HIPAA Compliance for Medical Practices
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Our Partners at Compliancy Group Help Client Pass HIPAA Audit

Our Partners at Compliancy Group Help Client Pass HIPAA Audit | HIPAA Compliance for Medical Practices | Scoop.it

Compliancy Group announced today that it has helped a long-time client pass a HIPAA audit. The Department of Health

and Human Services (HHS) Office for Civil Rights (OCR) investigation into a potential HIPAA violation resulted in no fine for a user of their web-based compliance solution, The Guard.

HIPAA audits target hundreds of healthcare professionals a year, according to the HHS Wall of Shame.

 

Compliance Group is the only HIPAA solution on the market today that gives clients access to a HIPAA Audit Response Program (ARP). The Compliance Group HIPAA Audit Response Program gives clients the ability to formulate all the necessary reports that OCR auditors are requesting in order to illustrate their compliance efforts. Compliance Group’s team of expert Compliance Coaches gather the reports and adhere to strict audit deadlines to ensure that clients stand their best chance at emerging from an audit without being fined.

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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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Employer HIPAA Violations and COVID-19 Testing

Employer HIPAA Violations and COVID-19 Testing | HIPAA Compliance for Medical Practices | Scoop.it

As more and more businesses reopen and make the transition back to the office, many employers are requiring COVID-19 testing.

 

This has led many to ask, if testing employees for COVID-19 is a HIPAA violation. Employer HIPAA violations and COVID-19 testing are discussed below.

What are Employer HIPAA Violations?

Does HIPAA apply to employers? HIPAA requires covered entities and business associates to secure protected health information (PHI).

 

PHI is individually identifiable health information that is used to communicate past, present, or future health, the provision of healthcare, or the payment for the provision of healthcare. Employers’ human resources departments often collect information on employees that may be considered PHI. However, if the information isn’t used for the previously mentioned purposes, the employer is not subject to HIPAA.

 

However, employers’ self-insured health plans do fall under HIPAA jurisdiction, since they would have access to PHI to administer the health plan. As such, the employer would be required to safeguard PHI. If the employer failed to safeguard their employees’ PHI, this would be an employer HIPAA violation.

Employer HIPAA Violations and COVID-19 Testing

The Equal Employment Opportunity Commission (EEOC) released guidance on employee testing stating that testing must be consistent with business necessity, mandatory medical tests must be job related, and tests should be reliable and accurate.

 

“Applying this standard to the current circumstances of the COVID-19 pandemic, employers may take steps to determine if employees entering the workplace have COVID-19 because an individual with the virus will pose a direct threat to the health of others,” stated the EEOC.

 

Christopher Durham, an attorney with Duane Morris in Philadelphia, has made the following recommendations for employer COVID-19 testing:

◈ If employers decide to test employees for COVID-19, they must do so on a nondiscriminatory basis. This means that if an employer tests one employee, they must test all employees.

◈ Testing records must be confidential. If an employee tests positive, their identity  cannot be revealed.

◈ Testing, screening, or inquiries that are not necessary to address potential direct threat are prohibited.

◈ If an employee has a medical condition that requires alternative testing, the employer must make accommodations for such testing.

◈ If an employee refuses testing, employers will need to consider how to handle an employee’s refusal. For example, the employer could refuse access to the worksite for employees that refuse testing.

◈ If an employee cannot access the worksite while waiting to be tested, or awaiting test results, there may be an obligation to compensate the employee under wage and hour laws for time spent waiting.

◈ Employees should be required to consent in writing to the screening.

◈ Employers should consider test accuracy when selecting a test to use.

◈ There should be predetermined conditions for an employee who tests positive to be able to return to the workplace. 

◈ Employers must consider the implications of a positive test result (i.e., exposure implications for employees that may have come into contact with the positive employee in the days leading up to the positive test).

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What is a BAA? (HIPAA Business Associate Amendments)

What is a BAA? (HIPAA Business Associate Amendments) | HIPAA Compliance for Medical Practices | Scoop.it

What are a Covered Entity’s Obligations under the HIPAA Business Associate Amendment?

Since the term “HIPAA Business Associate Amendment” is simply another name for “Business Associate Agreement,” a provider’s rights and responsibilities under the HIPAA business associate amendment are the same as those under a regular business associate agreement.

Did you vet your vendors? If not you’re at risk! Learn how to send your vendors risk assessments here.

For Google to enter into a HIPAA business associate amendment with a provider, that provider must first have an existing agreement in place with Google. Once the agreement is in place, Google will enter into the amendment, provided that a provider represents:

 

◈ That the provider, through whomever signs the agreement (i.e., CEO, CIO, COO), has the authority to bind the business to the terms of the agreement;

 

◈ That the provider has read and understood the terms of the business associate amendment; and 

 

◈ The provider agrees to the terms of the agreement. 

If (and only if) a provider agrees to these terms, Google will enter into the business associate amendment. 

 

The business associate amendment requires that a provider cannot request Google use or disclose PHI in any manner that would not be permissible under HIPAA, if done by a covered entity itself (unless otherwise expressly permitted under HIPAA for a Business Associate).

In addition, the provider must make use of the available security controls provided by Google. Finally, the agreement requires that the provider not transfer PHI from one Google product to another, except when Google has expressly entered into a separate HIPAA business associate agreement for use of such Google services.

 

In turn, Google may only use and disclose PHI as permitted under HIPAA, and as outlined in the main agreement and the business associate amendment.

 

Google may also, as permitted by HIPAA, use and disclose PHI for the proper management and administration of Google’s business and to carry out the legal responsibilities of Google. Google will only use or disclose PHI for these purposes:

 

◈ Required by law; or

◈ If Google obtains written reasonable assurances from the person to whom the PHI will be disclosed that the PHI will be held in confidence, used only for the purpose for which it was disclosed, and that Google will be notified of any breach.

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HIPAA Now: What you Need to Know About HIPAA Compliance

HIPAA Now: What you Need to Know About HIPAA Compliance | HIPAA Compliance for Medical Practices | Scoop.it

HIPAA Now: Effective HIPAA Compliance Program

An effective HIPAA compliance program must ensure the confidentiality, integrity, and availability with safeguards. These safeguards include administrative, technical, and physical. An effective HIPAA compliance program consists of several components. 

  • Risk Assessments. Covered entities are required to conduct six self-audits annually. Completing self-audits measures an organization’s administrative, physical, and technical safeguards against HIPAA standards.

 

  • Gap Identification and Remediation. Upon completion of self-audits, gaps in safeguards are identified. To be HIPAA compliant, organizations must address gaps with remediation plans. Remediation efforts close gaps so that an organization’s safeguards are adequately securing PHI.

 

  • Policies and Procedures. A major component of HIPAA now is illustrating compliance through documentation. As such, organizations must have customized policies and procedures dictating how they adhere to the HIPAA Security, Privacy, and Breach Notifications Rules.

 

  • Employee Training. To ensure that employees properly use and disclose PHI, they must be trained annually. HIPAA training should include HIPAA basics, their organization’s policies and procedures, proper use of social media, and cybersecurity. 

 

  • Business Associate Management. Before working with a vendor, it is essential to assess their safeguards. Vendors (business associates) are required to be HIPAA compliant to work with healthcare clients. They must also be willing to sign a business associate agreement (BAA). A BAA must be signed before it is permitted to share PHI with the business associate. A BAA is a legal document that dictates the safeguards the business associate is required to have in place, it also requires each party to be responsible for maintaining their compliance.  

 

  • Incident Response. Organizations that experience a breach have an obligation to report it. Depending on the size of the breach, reporting requirements differ. Breaches affecting 500 or more patients must be reported within 60 days of discovery to the HHS, affected patients, and the media. Breaches affecting less than 500 patients must be reported within 60 days from the end of the calendar year in which the breach was discovered (March 1) to the HHS and affected patients. 
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What is a HIPAA Service?

What is a HIPAA Service? | HIPAA Compliance for Medical Practices | Scoop.it

A HIPAA service is a service performed by one entity, that enables another entity to meet its HIPAA compliance obligations.

 

Under HIPAA, healthcare providers frequently contract with vendors who perform services involving protected health information.

 

The services include billing, collections, medical transcription, e-prescribing, and many others.

 

If a vendor is performing such a HIPAA service, the vendor is considered to be a business associate, and must comply with HIPAA regulations.

When is a HIPAA Service Used?

Healthcare providers frequently contract with other entities to perform services involving protected health information (PHI). Sometimes, healthcare entities will contract with a service for the sake of convenience. For example, if a patient has not paid for healthcare services, a healthcare organization may refer the patient’s account to a collections agency.

 

Once the account is referred, the collections agency seeks payment directly from the patient. By contracting with the collection agency to provide this service, the healthcare entity can spend time on other activities. 

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Healthcare providers also contract with other entities to provide a HIPAA service when the service the provider needs is outside its area of expertise. For example, the healthcare provider may not have a designated IT department capable of providing remote backup services.

 

Healthcare providers often contract with IT consultants and contractors to provide these and other security services that allow the provider to satisfy its obligations under the HIPAA Security Rule.

What is Required When a Provider Uses a HIPAA Service?

Entities with which providers contract to provide services involving creation, maintenance, receipt, or transmission of protected health information, are known under HIPAA as “business associates.” Before a business associate can create, maintain, provide, or transmit PHI, the business associate must enter into an agreement with the provider.

 

This agreement, known as a business associate agreement or business associate contract, must contain language requiring the business associate to provide satisfactory assurances to the provider that the business associate will appropriately safeguard the protected health information it receives or creates on behalf of a provider. The HIPAA Privacy Rule requires that these satisfactory assurances must be in writing. 

 

 

The business associate agreement must contain the following components, among others:

 

◈ A description of when the business associate is permitted to use PHI, and when the business associate is required to use PHI;

◈ A provision prohibiting the business associate from further using or disclosing the PHI other than as permitted or required by the contract or as required by law;

◈ A requirement that the business associate use appropriate safeguards to prevent a use or disclosure of the protected health information other than as provided for by the agreement.

 
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5 Ways to Stay HIPAA Compliant with Telemedicine

5 Ways to Stay HIPAA Compliant with Telemedicine | HIPAA Compliance for Medical Practices | Scoop.it

Here are 5 things you can do to stay HIPAA compliant while still providing an ideal telemedicine experience.

1. Pick the Right Location

HIPAA compliance goes beyond the actual technology and also affects the provider’s surroundings during the visit. Providers must select a secure and quiet location where the only people who can see or hear the visit are people who are directly related to care.

 

This means that offices in homes must be private and that sessions done from unfamiliar locations must also be secure. Often, telehealth visits are provided on the fly due to urgent complaints or last-minute needs from patients. Even in those situations, the provider must find a location where the patient cannot be overheard by those not involved in their care.

2. Secure the Patient Environment

It is highly recommended that the patient is in a private location where there are no uninvited individuals who can overhear. The burden of ensuring that patients are in a secure location actually falls on the patient, and not the provider. The patient is responsible to secure their own safe space for distance treatment under HIPAA.

 

That said, many providers take the extra step, and they will have patients shows them the room that they’re in, identify anyone who shares the space with them, provide an address for where they are currently located to match it with the address on file, and even discontinue the session if they’re not comfortable with the security.

 

These procedures vary considerably by the provider, and there are no clear-cut rules in HIPAA regulations that advise how to address these concerns. Limiting visits based on privacy concerns is an internal protocol for each practice.

3. Give Proper Instruction (At A Distance)

By working with a platform that notifies and shares best practices with patients, patients can be educated before beginning the session and reduce the burden on the provider to verify the patient’s location.

 

Notifications that are sent out in advance of the appointment should encourage pre-visit routines like preparing necessary information, testing connection speed and securing the environment.

 

Users should have an understanding of what is considered acceptable for the visit, and the notifications should be customizable to include any pertinent information for this specific connection attempt. The instructions for a behavioral health visit may be different than a well visit, and the customization of the notifications that go out gives providers an opportunity to ensure that their patients have this information without delay.

4. Utilize Proper Security Protocols

Most of the work to ensure HIPAA compliance should be done by the platform that you’re using. The connection should be encrypted and the platform secure.

 

Beyond that, providers have a responsibility to ensure that their own location is secure, and many choose to develop patient security protocols as well. The burden of ensuring HIPAA compliance is not as complicated as it can seem.

 

As long as no one aside from the healthcare provider and the treatment team has access to the patient’s information, you have done most of the work.

5. Don’t Sacrifice on Video Connection

The platform itself must encrypt the transmission of the video feed, but it can’t sacrifice connection strength to do it. By working with a platform that can provide a consistent connection with low bandwidth requirements, it is possible to get a HIPAA compliant platform that is easy to use even on mobile data.

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Study Shows Improvement in Provider HIPAA Right of Access Compliance

Study Shows Improvement in Provider HIPAA Right of Access Compliance | HIPAA Compliance for Medical Practices | Scoop.it

The HIPAA Privacy Rule’s “Right of Access” provision requires providers to make patient medical records available for viewing, inspecting, and copying. In early 2019, the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) launched a HIPAA Right of Access enforcement initiative. 

 

A recent study by citizen.com revealed that since the initiative was launched, provider Right of Access compliance has increased.  

How Did the Study Measure Provider Right of Access Compliance?

To measure provider right of access compliance, Citizen compiled a scorecard for 820 healthcare providers.

 

A wide range of healthcare providers were assessed for the study, from single physician practices to large, integrated healthcare delivery systems.

 

The “grade” Citizen assigned to each provider on the card reflects the providers’ responses to patient requests for access for their healthcare data from the period of 2/10/19 through 2/13/20.

 

The patients who made the requests for access were Citizen users. Based on the feedback these users submitted to Citizen as to the timeliness of the provider’s response, Citizen developed a “compliance score” for each provider. The score ranges from a low of “1” to a high of “5.” 

 

A 1-star rating represents a non-HIPAA compliant response. 2-stars were awarded when requests were eventually resolved satisfactorily, but only after multiple escalations to supervisors. A 3-star rating was given when the request was satisfied with minimal intervention, and a 4-star rating was given to providers that are fully compliant and that gave a seamless response.

 

A 5-star rating was given to those providers who, in providing access, went above and beyond the requirements of HIPAA.

What Were the Results of the Right of Access Compliance Study?

Under the scorecard, only 27% of providers received a “1”; that is, only 27% were not compliant with the HIPAA Right of Access. This figure is a significant improvement from the previous scorecard, which revealed that a majority of providers – 51% – were not compliant with the Right of Access.

 

In addition, the percentage of providers awarded 4 stars for their responses increased from 40% to 67%, and the percentage of providers awarded 5 stars increased from 20% to 28%.

 

Not only are more people being given more timely access to their records, they are paying less for that access as well.

 

Under the Right of Access, providers may charge patients a reasonable, cost-based fee (i.e., costs of reproduction of records, including copying costs and mailing costs) for record production. Only 6% of the 820 healthcare providers on the scorecard actually charged a fee.

 

In addition, the latest scorecard information reveals that providers are not subjecting patients to burdensome paperwork requirements as much as in past years.

 

In previous studies, many healthcare providers required patients to complete a standard form, yet this year, most providers accepted any form of written request and did not require patients to complete a particular form before the request was processed.

 

Citizen attributes the improvements to right of access compliance not only to the enforcement initiative, but to new rules recently published by HHS’ Centers for Medicare and Medicaid Services and the HHS’ Office of the National Coordinator for Health IT, which makes it easier for patients to obtain copies of their healthcare data.

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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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Is Freshdesk HIPAA Compliant?

Is Freshdesk HIPAA Compliant? | HIPAA Compliance for Medical Practices | Scoop.it

Under HIPAA, Freshworks, the SaaS provider offering Freshdesk, is considered a business associate when working with healthcare clients to manage their CRM. In the past, Freshdesk HIPAA compliance was not possible, as the company was unwilling to sign a business associate agreement (BAA).

 

A BAA is a legal document that is required by the Health Insurance Portability and Accountability Act (HIPAA), mandating that HIPAA business associates (BAs) have safeguards in place securing electronic protected health information (ePHI) in order to be compliant.

 

Freshworks has recently enabled Freshdesk HIPAA compliance by signing BAAs with their healthcare clients. However, the BAA ONLY covers Freshdesk, not extending to Freshworks’ other services. To use Freshdesk in accordance with HIPAA standards, there are other requirements that must be configured and enabled other than signing a BAA.

What is Required for Freshdesk HIPAA Compliance?

Freshdesk HIPAA compliance comes down to how it is configured. 

The following configurations must be implemented for Freshdesk HIPAA compliance:

  • Freshconnect: this Freshdesk feature must be disabled for HIPAA compliance.
  • Custom Mailbox: this feature allows users to configure their own custom mail server with Freshdesk. With custom mailbox turned on, users have full control over incoming and outgoing emails, allowing users to manage emails. Learn more here.
  • IP Whitelisting: allows administrators to allow access to their support portal to only users with an IP address approved by the administrator. Learn more here.
  • SAML SSO: Security Assertion Markup Language (SAML) is a means for communicating identities between two web applications. SAML enables the utilization of single-sign-on (SSO); SSO is a means for users to use a single login credential for multiple platforms. SSO reduces identity theft by validating users logging into the support portal. Learn more here.
  • SSL: SSL is enabled for all users that host their support portal on freshdesk.com (yourcompany.freshdesk.com). However, when companies utilize a custom domain for their support portal (support.yourcompany.com), they need to configure a custom SSL certificate. Learn more here.

Other Configuration Recommendations

There are additional protections that Freshworks recommends Freshdesk users implement for Fredesk HIPAA compliance. Although they are not required, users should consider implementing them to further their ePHI security.

  • Secure Data Migration: Freshdesk enables secure data migration without the need for user’s data to be stored in Freshworks local database. Learn more here.
  • Data Sanitization: masks sensitive data in the patient conversation, preventing unauthorized access.
  • Data Encryption: although not mandated for Freshdesk HIPAA compliance, data encryption converts sensitive data into a format that is unreadable for anyone without a decryption key. Freshdesk enables users to add an encrypted single line field in users’ forms. However, default fields cannot be encrypted, and therefore should not be used for ePHI. Freshworks recommends that any PHI be stored in a custom encrypted field.
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Is Google Forms HIPAA Compliant?

Is Google Forms HIPAA Compliant? | HIPAA Compliance for Medical Practices | Scoop.it

Google Forms is a cloud-based form that can be used to conduct surveys or fill out questionnaires.

 

A provider may use Google Forms to get feedback from patients about recent appointments, or to inquire if they would be interested in a particular service, should the provider choose to add it to their services.

 

However, before a provider may use Google Forms for this type of communication, it is important to determine whether or not Google Forms is HIPAA compliant. Google Forms HIPAA compliance is discussed below. 

Google Forms HIPAA Business Associate Agreement

A key factor when determining a software’s HIPAA compliance is the willingness to sign a business associate agreement (BAA). Google Forms is part of Google’s G Suite offerings, and as such is covered under the G Suite business associate agreement. Before a user is permitted to use Google Forms in conjunction with protected health information (PHI), the user must sign Google’s BAA.

 

For more information on how to get your Google Forms HIPAA BAA, please click here.

Google Forms HIPAA Safeguards

In addition to its willingness to sign a BAA, HIPAA compliant software must include safeguards to ensure the confidentiality, integrity, and availability of PHI: 

  • Access controls. Allows administrators to designate different access levels to information based on an employee’s job function.
  • Audit controls. Tracks access to information to ensure that protected health information is accessed in accordance with the HIPAA Privacy Rule minimum necessary standard.
  • User authentication. Utilizes unique login credentials to ensure that users are who they appear to be.
  • Encryption. Masks sensitive data so that it can only be accessed by authorized users.

For more information on Google Forms HIPAA compliant configuration, please click here.

Google Forms HIPAA Training

No software is fully HIPAA compliant, it is up to the end user to ensure that it is being used in a HIPAA compliant manner. Google Forms HIPAA training is essential for all users to understand how to use the platform in a HIPAA compliant manner. All employees that will be using Google Forms should be trained on proper use before they are permitted to use the platform. 

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HIPAA Data Backup Plan and Disaster Recovery Plan

HIPAA Data Backup Plan and Disaster Recovery Plan | HIPAA Compliance for Medical Practices | Scoop.it

The requirements of a HIPAA data backup plan and disaster recovery plans are discussed below.

What are the Requirements of a HIPAA Data Backup Plan?

A HIPAA data backup plan is a component of the administrative safeguards that must be implemented under the HIPAA Security Rule.

 

The data backup plan, which is part of the administrative safeguard requirement to have a contingency plan, consists of establishing and implementing procedures to create and maintain retrievable, exact copies of electronic protected health information (ePHI).

 

Is your organization protected against breaches? Download the free cybersecurity eBook to get tips on how to protect your patient information.

 

Data that is secured and backed up must be capable of being recovered (i.e., must be recoverable or retrievable).

 

The requirement that data be capable of being recovered comes from a related provision of the contingency plan requirement – the disaster recovery plan requirement.

 

Under a disaster recovery plan, a covered entity or business associate establishes (and implements as needed) procedures to restore any loss of data.

What Should I Consider When Developing a HIPAA Data Backup Plan?

When developing a HIPAA data backup plan, covered entities and business associates should consider the nature of the ePHI that must be backed up, including how many identifiers the ePHI has. 

 

The HIPAA Security Officer should make an inventory of all sources of data, to determine the nature and type of ePHI an organization stores.

 

There are many potential sources of ePHI. These include, among others, patient accounting systems, electronic medical records, health maintenance and case management information, digital recordings of diagnostic images, electronic test results, and any other electronic documents created or used.

Where Should I Store Backup Copies of Data?

There are two types of backup storage organizations should use:

 

Backup #1 (Local Storage Backup): The first kind of backup (Backup #1) you should use is backup through a local, onsite appliance. In this kind of data backup, backup data is stored on a local storage device (appliance), such as a hard disc, CD, or hard drive.

Backup #2 (Offsite Backup): The second kind of backup is offsite backup. Offsite backup consists of either backing up data to the cloud, or storing backup data at an offsite facility. Storing backup data with a HIPAA compliant cloud provider allows an organization to easily retrieve information from the cloud.

 

With cloud storage, backup data can be retrieved at any time. Storing backup data at an offsite facility (a physical location other than your worksite) allows recovery of backup data if backup data stored locally, onsite, is destroyed or damaged because the premises themselves have been damaged to emergencies such as earthquakes and floods. 

What is the Difference Between a HIPAA Data Backup Plan and a Disaster Recovery Plan?

The difference between backups and disaster recovery is a matter of scope. Backing up data refers to backing up actual copies of data.

 

A backup plan does not take disaster response into account. A disaster recovery (DR) plan, in contrast, is a strategy for disaster event response, which response includes deployment of the backups – in other words, putting the backups into action.

What Steps Does the Disaster Planning Process Consist of?

There are four essential steps to complete in the disaster recovery planning process. These are discussed in turn.

 

Step 1: Performing a Business Impact Analysis (BIA)

 

A business impact analysis (BIA) is a thorough assessment and inventorying of an organization’s virtual environment.

 

In this process, the organization must take into account the volume and type of data that is being managed; where the data is being stored; how much in terms of resources and time must be expended to restore access to different types of data; and how critical each type of data is to business operations.

 

The more vital the data is to the business’s ability to function, the higher that data’s priority of restoration, and resource allocation, should be.

 

Step 2: Performing a Risk Assessment

 

Conducting a risk assessment consists of running and evaluating hypothetical external situations that can hurt your business. External situations that can damage your business include natural disasters, such as hurricanes and blizzards.

 

External situations also include man-made events, such as active shooter situations and acts of terror. 

 

When conducting the risk assessment, an organization should consider all potential external incident types, and the likelihood of their occurrence.

 

The organization should also consider the nature and severity of the impact each incident may have on the organization’s ability to continue normal operations.

 

It is necessary to consider all the possible incident types, as well as the impact each may have on the organization’s ability to continue to deliver its normal business services.

 

In preparing the risk assessment, organizations should review all records and sources of information at their disposal to assess the threat posed by each instance. Records and sources of information can include, for example:

  • Employee recollection of prior disruptive events and how they affected business operations;
  • First-responder organizations advice; and
  • Disaster recovery resource libraries from government agencies, such as the Federal Emergency Management Agency (FEMA).

 

Step 3: Create a Risk Management Strategy

 

Once you have identified data processes and the business impacts of disruptions to them, combined with likelihood of a given disaster taking place, you should develop a risk mitigation strategy. This strategy should provide for specific backup solutions and disaster recovery procedures for critical data.

 

Factors to consider in developing a strategy (among others) include legal factors (laws may restrict where data can be stored); recovery point objectives (RPOs), which measure how much data an organization can afford to lose as the result of a disaster; and recovery time objectives (RTOs), which are metrics that calculate how quickly an organization needs to recover IT services and infrastructure after a disaster to maintain business continuity. 

 

Step 4: Configure and Run Testing Exercises on Your Disaster Recovery Plan

 

Once the risk management strategy is in place, you must engage in testing scenarios to ensure that strategy is properly configured. Testing exercises can differ in complexity.

 

The goal of any testing exercise is to ensure that data has been backed up in accordance with your recovery point objectives, and to ensure that the strategy actually works.

 

Once testing has confirmed that the risk management strategy is sound, the strategy is “ready to use.” Bear in mind, however, that testing should not be conducted only before strategy rollout.

 

Testing should be performed continuously – especially after an incident occurs. This way, you can refine and make changes to the strategy you deploy.

 

Data backup plans and disaster recovery plans are required under the HIPAA Security Rule. Implementing robust backup and disaster recovery plans can help keep your business running smoothly and securely. 

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Does the HIPAA Privacy Rule apply to the Novel Coronavirus (COVID-19)?

Does the HIPAA Privacy Rule apply to the Novel Coronavirus (COVID-19)? | HIPAA Compliance for Medical Practices | Scoop.it

The Novel Coronavirus is spreading so rapidly that it will most likely become a pandemic.

 

The World Health Organization says that a pandemic is the worldwide spread of a new disease. A pandemic is when an epidemic spreads between countries, per David Jones, MD, Ph.D.

 

Even in times of crisis like this, HIPAA-covered entities must follow all reasonable safeguards to protect the privacy of their patients who may be infected with the disease concerned, in this case, we are talking about the novel coronavirus. 

 

However, the HIPAA Privacy rule does offer some accommodation in such cases.

Special considerations in the HIPAA Privacy Rule

The HIPAA Privacy Rule provides special considerations in the event of an epidemic or pandemic. As a covered entity or business associate, you should be aware of these individual cases.

 

The Privacy Rule recognizes that public health authorities need some access to protected health information (PHI) to ensure public health and safety in the event of an emergency such as the one we are experiencing with the novel coronavirus.

 

Covered entities are authorized to disclose PHI, without a patient’s consent, if that PHI disclosure is needed to treat the patient or even to treat another patient.

 

Business Associates may also be able to disclose necessary information on behalf of the covered entity, as long as this disclosure is permitted within the parameters of the Business Associate Agreement.

What can you share with public health or disaster relief organizations?

The Department of Health and Human Services has stated explicitly that covered entities are permitted to disclose needed PHI to the Centers for Disease Control and Prevention (CDC) or a state or local health department when this disclosure is expected to help prevent or control a disease.

 

A hospital may, for instance, report periodically to the CDC about patients potentially or actually exposed to the novel coronavirus.

 

Similarly, they may also share protected health information with disaster relief organizations like the American Red Cross, that are authorized to coordinate relief effort and notify family members or others involved in the patient’s care.

Disclosing PHI to other individuals, family, and friends

Interestingly, covered entities are also permitted to disclose the minimum necessary PHI to persons at risk of contracting or spreading the disease, as long as another law allows the covered entity to make such a notification. 

 

Sharing needed PHI with family and friends is also allowed as long it is done in the best interests of the patient concerned.

 

Here the doctor or another healthcare provider must exercise his or her best professional judgment and make the decision appropriately.

 

What can you tell the media?

Protected health information that can identify a patient should typically not be disclosed to the media without the written authorization of the patient. There are definite exceptions for certain limited cases here, for which you may refer to the HIPAA Privacy Rule for guidance.

In conclusion

The summary is: In the event of an epidemic or pandemic, such as what the Novel Coronavirus is likely to be, follow HIPAA Privacy precautions carefully.

 

Disclose only the minimum necessary Protected Health Information (PHI) to public health organizations and friends and family of the affected patient, and only to the extent that this disclosure helps treat the patient or other patients, and is in the patient’s best interests.

 

Make sure that all your employees and health care workers are trained and well informed to make any decision using their best judgment.

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The HIPAA Timeline

The HIPAA Timeline | HIPAA Compliance for Medical Practices | Scoop.it

The Health Insurance Portability and Accountability Act was passed on August 21, 1996, during the re-election campaign of President Bill Clinton.

 

The law was the end-product of twin concerns of Congress as America entered into the 21st century. One of these twin principal concerns was, of course, a fear that as new technologies were developing, existing laws – mostly a patchwork of laws on the state level – were inadequate to protect the privacy and security of patient health information.

 

Regulation of this privacy and security is embodied in Title II of HIPAA. Title I of HIPAA, however, addresses an equally important concern and is an equally important part of the HIPAA timeline.

 

Title I was passed to ensure that a change in employment would not result in termination of health insurance coverage.

What is the Importance of Title I in the HIPAA Timeline?

Title I of HIPAA plays an important role not only in the HIPAA timeline but in the timeline of health insurance coverage developments in America generally. In 1985, a federal law, the Consolidated Omnibus Budget Reconciliation Act (COBRA) was passed.

 

That law required employers of a certain size to offer continuation of health plan benefits to employees after termination of their employment.

 

In 2010, the Patient Protection and Affordable Care Act (PPACA) passed. That law strengthens existing COBRA law. For example, under the PPACA, an insurer generally cannot refuse to sell a policy of healthcare insurance to an individual because that individual has a preexisting medical condition.

 

Therefore, when an individual becomes eligible for COBRA coverage, that individual cannot be denied this coverage because of a preexisting medical condition.

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3 Things Everyone Should Know About The HITECH ACT

3 Things Everyone Should Know About The HITECH ACT | HIPAA Compliance for Medical Practices | Scoop.it

The American Recovery and Reinvestment Act passed into law on February 17th, 2009. Included in this bill is a section titled the Health Information Technology for Economic and Clinical Health Act, or HITECH for short.

 

This law allocates $18 billion as incentives through Medicare and Medicaid reimbursement systems, providing grants and revolving loan funds to hospitals and physicians considered meaningful users of electronic health records.

 

These grants and loan funds may be used to purchase EHRs and new healthcare technology. If you’re a small to medium sized healthcare practice in need of a consultation regarding HITECH Act compliance, then look no further.

 

EHR has a compliance department that will assist you with matters such as this. Listed are three things both eligible and ineligible providers should be aware of when demonstrating meaningful use of EHR systems, thereby improving health care throughout the country.

 

THE DEPARTMENT OF HEALTH AND HUMAN SERVICES ISSUES “FINAL RULES”

 

The Department of Health and Human Services issued three final rules for the implementation of the requirements of the HITECH Act. The new rules stipulate that those who qualify for the incentive program can receive as much as $44,000 in grants and other incentives over a five-year term through Medicare.

 

Furthermore, up to $63,750 over 6 years through Medicaid. Hospitals can earn millions of dollars in grants and revolving loans for implementing and becoming meaningful users of certified electronic health records. The third rule establishes objectives for what is considered ‘meaningful use,’ also providing metrics eligible applicants must meet in order to reap all of the benefits of the EHR incentive program.

 

EHR TECHNOLOGY STIPULATIONS

 

In order to be compliant with the HITECH Act, another stipulation addressed in The Department of Health and Human Services final rules was the Temporary Certification Program for Health Information Technology.

 

This certification program establishes a process for businesses and professionals to test and certify for using EHR technology. If you want to take advantage of all the benefits this program has to offer, then you must certify first.

 

MEDICAID AND MEDICARE INCENTIVE PAYMENTS ESTIMATED TO RISE

 

Experts estimate that over the next ten years, the Federal government will spend over $26 billion in grants to medical professionals and hospitals implementing the standards set forth in the HITECH Act.

 

 

If you are a small to midsize healthcare practice looking to save money and benefit from the outstanding economic benefits the HITECH Act’s financial EHR implementation incentives provide, contact EHR1 today for a certified EHR and expert consulting.

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HIPAA and Coronavirus Privacy: Retail, Restaurants, and Theme Parks

HIPAA and Coronavirus Privacy: Retail, Restaurants, and Theme Parks | HIPAA Compliance for Medical Practices | Scoop.it

As the spread of the coronavirus seems to be slowing, many people are preparing to get back to life as usual.

 

Consumers are anxiously awaiting the reopening of the country, with some states further along than others. The goal is to safely reopen retail stores, restaurants, and theme parks.

 

This has led some of these establishments to require proof of negative COVID-19 test results, causing many consumers to cry HIPAA violation. Is this a HIPAA violation? HIPAA and coronavirus privacy is discussed below.

HIPAA and Coronavirus Privacy

The coronavirus pandemic has caused many businesses to reevaluate how well they are protecting consumers.

 

Many businesses have increased cleaning protocols to prevent the spread of the virus, as well as implemented new standards for consumers entering the establishments.

 

Several businesses are requiring employees and consumers to wear masks, are conducting temperature checks on anyone entering the business, and requiring proof of negative COVID-19 test results. These new requirements have many consumers concerned that their privacy rights under HIPAA are being violated.

 

HIPAA established industry standards for the privacy of protected health information (PHI). Under HIPAA, coronavirus test results are considered PHI. As PHI, covered entities and business associates cannot disclose a patient’s coronavirus test results outside of treatment, payment, or healthcare operations. 

 

But what about during a global pandemic? These entities are permitted to disclose coronavirus test results to public health authorities for the purpose of public safety.

 

This is to notify people who may have come into contact with a coronavirus positive patient. However, disclosed information must only be the minimum necessary information to accomplish the purpose of the disclosure.

Can Consumer Businesses Ask Patrons for Test Results?

Consumer businesses such as retail stores, restaurants, and theme parks are neither covered entities nor business associates. Since they are neither covered entities or business associates, these establishments do not fall under the jurisdiction of HIPAA law.

 

As such, they can ask patrons for proof of negative COVID-19 test results, without fear of violating HIPAA, before they are permitted entry to these establishments. 

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Is CallRail HIPAA Compliant?

Is CallRail HIPAA Compliant? | HIPAA Compliance for Medical Practices | Scoop.it

CallRail is a software service that enables call tracking, recording, and analytics. By utilizing CallRail businesses track marketing initiatives by determining which marketing campaigns drive calls.

 

Organizations working with protected health information (PHI) must ensure that the software they’re using is HIPAA compliant. That begs the question, is CallRail HIPAA compliant?

Is CallRail HIPAA Compliant: Security Features

HIPAA requires that software used by organizations working with protected health information (PHI), have proper security measures safeguarding PHI.

 

These safeguards must ensure the confidentiality, integrity, and availability of the PHI they work with.

 

To address this, CallRail utilizes end-to-end encryption (E2EE). E2EE masks sensitive data from one endpoint to another (an endpoint is a device that connects to the internet such as a laptop, tablet, or smartphone). “Unmasking” data requires a decryption key, as such, data can only be read by authorized users.

 

Additional security features for CallRail’s HIPAA compliant accounts include:

 

◈ Automatic logoff. Users are logged out every 30 minutes.

 

◈ Integrations. There are restrictions on integrations that send PHI to third parties.

 

◈ Voicemail privacy. Voicemail transcriptions are confidential.

 

◈ Access to recordings. Accessing the recording link will require a login. Only Client Manager or Client Reporting users have access to recordings. As such, they must log into the account to listen to call recordings.

 

◈ Caller ID. Caller ID information isn’t included in Call Notification emails. This information is only available upon logging into CallRail.

 

◈ Form submission. Form submission alerts received through text messages don’t include messages from the lead. This information is only available upon logging into CallRail.

 

◈ Email notifications. Emails only include the caller’s phone number. To access the message, users must log into CallRail.

Is CallRail HIPAA Compliant: Business Associate Agreements

Software companies that work with healthcare clients, or may have access to PHI as part of their job function, are considered business associates.

 

An essential part of HIPAA compliance is ensuring that business associates will protect PHI. Business associate agreements (BAA) dictate the security measures business associates are required to have in place to service their clients.

 

A BAA requires each signing party to agree to be HIPAA compliant, and states that each party is responsible for maintaining their compliance. Software companies that are unwilling to sign a business associate agreement cannot be used in conjunction with PHI.

 

CallRail states on their website that they will sign a BAA with their healthcare clients.

Is CallRail HIPAA Compliant?

Yes, provided users enable the proper security features, and have a signed business associate agreement, CallRail can be used in a HIPAA compliant manner.

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HIPAA Policies and Procedures Templates

HIPAA Policies and Procedures Templates | HIPAA Compliance for Medical Practices | Scoop.it

HIPAA Policies and Procedures Templates are form documents that relate to a particular area of HIPAA compliance.

 

HIPAA Policies and Procedures templates provide information on what an organization must do to be compliant in that area. As an example, HIPAA Policies and Procedures Templates include a Policy and Procedure Template for Breach Notification.

 

The template contains general language about how to detect and report a breach. 

What Should Be Included in HIPAA Policies and Procedures Templates?

For a healthcare organization to meet HIPAA compliance requirements, its physicians, nurses, other medical staff, and any other employees who may encounter protected health information (PHI) or electronic protected health information (ePHI) must understand what their job roles allow them to do.

 

HIPAA Policies and Procedures Templates include, for example, a policy and procedure for the HIPAA “Accounting of Disclosures” provision of the HIPAA Privacy Rule. This provision requires healthcare organizations to give patients an accounting of entities and persons to whom the organization has sent patient PHI.

 

When a patient requests an accounting, the healthcare organization must have a policy, or overall principle, about accountings of disclosures. This principle can be put in writing, as something along the lines of “The law requires us to provide patients with the names of people and organizations we have given their PHI to. The law also requires that we let patients know what PHI we disclosed.” 

 

The organization can only handle specific patient requests once it has implemented a series of processes for doing so. These processes are called procedures.

 

A procedure is a series of steps allowing for the organization to provide the accounting. Procedures that are required in the accounting of disclosures context include procedures for determining who is qualified to answer a request (so that only people whose job duties require access to PHI can answer), what requests require the organization to provide the accounting and what requests the organization need not provide an accounting for, how the accounting is to be provided (i.e., by first-class mail, overnight mail, fax with a HIPAA compliant fax cover sheet), and when (within what timeframe) the accounting must be provided.

 

The organization must also have a process in place that addresses what it must do when a patient complains that the accounting he or she received was not complete, or did not contain required information.

Using HIPAA Policies and Procedures Templates, which require that the same process be followed each time a patient makes a request, ensures the organization will consistently and accurately meet its compliance requirements.

 

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Telehealth, Video Tech Tools and HIPAA Compliance

Telehealth, Video Tech Tools and HIPAA Compliance | HIPAA Compliance for Medical Practices | Scoop.it

elemedicine has been around for years, but as a healthcare service it has been underutilized.

 

Today, virtual visits for medical care have skyrocketed because of the COVID-19 outbreak and other factors.

 

Telehealth is experiencing a revolutionary moment like never before. By the end of 2020, virtual medical care usage is estimated to reach upwards of 1 billion interactions, according to analysts at Forrester Research. 

 

In addition, some restrictions that were barriers to entry before have been lifted in response to the public health pandemic. And in March 2020, the Trump Administration expanded Medicare's coverage allowing beneficiaries to receive more extensive care through telehealth visits. These are done using video and audio applications. 

 

With the advent of stay-at-home orders and social distancing, technology is healthcare's solution for delivering continuous patient care. Tech tools' enable widespread access, bringing an unprecedented reach to a larger patient population.

 

For medical practitioners, the shift of using video platforms to communicate can come with risk and HIPAA compliance concerns. OCR asks that telehealth sessions be conducted in a private environment.  Sometimes this could be achieved with a simple task such as closing an office door or lowering one's voice.  

 

The Office for Civil Rights has issued an announcement, guiding on which audio and video communication platforms are acceptable and not acceptable for patient interactions during the coronavirus pandemic. 

 

As stated officially by OCR on its website:

"OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency."

In this blog post, we will highlight some of the video communication platforms that follow OCR's public health emergency guidance. Of course, keep in mind that compliance regulations might change in upcoming months.

Telehealth video calling platforms to use amid the pandemic

Under OCR's notice, covered healthcare providers can use certain platforms for non-public facing video communications with patients, as these platforms are HIPAA compliant and will enter into Business Associate Agreements (BAAs).

Some of these are:

  • Skype for Business / Microsoft Teams
  • Updox
  • VSee
  • Zoom for Healthcare
  • Doxy.me
  • Google G Suite Hangouts Meet
  • Cisco Webex Meetings / Webex Teams
  • Amazon Chime
  • GoToMeeting
  • Spruce Health Care Messenger

Zoom is on this list, but with the recent rise in security attacks from threat actors joining Zoom meetings uninvited, we have seen advice from various  entities to use a different video platform when communicating with patients, until all security and privacy issues with Zoom are fixed. No one wants to deal with Zoom-bombing during an important medical visit. 

It's important to note that these technological tools are third-party providers and they may pose privacy risks. However, using FaceTime, for instance, during the pandemic is not necessarily a compliance violation, depending on a case by case basis. 

What if patient does not have access to video telehealth formats

If the telehealth session is being conducted in good faith during this public health emergency, then OCR permits the use of audio methods like wireless phone, landline phones to conduct the session. If using email or texting, they ask the covered entity to try and utilize safeguards whenever possible, such as secure email or secure texting.  

Avoid using TikTok for telehealth sessions

On the other hand, OCR stated the following public-facing applications are not to be used when providing telehealth services, even during the public health crisis. OCR is not the sole government agency warning about TikTok's security implications. The wildly popular app has come under fire for underage privacy and international security concerns by U.S. lawmakers and security professionals.  Using public-facing communications could be an evidence of bad faith on the part of the provider, which could make the provider liable for OCR enforcement actions. 

Avoid using these platforms for telehealth:

  • Facebook Live
  • Twitch
  • TikTok

 

Not only that, the guideline explains to avoid using any public-facing technology, meaning the session can be seen by a group. 

For privacy protections and peace of mind, OCR advises to turn to HIPAA compliant technology platforms.

 

There are vendors available, who will enter into a HIPAA Business Associate Agreement with a covered entity. Check with the vendor to see if that's the case. When in doubt, reach out to third-party HIPAA experts to ensure your following compliance regulations as you transition to doing telehealth. 

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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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4 Tips: HIPAA Compliance for Small Practices

4 Tips: HIPAA Compliance for Small Practices | HIPAA Compliance for Medical Practices | Scoop.it

When determining what HIPAA safeguards are appropriate for your organization it is important to address the following:

 

    1. Policies and Procedures. HIPAA compliance for small practices requires you to create customized policies and procedures. This ensures that the policies and procedures that you implement apply directly to the way your practice operates.To be HIPAA compliant, policies and procedures must be written and must be reviewed annually to account for any changes in business operations. Policies and procedures dictate privacy and security protocols for your organization, as well as the proper uses and disclosures of protected health information (PHI)
    2. Self-audits. Self-audits measure your practice’s administrative, physical, and technical safeguards against HIPAA standards. Conducting self-audits allows you to identify the gaps in your safeguards so that you may create remediation plans to bolster your safeguards.
    3. Notice of Privacy Practices. A Notice of Privacy Practices (NPP) is a written notice that covered entities are required to provide to their patients. The Notice provides patients with information regarding how their PHI will be used and disclosed by the covered entity. It also dictates the patient’s rights in regards to their PHI.
    4. Business Associate Agreements. Business associate agreements (BAAs) are legally binding contracts signed between a covered entity and their business associates. A business associate is any entity that creates, maintains, stores, receives, or transmits on your behalf. A BAA mandates the protections that the business associate must have in place before PHI can be shared with them. 
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How to Report a HIPAA Violation

How to Report a HIPAA Violation | HIPAA Compliance for Medical Practices | Scoop.it

It is important for all employees in the healthcare and healthcare insurance industries to understand what constitutes a HIPAA violation and how to report a HIPAA violation. Understanding what constitutes a HIPAA violation should be included in the Covered Entity´s HIPAA training, as should the correct person to direct the report to – who then has the responsibility to determine whether ot not the HIPAA violation should be reported to the Department of Health and Human Services’ Office for Civil Rights (OCR).

 

Potential HIPAA violations must be investigated internally by HIPAA Covered Entities and – where applicable – their Business Associates to determine the severity of the breach, the risk to individuals impacted by the incident, and to ensure action is taken promptly to correct the violation and mitigate risk.

 

The sooner a potential HIPAA violation is reported, the easier it will be to limit the potential harm that may be caused and to prevent further violations of HIPAA Rules.

Reporting HIPAA Violations Internally

When healthcare or insurance professionals suspect a violation of HIPAA has occurred, the incident should be reported to a supervisor, the organization’s Privacy Officer, or to the individual responsible for HIPAA compliance in the organization.

 

Accidental HIPAA violations occur even when great care is taken by employees. The HIPAA complaint will have to be investigated internally and a decision made about whether it is a reportable breach under provisions of the HIPAA Breach Notification Rule. Oftentimes, minor incidents are so inconsequential that they do not warrant notifications to be issued, such as when minor errors are made in good faith or if PHI has been disclosed and there is little risk of knowledge of PHI being retained.

 

If you have made a mistake, accidentally viewed PHI of a patient that you are not authorized to view, or another individual in your organization is suspected of violating HIPAA Rules, you should report HIPAA violations promptly. The failure to do so is likely to be viewed unfavorably if it is later discovered.

How to Report a HIPAA Violation to HHS’ Office for Civil Rights

It is also permitted for employees and patients to bypass notifying the covered entity and make a HIPAA complaint directly with OCR if it is believed that a Covered Entity has violated the HIPAA Privacy, Security, or Breach Notification Rules.

 

In all cases, serious violations of HIPAA rules including potential criminal violations, willful/widespread neglect of HIPAA Rules, and multiple suspected HIPAA violations should be reported to the Office for Civil Rights directly.

 

HIPAA complaints can be submitted via the OCR’s Complaint Portal online,  although OCR will also accept complaints via fax, mail, or email. Contact information for HIPAA violation reporting can be found on the above link.

 

In order for OCR to determine whether a violation is likely to have occurred, the reason for the HIPAA complaint should be written stated along with the potential violation. Information will need to be supplied about the covered entity (or business associate), the date when the HIPAA violation is suspected of occurring, the address where the violation occurred – if known, and when the complainant learned of the possible HIPAA violation.

 

Complaints should be submitted within 180 days of the violation being discovered, although in certain cases, an extension to the HIPAA violation reporting time limit may be granted if there is good cause.

 

While complaints can be submitted anonymously, it is important to bear in mind that OCR will not investigate any HIPAA complaint if a name and contact information is not supplied.

 

All complaints will be read and assessed, and investigations into HIPAA complaints will be launched if HIPAA Rules are suspected of being violated and the complaint is submitted inside the 180-day timeframe.

 

Not all HIPAA violations result settlements or civil monetary penalties. Oftentimes, the issue is resolved through voluntary compliance, technical guidance, or if the covered entity or business associate agrees to take corrective action.

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The HIPAA Privacy Rule and Provider to Provider Communications

The HIPAA Privacy Rule and Provider to Provider Communications | HIPAA Compliance for Medical Practices | Scoop.it

The HIPAA Privacy Rule allows for provider to provider communications – for providers that are part of a patient’s care team – to exchange clinical information, including protected health information (PHI) among each other. 

 

Circumstances under which provider to provider communications involving use and disclosure of PHI are addressed below.

When Are Provider to Provider Communications Permitted Under the HIPAA Privacy Rule?

Generally, under the HIPAA Privacy Rule, which imposes restrictions on the use and disclosure of PHI by covered entities (including healthcare providers), any pertinent clinical care information, including mental health treatment information, can be disclosed and discussed between a patient’s current treatment providers (that is, can be the subject of provider to provider communications) without written authorization by the patient, representative, or guardian, except for the content of written psychotherapy notes.

What Constitutes Psychotherapy Note Information?

The HIPAA Privacy Rule definition of a “psychotherapy note” is quite restrictive. Under HIPAA, psychotherapy notes consist of:

  • A mental health professional’s written analysis, of
  • A conversation that occurred, during
  • A private counseling session

The written analysis must be maintained separately from the medical record to qualify as “psychotherapy notes.”

 

Generally, patients do not have the right to obtain a copy of these under HIPAA. When a psychologist denies a patient access to these notes, generally, the denial is not subject to appeal or review.

 

A provider may, in the exercise of his or her discretion, choose to provide a copy of the patient’s psychotherapy notes to the patient, consistent with applicable state law.

The Privacy Rule does permit psychotherapy notes to be disclosed under very limited circumstances:

  1. A covered entity may disclose protected health information contained in psychotherapy notes to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death, or other duties as authorized by law. 
  2. A covered entity may use or disclose protected health information in psychotherapy notes to the extent that such use or disclosure is required by law and the use or disclosure complies with and is limited to the relevant requirements of such law.
  3. A covered entity may use or disclose psychotherapy notes for its own training programs in which students, trainees, or practitioners in mental health learn under supervision to practice or improve their skills in group, joint, family, or individual counseling.
  4. A covered entity may use or disclose psychotherapy notes to defend itself in a legal action or other proceeding brought by the patient.
  5. A covered entity may, consistent with applicable law and standards of ethical conduct, use or disclose psychotherapy notes, if the covered entity, in good faith, believes the use or disclosure:
    • Is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public; and
    • Is to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat.

 

A covered entity MUST disclose psychotherapy notes, when disclosure is required by the Secretary of Health and Human Services, to determine whether the entity is HIPAA compliant.

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PHI Protection: How to Secure Healthcare Data

PHI Protection: How to Secure Healthcare Data | HIPAA Compliance for Medical Practices | Scoop.it

Healthcare data breaches have been highlighted recently, with several large breaches occurring over the last few months. Hackers target the healthcare industry as they hold a wealth of sensitive information on their patients, and often have less secure data than in other industries.

 

Ransomware attacks continue to rise as healthcare organizations often need to pay the ransom to get their data back.

 

A ransomware attack occurs when a hacker gains access to data, often encrypting the data until a sum of money is paid.

 

A healthcare organization losing access to their data can mean a matter of life or death, so they often pay the hackers.

 

As protected health information (PHI) is ten times more valuable than financial information on the darkweb, it is important to know how to implement PHI protection. 

How to Implement PHI Protection

PHI protection is an essential part of preventing or mitigating a healthcare breach. The first step to implementing PHI protection is to know where the sensitive data is stored, how it is transmitted, and how it is used.

 

Identifying these will allows an organization to determine what protections should be in place for each device, enabling more thorough security measures to be implemented. 

In addition organizations should:

  • Complete a security risk assessment (SRA) to determine where security measures may be lacking. Once gaps are identified, organizations should create remediation plans to ensure PHI protection. To be HIPAA compliant, covered entities and business associates must conduct thorough SRAs annually.
  • Encrypt data to reduce the risk of healthcare breaches. Encrypted data cannot be viewed without a decryption key, making it the most effective for PHI protection. Although not explicitly mandated by the Department of Health and Human Services (HHS), it is recommended.
  • Train employees on organization policies and procedures as well as HIPAA requirements. The majority of healthcare breaches occur as a result of human error. Employees must be trained on what constitutes PHI, and how to properly handle it. Additionally, employees should be able to recognize phishing emails and what to do if they suspect an email is malicious.
  • Vet vendors by sending them an SRA to complete. Covered entities have an obligation to ensure that the vendors that they are working with have the proper measures in place for PHI protection. If the vendor lacks security measures, they must implement adequate safeguards before they are permitted to receive PHI.
  • Sign business associate agreements (BAAs) with all vendors before PHI is shared. BAAs limit the liability for both parties in the event of a breach as they state that each party has agreed to be HIPAA compliant, and they are responsible for their own compliance.

PHI protection should be a top priority for anyone working in healthcare. Healthcare organizations that have the proper security measures surrounding PHI will limit the risk of experiencing a breach.

 

If a breach should occur, an organization that has proper PHI protection will be better prepared to respond to the breach. 

 

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Is Zoom HIPAA Compliant?

Is Zoom HIPAA Compliant? | HIPAA Compliance for Medical Practices | Scoop.it

Is Zoom HIPAA Compliant?

The HIPAA Privacy Rule

Zoom provides remote conferencing services that combine video conferencing, online meetings, chat, and mobile collaboration. When using Zoom, healthcare providers share protected health information (PHI).

 

Zoom, since it performs functions that involve the use or disclosure of a covered entity’s protected health information (PHI), is regarded as a business associate of that covered entity.

 

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Under the HIPAA Privacy Rule, a healthcare provider must obtain satisfactory assurances from its business associate that the business associate will appropriately safeguard the protected health information it receives or creates on behalf of the covered entity.

 

Protected health information includes electronic protected health information (ePHI), which consists of any protected health information (PHI) that is created, stored, transmitted, or received in any electronic format or medium.

 

The satisfactory assurances that must be obtained, are set forth in a business associate agreement, which is a contract between a provider and a business associate – in this case, Zoom.

 

The contract must describe the permitted and required uses of protected health information by the business associate; provide that the business associate will not use or further disclose the protected health information other than as permitted or required by the contract or as required by law; and require the business associate to use appropriate safeguards to prevent a use or disclosure of the protected health information other than as provided for by the contract.

 

Zoom has stated that it is prepared to sign a business associate agreement with healthcare organizations.

 

Zoom also has taken steps to ensure its platform incorporates all of the necessary security controls to satisfy the HIPAA Security Rule.

Is Zoom HIPAA Compliant? The HIPAA Security Rule

To meet the requirements of the Security Rule, a video conferencing application such as Zoom must offer certain administrative, technical, and physical safeguards, to ensure the confidentiality, integrity, and availability of ePHI.  

 

The answer to the question of “Is Zoom HIPAA compliant” is “yes,” because Zoom meets the following required Security Rule measures:

  • Zoom contains authentication measures. Authentication consists of implementing procedures to verify that a person or entity seeking access to electronic protected health information is the person he or she claims to be. Zoom, on its website, indicates that it provides two common types of authentication:
    • OAuth 2.0, for authenticating a user context;  and 
    • JSON Web Tokens (JWT) for authenticating server-to-server apps. Zoom states on its website that JWT authentication is best used for transmitting data to and from Zoom between trusted services or servers.
  • Zoom contains access control measures. The Security Rule requires access controls. Access controls regulate who or what can view or use resources in a computing environment. Access controls are necessary so that only those with a legitimate need to access ePHI are given access to that ePHI.
  • Zoom uses end-to-end encryption to secure all communications. End-to-end encryption is necessary to ensure only the sender and recipient of an electronic message can read the content of that message. The setting “Require Encryption for 3rd Party Endpoints (H323/SIP)” is enabled for all members of an account, upon sign in.

Is Zoom HIPAA Compliant? Other Security Features

Upon signing a BAA with Zoom, the following security measures are enacted on a Zoom account:

  • Cloud Recording will be disabled.
  • Encrypted chat will be enabled.
  • The setting “Require Encryption for 3rd Party Endpoints (H323/SIP)” will be enabled for all members of an account.
  • Text messages will be encrypted.
  • Offline messages will only be available after all parties initiate a cryptographic key exchange.

 

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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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Telemedicine and HIPAA 

Telemedicine and HIPAA  | HIPAA Compliance for Medical Practices | Scoop.it

The digital age has presented numerous benefits for a variety of economic sectors with the health industry among the biggest winners.

 

From faster communication between patients and health professionals to better service delivery, health organizations have seen improvements in a variety of daily operations. Sadly, the digital age is a double-edged sword, and as more health organizations use the latest technology, there is the looming threat of poor data security.

 

Threats such as the WannaCry ransomware attacks, which have wreaked havoc on the economy to date, are a constant reminder that data security should be a priority for organizations looking to leverage advancements in technology.

 

For instance, while telemedicine promises improved service delivery, it introduces a security complexity.

 

HIPAA (Health Insurance Portability and Accountability Act) regulations have been a cornerstone for setting and raising the security standards in healthcare, and telemedicine might actually make it easier for health organizations to remain compliant.

 

At the same time, a lot has to be done to improve the security loopholes presented by such technologies.

 

Here are how HIPAA and Telemedicine fit with each other and the things that need to be done for better data security.

The Constant Threat Of A Data Breach

Data collected by health organizations can be a gold mine for most threat actors. Some of the Protected Health Information (PHI) data include personal addresses, names, medical history, identification numbers, and even credit card numbers.

 

In the wrong hands, these data can be used for identity theft, for buying medical supplies fraudulently, or even holding health data at ransom as in the case of WannaCry attacks.

 

The sad truth is that ePHI will be at the disposal of threat actors unless the right security controls are put into place.

 

First, unless internal organization systems are strong enough, it can be easy for hackers to gain access to networks or even user accounts.

 

In some cases, they may only need to access a low-level user account before escalating their privileges. Second, when it comes to third party business stakeholders, failing to pick security-concerned partners will easily lead to data breaches.

 

Lastly, insider threats continue to be a risk. If access control isn’t a staple of a health organization’s security system, it can be easy for a disgruntled employee to offer this data out to threat actors.

 

All these are concerns that can be handled by HIPAA compliance, and embracing telemedicine with HIPAA compliance at the back of your mind is a step in the right direction.

How Telemedicine Has Revolutionized The Health Sector

In a nutshell, telemedicine has made the transfer of medical data at a distant quite easy. Diagnoses, medical history, lab tests, and prescriptions can be transferred more easily and cheaper than normal.

 

It also saves the costs of having to transfer patients from their homes to hospitals for diagnoses that could easily be done via video calls.

The HIPAA Rules That Affect Telemedicine

The HIPAA guidelines cover more than the patients and doctors communicating ePHI at a distance. It deals with the communications channels and any third party involved in the communication process. Ideally, for telemedicine to be compliant with HIPAA, the parties involved need to comply with these security rules:

  • Ensure that only the authorized parties gain access to ePHI
  • The channels of communication used to communicate ePHI at a distance ought to be secure enough to the standards of HIPAA.
  • There needs to be a system in place for monitoring the different communications containing ePHI to prevent the chances of accidental or malicious data breaches.

As long as physicians have effective safeguards in place for addressing access control, the first bullet point should be easy to comply with. As for the second point, insecure channels such as email, Skype, and SMS are eliminated from ever being used. Lastly, the onus is upon those in charge of the ePHI technology to ensure that there are systems in place that can help monitor communication and facilitate the deletion of unused data if the need arises. Both of the last points also look to address issues relating to where ePHI is stored.

Why Conventional Communication Channels Might Not Suffice

If the ePHI created by a physician (covered entity) is stored by a third party, the third-party and the covered entity have to sign a Business Associate Agreement (BAA).

 

The BAA ought to include details about the methods the third party will use to secure the data and procedures for auditing the data’s security in accordance with the HIPAA guidelines.

 

Since the copies of ePHI are bound to remain in the servers of conventional communication firms, such as Google, Verizon, and Skype, the covered entities ought to have a BAA with such bodies to remain compliant with HIPAA. Sadly, Verizon, Google, and Skype might not enter into such BAAs, meaning that the covered entities will remain liable for fines for any breaches that occur from the lack of HIPAA compliance by these third-party entities.

 

The covered entities, telemedicine providers, might also fail HIPAA audits.

Aligning Compliance And Telemedicine

The ideal messaging solution should be secure. It should also offer the same communication speed as Skype, SMS, or email, while also complying with the HIPAA security rule. This means that only authorized users should be allowed to access ePHI, the communication channel should be secure, and it should be fairly easy to monitor the activity on the channel.

 

The channels of communication should also be user-friendly enough for both patients and physicians to use during interactions.

 

Each authorized user can gain access to the channel through a centrally-issued username and password, which allows them to communicate with other users within the private communication network of the covered entity.

 

The channel should allow all types of communications, including images, documents, and videos. These media should be encrypted both while in transit and at rest. As for monitoring the communication, the messages should be monitored through a cloud-based platform to ensure secure messaging policies are adhered to according to HIPAA rules.

Telemedicine Makes HIPAA Compliance Easier

While this might seem hard to believe, telemedicine might actually make compliance to HIPAA easier for health entities. Unlike convention medical services that had to introduce HIPAA compliance as an afterthought, telemedicine can be crafted with HIPAA compliance at the center of it all.

 

As such, any applications and technologies used in the communication of ePHI at a distance can leverage the latest technological advancements and data security practices.

 

These can include multiple data encryption methodologies and even comprehensive system testing. Any partnerships with third-party vendors will also be based on whether they can have a sustainable BAA with them or not.

 

Telemedicine presents too big an opportunity to be ignored. Even better, the HIPAA guidelines can act as a baseline for security standards for health organizations looking to embrace telemedicine. Since it is easy to be compliant, keen organizations can enjoy its perks without fearing costly fines.

 
 
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