compliance for Medical Practices | Scoop.it

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a US legalization that requires healthcare professionals and institutions to secure health information from deletions and data breaches.

 

This law has become relevant in today’s dental practice due to increased data breaches caused by ransomware and cyber attacks.

 

The law’s requirements on HIPAA can be demanding and challenging to understand, but we’ve made it easy for you below. There are three areas you need to be compliant with HIPAA.

 

• PHYSICAL – these are measures that prevent loss of devices and physical theft on medical information e.g. keeping workstations away from the public eye and limiting physical access to computers.

 

• ADMINISTRATIVE – measures that make sure patient data is accessible to authorized personnel and is correct. For example, identifying which employees have access to medical information.

 

• TECHNICAL – these are measures that protect your devices and networks from unauthorized access and data breaches e.g. encrypting files that you upload to a cloud or send via email.

 

The components above represent every aspect of your dental practice from your record-keeping and policies to your building safety and technology.

 

HIPAA also requires all your staff members to work together to protect patient data and be on the same page.

 

HIPAA COMPLIANCE

 

The administrative, physical, and technical requirements for HIPAA security may be a lot of information for you to take in. Additionally, it can be overwhelming for you to handle its compliance in your dental practice solely.

 

To make it easier, HIPAA compliance is an organization-wide issue. This means all your employees will have to understand and know their role in securing dental information.

 

Alternatively, you can outsource your HIPAA compliance to consultants, web services, and IT contractors.

 

This ensures your dental practice meets the required standards and makes your life easier. However, outsourcing your HIPAA responsibilities doesn’t mean you ignore your legal obligations.

 

Your company should always stay on top of any HIPAA changes in recommendations and adopt advanced practices to improve medical information security.

 

Ultimately, ensure your dental practice upgrades all its old technology for better and efficient systems that contribute to medical information security.

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Do you Know the Recent Changes in HIPAA?

Do you Know the Recent Changes in HIPAA? | HIPAA Compliance for Medical Practices | Scoop.it

The recent HIPAA changes extend the scope and extent of the Health Insurance Portability and Accountability Act and the Health Information Technology for Economic and Clinical Health Act (HITECH). Many of the new HIPAA rules for 2013 account for changes in working practices and advances in technology since the original legislation was enacted in 1996.

 

Within the recent HIPAA changes, the Security Rule introduces three “safeguards” to protect the integrity of electronically stored and transmitted Protected Health Information (ePHI). These three safeguards are:

  • Administrative Safeguards – covering factors such as the assigning of an information security officer, business associate agreements, risk assessments, training and the development of appropriate policies.
  • Physical Safeguards – covering equipment specifications, controls for devices and media used to store ePHI (including flash drives), and physical access to servers and other hardware on which ePHI is stored.
  • Technical Safeguards – covering issues such as who can remotely access a database on which ePHI is stored, audit controls, transmission security and how access to and the communication of ePHI is monitored.

 

These safeguards are of particular significance to covered entities that have implemented BYOD policies, have storage issues with the requirement to save six years of ePHI, or who provide unfiltered Internet access.

 

In order to comply with the recent HIPAA changes, covered entities must implement mechanisms that ensure the end-to-end security of patient data and have processes in place to prevent a data breach.

A Revised Definition of Data Breaches

Also included among the new HIPAA rules for 2013 was a revised definition of what constitutes a data breach. A data breach will now be presumed to have occurred when there has been the unauthorized exposure of ePHI unless the healthcare organization, health insurance provider, employer or vendor/business associate can demonstrate that there is a low probability that patient data was compromised.

 

One of the best ways of demonstrating a low probability that patient data was compromised is through encryption. The encryption of data is an “addressable” requirement of the HIPAA Security Rule, meaning that it does not have to be implemented if a covered entity can show it is not necessary, or if a suitable alternative to the requirement is instigated.

 

However, by encrypting all personal identifiers and health-related data any unauthorized exposure of ePHI will be undecipherable, unreadable and unusable – resulting in a low probability that patient data was compromised.

 

The encryption of data in databases, on servers, on flash drives or as it moves through a network can also help covered entities avoid OCR fines for failing to comply with the recent HIPAA changes.

The Implementation of Encryption in Healthcare

The implementation of encryption in healthcare is not difficult to achieve. Many covered entities are switching their primary method of communication to secure messaging. Secure messaging compliments the BYOD policies that many covered entities have introduced, and eliminates the risk of a data breach – not only through encrypted communications, but also by encapsulating communications within a private network that provides full message accountability.

Secure messaging not only helps to comply with the recent HIPAA changes, but the mechanisms intended to provide an audit trail for ePHI also accelerate the communications cycle in many areas of healthcare. Secure messaging has also been proven to foster collaboration and enhance productivity – improving the speed of diagnoses, the accuracy with which prescriptions are filled and reducing the volume of adverse events.

Whereas secure messaging resolves the issue of encryption in healthcare since the new HIPAA rules for 2013 were introduced, secure email archiving is an appropriate solution for communications sent and received prior to the recent HIPAA changes. Covered entities have to keep healthcare data for a minimum of six years, and secure email archiving not only stores them in an encrypted format, but also indexes emails and their content for easy retrieval in the event of discovery or compliance audit.

The Cyber Threat to the Integrity of ePHI

The single largest cause of data breaches has been, to date, human error. Employees mislaying USB Flash drives, unencrypted laptops stolen from the back seat of a car and the improper disposal of ePHI have been responsible for many millions of records being exposed. Aware that employees are the weakest link in a covered entity´s cybersecurity defenses, criminals are targeting them through phishing campaigns and malware downloads.

One of the strongest defenses against cyber threats is the implementation of a web filter. With a suitably robust web filter, covered entities can prevent employees being directed to bogus websites that request their login credentials and sites that harbor malware. Web filtering solutions can also be configured to prevent the download of certain file types, making it harder for a cybercriminal to break through a covered entity´s cybersecurity defenses.

Web filters also have a productivity-enhancing benefit. With the ability to restrict access to any website, administrators can prevent employees from using social media channels, visiting shopping portals or watching live-streamed videos during working hours. Restricting access to certain areas of the Internet can also eliminate potential HR issues and create a more user-friendly working environment.

 
 
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HIPAA Training is not HIPAA Compliance

HIPAA Training is not HIPAA Compliance | HIPAA Compliance for Medical Practices | Scoop.it

We hear from so many doctors’ and dentists’ offices that they are “HIPAA-compliant” because they have completed the required annual HIPAA training for their staff.   FALSE! HIPAA Training is not HIPAA Compliance. HIPAA Training is only one of the components of HIPAA Compliance – thinking otherwise could lead to a false sense of security.

 

HIPAA law consists of various requirements in the areas of security and privacy, use and disclosure of PHI (protected health information) and in breach notification rules.

Minimum steps needed for HIPAA Compliance:

At the very minimum, a doctor’s or dentist’s office must do the following for HIPAA Compliance:

  1. Exercise privacy in the office everywhere.   Be careful about accidental disclosure of patient information.
  2. Display the Notice of Privacy Practices prominently in your office lobby and on your website.
  3. Exercise caution in the use and disclosure of PHI (Protected Health Information).     Patients have the right to review and obtain their PHI.   The onus falls on the medical practice to secure and protect PHI from unauthorized disclosure of any kind.
  4. Conduct the mandatory annual risk assessment, or hire an expert to conduct it for you.   The assessor must take into consideration all the security and privacy-related criteria while conducting the assessment, including all your administrative, physical and technical safeguards.   A detailed list of recommendations and action items should follow as a result of the risk assessment.
  5. Prepare and follow security and privacy policies and procedures.   Your risk assessment should highlight the minimum required policies and procedures that you would need to prepare or obtain.   Physicians and staff members should be familiar with and should follow these policies and procedures on a daily basis.
  6. Provide annual HIPAA Training to your staff and physicians.

Breach notification:

Breaches have unfortunately become only too common these days in an environment where medical records are extremely valuable in the black market.   HIPAA law also specifies strict breach notification requirements in the event of a breach.   The Office of Civil Rights (OCR) of the Department of Health and Human Services (HHS) requires the practice to inform all individuals whose data might have been lost or stolen.  

 

A breach of more than 500 records is considered a reportable breach, that is, the practice must notify HHS.   This could result in an audit of the practice by federal agencies, and the first thing they are going to ask you for is a copy of your last annual risk assessment.

Small practices may be targets of breaches too:

Many small practices think that they are too small to be targeted.   False again!   If you look at the HHS "Wall of Shame" which lists reported breaches of more than 500 patient records, you will see several small practices listed there who have undergone breaches.   The reality is that smaller practices are likely to be even more affected by a breach considering the high expenses and workload that follow.    The Ponemon Institute has calculated the average healthcare data breach cost to be $380 per record - for 500 records, that comes to approximately $190,000, which can be highly damaging for a small healthcare practice.

 

We often hear from dentists that they do not believe they need to comply.   Also False!  In fact, just recently, on January 2018, Steven Yang, DDS of California and Zachary Adkins, DDS of New Mexico had breaches of 3000+ patient records each due to the theft of a laptop and other portable electronic devices respectively.   

 

Robert Smith, DMD of Tennessee reported 1500 records breached after a hack.  Several other providers such as physicians, hospitals, pharmacies, health plans, and business associates have experienced breaches in the recent past.   It can and will happen to anyone regardless of size - please do not think that it won't happen to you!

Culture of Security and Privacy:

HIPAA Training is not HIPAA Compliance.   Practices should take these requirements seriously as they are here to protect patients and medical professionals.   Protect yourself and your patients by incorporating a culture of security and privacy compliance in your medical practice.

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The HIPAA Privacy Rule and Facility Directories

The HIPAA Privacy Rule and Facility Directories | HIPAA Compliance for Medical Practices | Scoop.it

The HIPAA Privacy Rule generally permits hospitals and other healthcare facilities to maintain facility directories that provide certain basic information about patients within the facilities.

 

The HIPAA Privacy Rule and facility directories is discussed below.

What are Facility Directories?

Under the HIPAA Privacy Rule, covered entities, including hospitals and other covered health care providers, may use the following protected health information (PHI) in facility directories:

  • A patient’s name;
  • A patient’s location in the covered entity’s facility;
  • A patient’s condition described in general terms, that does not communicate specific information about the individual; and
  • The individual’s religious affiliation.

Covered entities may disclose the appropriate directory information listed above – except for religious affiliation – to anyone who specifically asks for a patient by name. Religious affiliation may be disclosed to members of the clergy. 

 

 For example, the HIPAA Privacy Rule and facility directories regulations allows a hospital to disclose the names of Methodist patients to a Methodist minister unless a patient has restricted such disclosure. 

What Rights Does the HIPAA Privacy Rule and Facility Directories Regulations Allow Patients?

The patient must be informed about the information to be included in the directory, and to whom the information may be released. In addition, patients must have the opportunity to restrict the information or to whom it is disclosed. Patients also have the right to opt out of being included in the directory.

 

The patient may be informed about the information to be included, to whom it may be released, and the right to restrict and to opt out. A patient may make his or her preferences about being included in the directory known, either orally or in writing.  

Can Directory Information be Made Available During an Emergency?

Even when, due to emergency treatment circumstances or incapacity, the patient has not been provided an opportunity to express his or her preference about how, or if, the information may be disclosed, directory information about the patient may still be made available if doing so is in the individual’s best interest.

 

Directory information about a patient may not be made available during an emergency, if making such information available is inconsistent with any known preference expressed by the patient.

 

In emergency scenarios, the covered entity, as soon as practicable, must inform the patient about the directory, and provide the patient an opportunity to express his or her preferences about how, or if, the directory information may be disclosed. 

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The Intersection Of HIPAA & The Hitech Act

The Intersection Of HIPAA & The Hitech Act | HIPAA Compliance for Medical Practices | Scoop.it

Since it passed in 2009, the HITECH (Health Information Technology for Economic and Clinical Health) Act was meant to enforce certain rules within the HIPAA Omnibus Rule. It’s important that those in healthcare IT understand the relationship between the two.

 

THE IMPACT OF THE HITECH ACT

 

The HITECH Act’s stated aim was to improve the on-boarding and meaningful use of HIT. In doing so, the HITECH Act also affected the standards of Health and Human Services (HHS) used to evaluate hospitals and expanded the scope of jurisdiction.

 

It also bolstered the HHS OCR’s (Office for Civil Rights) tools of enforcement. Georgina Verdugo, director of the OCR, said that added vigilance would help convince consumers of the privacy and security of their health information and protected personal information (PPI).

 

WHERE HIPAA AND HITECH MEET

 

By broadening the scope of HIPAA, the HITECH Act increased the number of participating stakeholders or business associates. Previously, HIPAA described a business associate as a person performing functions or activities for or on the behalf of a covered entity.

 

HITECH changed HIPAA’s definition of business associates to include:

*Health Information Organizations (HIO)
*Patient Safety Organizations (PSO)
*Gateways, portals, and e-prescribers
*Certain people providing PPI on behalf of another covered entity
*People involved in data transmission including subcontractors and delegates

 

HITECH also created new categories of HIPAA penalties. This was meant to distinguish violations based on nature, extent, and the harm caused to patients. Currently, there are three categories which correspond with three civil penalties outlined in the HITECH Interim Final Rule.

 

HIPAA-HITECH FURTHER CONNECTED

 

There are, of course, other areas where HIPAA and HITECH overlap. They are both sweeping and exhaustive legislation that often cover similar areas, especially where electronic medical records, are concerned.

 

This includes meaningful use and PHI. HITECH incentivizes the meaningful use of electronic medical records in order to improve health care and outcomes.

 

Other areas covered in both HIPAA and HITECH are breach reporting requirements, patient access to PHI, and facilitation of medical research.

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HIPAA Regulations for Radiologists 101

HIPAA Regulations for Radiologists 101 | HIPAA Compliance for Medical Practices | Scoop.it

HIPAA regulations are a complex set of rules and regulations that are designed to promote a more patient oriented medical system that enhances patient care. HIPAA regulations that promote the accessibility of medical records to patients and increase the security of electronic patient health information are also included in the HIPAA Omnibus Rule. Radiologists often receive patients through a referral system or send patient files to another medical doctor or facility after x-rays and other scans are interpreted. This constant sharing of sensitive patient information makes learning what are HIPAA regulations and how do they affect radiologists an important task for any radiologist.

 

HIPAA Omnibus Rule

The HIPAA Omnibus Rule has changed the way that patient information is collected, stored, transmitted and created in response to the HITECH Act. The HITECH Act offers organizations incentives for using electronic patient health information while improving the security of that data. When asking what are HIPAA regulations one of the most important things to consider is your organization’s privacy policy. New HIPAA regulations state that organizations and entities must update their privacy policies and business agreements to comply with the current standards.

 

Current HIPAA standards require that all businesses sharing patient information must be HIPAA compliant. For instance, if a radiologist receives referrals or bills insurance companies on behalf of clients, the insurance company and the organization referring clients should both be HIPAA compliant. Current business associate agreements will be allowed until late September of 2014, but after that date all business associates will need to comply with the HIPAA Security Rule to avoid penalties or fines.

 

What is Affected by HIPAA?

Nearly every aspect of creating, sharing and transmitting electronic patient health information has been affected by new HIPAA regulations. In addition to revising and updating your organization’s privacy policies and business agreements, you will also need to look at your internal records storage and the accessibility of patient records. For instance, your internal computer systems must be secure and protected from data loss or third-party access. Data encryption is required anytime that you transmit electronic patient information. If your organization is using a third-party storage system for patient health information, the company providing web-based storage services will also need to be HIPAA compliant.

 

One of the areas that will be most affected for radiologists is how patient information is disclosed. Since radiology is a field where referrals are very common, care must be taken to ensure formal, written consent is provided each time you share patient health information. For example, a radiologist sending the results of an x-ray to a general practitioner will need to have written consent by the patient to do so. In order to understand and comply with current HIPAA regulations, it is best to use a HIPAA compliance checklist and HIPAA compliance software. HIPAA compliance software will walk you through the process of meeting current HIPAA regulations and help you avoid the confusion of updating and revising your current policies and practices on your own.
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HIPAA Enforcement Trends for 2017

HIPAA Enforcement Trends for 2017 | HIPAA Compliance for Medical Practices | Scoop.it

Since the start of 2017 alone, HIPAA enforcement trends have indicated that this could be the most costly year for fines in history.

HIPAA, as a regulation, is managed by the Department of Health and Human Services (HHS). HHS designs and enacts policy and guidance about emerging trends in health care IT, patient privacy, and data security. The Office for Civil Rights (OCR) is the HHS body responsible for HIPAA enforcement and investigation.

HIPAA Fines by Year

OCR has been cracking down on HIPAA enforcement significantly in the past few years.

Compare these HIPAA fine totals by year:

  • 2015: $6,193,000
  • 2016: $23,504,800
  • 2017: $17,093,200

So far, in the first six months of 2017 alone, fines have increased by almost 300% over 2015’s fine total. And if the trend continues, 2017 is very likely to outpace 2016’s record-breaking $23 million as well.

Why the Increase in HIPAA Enforcement?

When OCR begins a HIPAA investigation for a violation or breach, it can take 3-4 years to reach settlement with the organization under investigation.

Four years ago in 2013, HHS released its Omnibus Rule. The Omnibus Rule made it mandatory for HIPAA business associates to be compliant with HIPAA regulation. For background: a covered entity is a health care provider, and a business associate is a vendor hired by that provider.

In the past year, many of the multi-million dollar fines levied by OCR have been the direct result of BA non-compliance. If a covered entity shares health care information with a BA without first executing a business associate agreement, the sharing of that data is considered a violation of HIPAA and is subject to significant fines. In cases where OCR detects “willful neglect” of HIPAA regulation, fines can reach up to $50,000 per incident.

With HIPAA enforcement trending toward stricter and more severe financial penalties for improper relationships with BAs, it’s no wonder why fines have been steadily increasing year after year. Now that some of the major OCR investigations involving BA non-compliance have started reaching settlement, behavioral health providers need to ensure that their relationships with their vendors are lawful under the HIPAA Omnibus Rule.

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