HIPAA’s New Rules for 2013 – Are You Impacted?

Good write-up by Varonis discussing the finalized regulatory rules for HIPAA:

What has changed

With the finalized rules (which by the way run over 500 pages) not only do business associates come under HIPAA, but a new class of consultants and subcontractors who perform workon behalf of the business associates also have HIPAA obligations.

In effect, the final rules say that any company that has access to e-PHI is treated just like a hospital or HMO. By the way, HIPAA/HITECH’s Breach Notification Rule, which originally required health companies and their business associates to report e-PHI disclosures, is now extended to medical data subcontractors as well.

The ultimate intent is to close off any holes in security and enforcement when the business associates themselves outsource data processing to others.

Read entire article: http://blog.varonis.com/hipaas-new-rules-reach-far-beyond-healthcare-providers-are-you-impacted/

After 2.5 years, HHS finally finalizes modifications to HIPAA rules

Excellent and detailed write-up of the new HIPAA rules that take effect on September 23, 2013:

On January 17, 2013, the U.S. Department of Health and Human Services (“HHS”) issued the highly anticipated omnibus final rule (the “Final Rule”) to modify the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) pursuant to the Health Information Technology for Economic and Clinical Health Act (“HITECH”). Following the enactment of HITECH, HHS issued interim final rules to implement the breach notification requirements and certain of the enforcement provisions of HITECH (collectively, the “Interim Rules”), and in July of 2010 HHS issued a proposed rule to implement modifications to the privacy and security provisions of HIPAA. Since that time, Covered Entities and their Business Associates and subcontractors have been awaiting the Final Rule to confirm the extent to which these modifications, which are aimed primarily at strengthening the privacy and security protections for protected health information (“PHI”) and tightening the HIPAA enforcement provisions, will impact their operations, contractual relationships and potential exposure for HIPAA liability.

Read all the gory details here: http://www.lexology.com/library/detail.aspx?g=40defc09-2337-435e-be56-2bef662a67e7

10 Affordable Health Care Act changes to be aware of for 2013

2013 HIPAA ChecklistWith 2013 right around the corner, you should be aware of the following 10 items for your checklist to make sure you’re ready for the Affordable Health Care Act.

Effective in 2013:

The following list itemizes the changes that generally will become effective in 2013.  The effective date depends upon a number of factors, including whether the health plan is grandfathered, the first day of the plan year, and the number of employees.

  • Women’s Preventive Health Care Mandates               
    Applicable To: Non-grandfathered plans only
    Effective:        Plan years beginning on or after August 1, 2012 (January 1, 2013 for calendar year plan years)
    Details:           Plans are required to provide in-network coverage with no cost sharing for preventive care such as coverage for contraceptives, contraceptive counseling, breastfeeding support, supplies and counseling, and screening for domestic violence.
  • Reduction in the Maximum Employee Contributions to a Health Flexible Spending Accounts
    Applicable To: Only health flexible spending accounts (generally offered under a cafeteria plan)
    Effective:        January 1, 2013 for calendar year plan years
    Details:           The maximum amount that an employee can contribute to a health flexible spending account on a pre-tax basis cannot exceed $2,500 per taxable year.  While the reduced limit is effective January 1, 2013 (or the first day of the plan year beginning after January 1, 2013 for plans with fiscal years), employers have until December 31, 2014, to adopt amendments to reflect this reduced limit.
  • Annual Benefit Limits
    Applicable To: Health plans other than health flexible spending accounts, health reimbursement accounts, and medical savings accounts
    Effective:        Generally only for the 2013 plan year (see below for changes in 2014)
    Details:           The annual limit on the dollar value of essential health benefits cannot be less than $2 million.
  • Reporting the Cost of Group Health Insurance Coverage on Forms W-2
    Applicable To: Employers that issued at least 250 Forms W-2 for 2012 (transition relief applies to exclude employers that issued fewer than 250 Forms W-2 for 2012, and certain types of plans)
    Effective:        For the 2012 W-2s to be issued by January 31, 2013
    Details:           The Forms W-2 issued by employers in early 2013 must report the value of any health coverage provided to each employee in 2012, regardless of who pays the premium for that coverage.  Employers should take steps to ensure that payroll departments or payroll providers are prepared for the new reporting requirement.
  • Summary of Benefits and Coverage and Notices of Material Modification
    Effective:          For open enrollment periods beginning on or after September 23, 2012 and for plan years beginning after that date
    Details:             Employer health plans must provide a Summary of Benefits and Coverage (SBC) to all plan participants, as well as to all employees who are eligible to participate.  If the employer makes a mid-year change in the plan provisions that would change the terms of the SBC, the plan also must provide a Notice of Material Modifications at least 60 days before the change takes effect.
  • Additional Medicare Tax Withholding
    Effective:          January 1, 2013
    Details:             An employer is required to withhold an additional 0.9% Medicare tax on an employee’s compensation in excess of $200,000.  The additional tax does not have an employer matching requirement.
  • Notice of Exchange Availability
    Applicable To: Employers subject to the Fair Labor Standards Act
    Effective:        Required by March 1, 2013
    Details:           Employers must provide a notice to employees concerning the availability of health coverage through the state-wide exchanges.  The notices will explain some of the benefits and consequences to employees if they choose to purchase a qualified health plan through the state exchange instead of electing coverage under an employer-sponsored health plan.  Employers are still waiting for additional guidance regarding these requirements, and some are predicting that this requirement may be postponed.
  • Taxation of the Retiree Drug Subsidy
    Effective:          January 1, 2013
    Details:             Employers who were providing retirees with prescription drug coverage that was generous enough to qualify for a federal tax subsidy will no longer be allowed to deduct all of those expenses.
  • Patient-Centered Outcomes Research Comparative Effectiveness Fee
    Applicable To: Plan sponsors maintaining a self-insured plan (insurers will pay this for fully-insured plans)
    Effective:        First payment is due by July 31, 2013
    Details:           Plan sponsors must begin to pay a fee (the “PCORI Fee”) to the Internal Revenue Service per average covered life ($1 for the first year, $2 for the second year, and increased as permitted in future years) per plan using Form 720.  These fees will be used to fund the new nonprofit corporation, the Patient-Centered Outcomes Research Institute, to support clinical effective ness research.  Some rules permit the limited aggregation of  plans.
  • Certification of Compliance to Health and Human Services (HHS)
    Effective:          By December 31, 2013
    Details:             Group health plans must file a certification statement with HHS certifying that their data and information systems for the plan are in compliance with the HIPAA standards and operating rules for health plan eligibility, electronic funds transfer, health claim status, health care payments, and remittance advice transactions.

 

Read more here, including 2014 preparedness items:
http://www.jdsupra.com/legalnews/2013-and-2014-under-the-affordable-care-00701/

5 Interesting HIPAA & HITECH Rule YouTube Videos

Need a refresher of some of the differences that HITECH brought to the HIPAA landscape? Check out the videos below.

Privacy & Security: The New HIPAA Rule

HIPAA Privacy, Security, and the HITECH Act

HITECH ACT – 2010 Changes in HIPAA Law

HITECH Act and Encryption in 5 Minutes

Information Security Program and HIPAA Compliance

Celebrate Earth Day 2011 with eco-friendly digital HIPAA reference materials

Here are the top 5 highest rated HIPAA books on Amazon that are available in earth-friendly digital Kindle format.  We thought it would be good to celebrate Earth Day by sharing these with you, and encouraging everyone who hasn’t gone paperless yet to consider doing so. Note that in most cases, buying the book in Kindle format is cheaper than buying the same book in print form. Handy tip for saving money, or justifying the cost of a Kindle if you don’t already have one!

#1: Practical Guide to HIPAA Privacy and Security Compliance

Practical Guide to HIPAA Privacy and Security Compliance

496 pages

Description:

This book is a one-stop resource for HIPAA privacy and security advice that can immediately be applied to any organization’s unique situation. It defines what HIPAA is, what it requires, and what can be done to achieve and maintain compliance. It describes the HIPAA Privacy and Security Rules and compliance tasks in easy-to-understand language, focusing not on technical jargon, but on what organizations need to do to meet requirements. Anyone preparing an organization for HIPAA laws will receive expert guidance on requirements and other commonly-discussed topics. The book enables organizations determine how HIPAA will impact them, regardless of whether they are a HIPAA Covered Entity.

#2: PKI Security Solutions for the Enterprise: Solving HIPAA, E-Paper Act, and Other Compliance Issues

PKI Security Solutions for the Enterprise: Solving HIPAA, E-Paper Act, and Other Compliance Issues

336 pages

Description:

  • Outlines cost-effective, bottom-line solutions that show how companies can protect transactions over the Internet using PKI
  • First book to explain how PKI (Public Key Infrastructure) is used by companies to comply with the HIPAA (Health Insurance Portability and Accountability Act) rules mandated by the U.S. Department of Labor, Health, and Human Services
  • Illustrates how to use PKI for important business solutions with the help of detailed case studies in health care, financial, government, and consumer industries

#3: A Guide to HIPAA Security and the Law

A Guide to HIPAA Security and the Law

372 pages

Description:

This publication discusses the HIPAA Security Rule’s role in the broader context of HIPAA and its other regulations, and provides useful guidance for implementing HIPAA security. At the heart of this publication is a detailed section-by-section analysis of each security topic covered in the Security Rule. This publication also covers the risks of non-compliance by describing the applicable enforcement mechanisms that apply and the prospects for litigation relating to HIPAA security.

#4: The Clinical Documentation Sourcebook: The Complete Paperwork Resource for Your Mental Health Practice

The Clinical Documentation Sourcebook: The Complete Paperwork Resource for Your Mental Health Practice

336 pages

Description:

The paperwork required when providing mental health services in the current era of third-party accountability can be quite daunting. The sourcebook is designed to help clinicians provide this documentation in a form that satisfies managed care requirements and maximizes prospects for approval of payments. Includes ready-to-use sample forms that meet the documentation requirements of virtually every managed care organization. The sourcebook also provides properly completed examples of each form, as well as a computer disk which contains word-processing versions of every form in the book.

#5: HIPAA Survival Guide for Providers: Privacy, Security and the HITECH Act

HIPAA Survival Guide for Providers: Privacy, Security and the HITECH Act

Description:

The HIPAA Survival Guide attempts a “forest from the trees” overview of the HIPAA Privacy and Security rules, and also includes a general overview of the HITECH Act as it pertains to these rules. The genesis of these rules is covered in the Background section. The HIPAA Survival Guide only targets a subset of covered entities, namely healthcare providers, focusing mostly on small providers, since this group will clearly be the most challenged by new laws and regulations.

The Third Edition of the HIPAA Survival Guide updates various substantive text of the first two editions and adds completely new material. The HITECH Act has indeed proven to be transformational. In order to deal more effectively with its changing regulatory landscape we have decided to release an updated version available on Amazon’s Kindle.

BONUS #6 – YES, IT’S A HIPAA ROMANCE NOVEL — HIPAA Hysteria

We’re really not sure how good this could be, but cmon — a steamy romantic novel set in the wild world of HIPAA compliance? Yes please!

HIPAA Hysteria

Description:

Is it a romantic comedy? Yes! Is it a legal thriller? Yes!

Margaret Nicks, a new graduate with a couple of degrees in health information management, becomes the Acting Director of Health Information Management at a hospital when the Director suffers a stroke. She quickly finds out that her new duty of getting the hospital HIPAA compliant won’t be easy. But she hires a consultant that she had met at a Cross Country seminar. Follow their struggles with the hospital doctors, staff, and administration to get them into compliance. They are attracted to each other, but legal ethics prevents him from dating her. After the compliance date, a hospital employee commits identity theft and blames it on the hospital’s failure to enforce HIPAA. Management tries to hang Margaret out to dry to save the hospital administrator and the governing board from liability. The U.S. Attorney indicts her under the theory of corporate criminal liability. So she hires the consultant, who is also an experienced defense attorney. Can he keep her out of federal prison? Will they end up an item after she is no longer his client?

Don’t have a Kindle yet? Get one at a discounted price on Amazon here.

Maryland’s Cignet Health Hit with $4.3 Million Fine for HIPAA Violations

The Obama administration has promised to be tougher when it comes to enforcing HIPAA laws. This week a Maryland health service company gained the dubious honor of being the first company or entity to be assessed a Department of Health and Human Services CMP – Civil Money Penalty. And with that penalty assessed at $4.3 million, obviously this should be a sign to all connected with HIPAA transactions that yes, this administration does mean business.

Cignet Health failed to honor the access to medical records requests of 41 of their patients between September 2008 and October of 2009. The company’s failure to cooperate with the subsequent investigation by HHS OCR (Office of Civil Rights) officials earned them another $3 million in fines at the end of the day. According to the official press release about the matter it was the HHS’s position that Cignet had displayed a willful neglect to the basic privacy rules laid down by HIPAA.

“Ensuring that Americans’ health information privacy is protected is vital to our health care system and a priority of this administration,” Health and Human Services Secretary Kathleen Sebelius said in a statement.

Common Misconceptions About HIPAA Heard at Smaller Medical Faculties

If you are a fully trained HIPAA professional whose day to day existence revolves around maintaining compliance this post is not for you. If on the other hand you are a busy member of staff at a doctors office or other smaller medical facility it probably is, since even after all these years there is still a huge amount of confusion about what does and does not constitute a HIPAA violation. Here are some of the most common myths about HIPAA compliance that are heard in medical facilities across the country over and over again:

HIPAA only regulates electronically transmitted data – Oh if only it were so, the life of a HIPPA compliance officer (and anyone else in the medical field) would be so much easier. But no, HIPAA applies to all forms of communication: written, verbal and any form of electronic transmission, including personal e mail notes and social networking posts.

If improperly released information is not exploited, there is no violation of the law – In many of the cases of improperly released PI that have hit the headlines over the last several years no one had any way of telling how and if patient data had been been exploited after the release of information but they still got hit with the big fines and penalties. It is the act of improperly releasing the information that is the violation.

Dentists, optometrists, nurses, and pharmacists are exempted from HIPAA regulations – We actually heard this one – from an individual employed in one of the aforementioned professions -and were flabbergasted. HIPAA governs anyone and everyone who creates or handles patient records – right down to the high school kid who works part time filing charts. Hopefully the professional who was under this misguided impression has now taken a serious crash course in HIPAA compliance.

Little HIPAA violations don’t matter, no one will ever find out – This is unfortunately the mentality of many employees in smaller medical offices. In fact though all it takes is one patient complaint and the whole office will be under serious scrutiny. And just as a reminder, the maximum fines and penalties for failure to comply with the HIPAA laws are $250,000 and 10 years imprisonment. Not to mention the damage the resultant inevitable bad publicity will have on any practice in both the short and the long term.

HIPPA Violations Scarier than Surgical Fires?

Wonder just how worried hospital administrators are about potential HIPAA breeches due to IT failure and mistakes? According to a poll taken and published by Healthcare IT News worried enough to put IT failures at number five on their Top Ten list of general technology hazards an institution might face.

According to that report the prospect of a data disaster that leads to a costly HIPPA breech is scarier than luer mis connections, over sedation, needle sticks, surgical fires and defibrillator failures.

Is this a bit of an over reaction? Surgical fires and needle sticks sound a lot more serious than data loss. However given the increasing number of HIPPA violations reported around the country in 2010 and in many cases the costly fines and horrendous publicity that came with them make this kind of concern understandable.

Some of these violations would never have been prevented by even the most sophisticated of IT security systems though. Take the recent reports about a physician who transmitted a great deal of personal patient information via email to his home in a completely insecure and unencrypted manner.

There was no malice involved, the man was merely trying to have the information at hand to review properly at the end of his long day. The story though highlighted the continuing need for the education of everyone who handles PI in what is and is not allowable under the HIPPA rules and regulations.

Happy New Year! Great HIPAA Jobs for 2011

The New Year is right around the corner and most of us will be thinking, as we do every year, about changing a few things in keeping with the spirit of the season. If one of those things is finding a better job in the HIPAA field we have done some of the work for you, finding once again some of the best opportunities out there.

Attorney -Group Health Insurance/HIPAA Job

Location: New Jersey

This Part-Time Attorney position will support Insurance Services daily legal needs including: carrier contract negotiations, HIPAA advice, Group Health and Workman’s comp Insurance advice and review of Business Associate Agreements and associated issues, assist in resolution of client issues, support insurance regulatory compliance processes and procedures, support product development with insurance regulatory reviews. Provide general business guidance as it relates to insurance regulatory and compliance matters. Advise on HIPAA compliance and update evolving policies and procedures as needed to maintain compliance with HIPAA.

Learn more about this HIPPA job here

Clinical Information Project Manager

Company: Sanford Health

Location: Sioux Falls, SD

The Project Manager will gather, analyze, design, develop, modify, test, implements evaluates, and maintain clinical information handling technologies: That collect data to support clinical practice That use data to support clinical decision-making That provide for identification of outcomes To develop plans for achieving identified outcomes To assist and document testing, training, activation and implementation of the plan To provide for outcome measurement and evaluation To communicate project progress and outcomes to appropriate health system departments & personnel. These job duties will be carried out using a high level of customer service while promoting and participating in the team approach

Apply for this opportunity here

Director of Compliance and HIPAA Officer

Company:Berger Health System

Location:Circleville, OH US

The Director of Compliance/HIPAA Officer oversees the Corporate Compliance Program, functioning as an independent and objective body that reviews and evaluates compliance issues/concerns within the organization and serves as the HIPAA Officer for Berger Health System and its entities. The position ensures the Board of Governors, management and employees are in compliance with the rules and regulations of regulatory agencies, that organization policies and procedures are being followed, and that behavior in the organization meets the organization’s Code of Conduct. This person will also assure that processes, policies, documentation and training are in place for full HIPAA compliance.

Learn more about this position here

Patient Accounting Analyst – HIPAA 5010 compliance Specialist

Company :CyberCoders Engineering

Location:Chicago, IL US

What you need for this position:
• In-Depth understanding of Patient Accounting
• EDI experience including ICD-10-CM and ICD-10-PCS
• Expert knowledge of Implementation Guides for HIPAA 5010
• ASC X12 affiliations, work group involvement, and network of other EDI experts
• Familiarity with multiple patient accounting systems (such as MedSeries4, Meditech, Invision, Epic Resolute, Affinity, GE Flowcast, or Allscripts)
• Available for Travel Monday through Thursday

To apply for this position click here

HIPAA Compliance Program Manager

Company: First Solution USA

Location: New London, CT

Our client, located near the Connecticut shore offers a full-time, direct hire, permanent job opportunity. Highly visible leadership role with hospital seeking a Program Manager to ensure compliance with all aspects of the Health Insurance Portability and Accountability Act (HIPAA), including but not limited to all current rules and regulations that have been instituted since the original act was instituted in 1996. The position requires development of a formal program that will ensure rapid implementation of new rules and regulations throughout the corporation, as well as ongoing activities that ensures this hospital is maintaining its compliance with all rules and regulations and actively working to reduce or to eliminate its exposure and risk in areas of non-compliance.
Reporting to the Vice President/General Counsel, you will influence, recommend and provide guidance and counsel to all leaders and staff within the hospital on HIPAA related matters.

To apply for this position click here

How Safe Is the Data in my EHR and Practice Management System?

Dr. Sharham Famorzadeh, Nuesoft’s Chief Technology Officer, explains the security benefits of medical practice management systems that run in the cloud, and addresses common concerns related to cloud computing. Do you agree? would you consider a cloud based practice management system?