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You are here: Home / Archives for topics / HIPAA
COMPLIANCE

Fraud recoveries grow as feds target telemedicine and COVID-19 add-on test scams

August 8, 2021 by

Despite the COVID-19 pandemic and continued sequestration of enforcement funds, the federal Health Care Fraud and Abuse Control Program (Program) reversed recent trends and recovered more money in FY 2020 than it had the year before. In fact, recoveries for the year reached nearly $3.1 billion, the highest return since 2016. Here’s a briefing for medical office managers on the July 14 OIG report and what it says about the current state of federal health care fraud enforcement. ROI increases for second year in a row The Program was created as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) under the joint direction of the Attorney General and HHS Secretary, acting through the OIG, to coordinate federal, state and local law health care fraud and abuse… . . . read more.

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CYBERSECURITY

Healthcare data breaches hit a new high in first half of 2021

August 8, 2021 by

While healthcare data breaches have become an all-too-common occurrence, the problem seems to be getting worse. According to the HHS’ Office for Civil Rights (OCR), there have already been 360 federally reported data breaches involving health information in the first half of 2021, the highest total for the first six months of a year since the government began tracking this data over a decade ago. Protected health information of nearly 23 million patients have been exposed as a result of this breach-fest. By comparison, there were 270 reported breaches involving 8 million patients in all of 2020. The breaches are getting bigger  The OCR tracks breaches across all industries. But, as in past years, healthcare was the number one culprit in the first half of 2021, accounting for 162, or… . . . read more.

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HIPAA

Could your organization’s website reveal your HIPAA non-compliance?

July 8, 2021 by

By Danika Brinda Did you know that your organization’s website can reveal to the world that you are out of compliance with HIPAA? A quick look at your organization’s website could reveal to a HIPAA auditor that your organization is struggling with HIPAA compliance. Wondering what I am referring to? The Notice of Privacy Practices! The regulations state that your organization must ensure that the most current version of your Notice of Privacy Practices is posted on the organization’s website (if one exists). Here is the specific language of the regulations: CFR 164.520(c)(3)(i) – A covered entity that maintains a website that provides information about the covered entity’s customer services or benefits must prominently post its notice (of privacy practices) on their website and make the notice available electronically through their website. Go… . . . read more.

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COMPLIANCE

New HHS policy makes your office potentially liable for LGBTQ discrimination

May 24, 2021 by

While it doesn’t directly relate to billing and reimbursement, federal civil rights laws have an impact on certain aspects of healthcare operations. These laws ban your office from discriminating on the basis of protected personal characteristics, including sex. So, compliance managers need to be aware that on May 10, the Department of Health and Human Services (HHS) issued an important bulletin affecting how the ban on sex discrimination will be enforced from now. Specifically, sex discrimination will go beyond just a person’s sex or gender but also their sexual orientation and/or gender identity. Here’s a rundown of the law and how it might affect your operations. Federal Discrimination Law, 101 The U.S. Civil Rights Act of 1964 makes it illegal to discriminate in different aspects of public activity, including employment and… . . . read more.

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HIPAA

New OCR data shed light on the costs of privacy noncompliance

May 2, 2021 by

HIPAA enforcement isn’t nearly as fat a cash cow as enforcement of False Claims Act (FCA) and other healthcare fraud laws is, it still takes a lot of money out of the pockets of providers and into the hands of the federal government. But tracking the economics of HIPAA enforcement is tough because the government doesn’t publish data on HIPAA recovery amounts the way it does with the FCA. However, new data from the HHS Office of Civil Rights (OCR) has recently emerged that offers some rare insight into the dollars and cents of HIPAA enforcement over the past two decades. Here are some of the key figures, which encompass April 2003, when HIPAA first began being enforced, through 2020: $129,722,482: Total amount of civil penalties and settlements collected by… . . . read more.

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COMPLIANCE

What medical office managers need to know about HIPAA

February 13, 2021 by

By Jordan MacAvoy bio The Health Information Portability and Protection Act (HIPAA) was enacted in 1996. The regulation stipulates standards that healthcare organizations and vendors must adhere to when it comes to patients’ protected health information (PHI). HIPAA-beholden organizations must secure their PHI for them to gain compliance status. Healthcare organizations and their vendors must appoint a HIPAA manager to oversee the implementation of the compliance program. If your organization has any HIPAA obligations and you get selected for this role, you should be aware of those regulations and what they mean to your business. Here’s what you should know as an office manager. Who are the covered entities? “Covered entities” refer to health insurers, healthcare providers, and any other professional individuals/organizations that handle patients’ medical information in the course… . . . read more.

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Telecommuting

Cybersecurity risks rise when medical admin staff work from home

February 12, 2021 by

By Ron Slyker The number of people who work from home has slowly increased from year to year. In 2020 that number skyrocketed as companies including medical offices were forced to implement telecommuting policies. Making the transition from traditional office to home office has brought some challenges, but arguably the most challenging aspect of the process has been maintaining cybersecurity. Now in 2021 the need for remote worker security is more important than ever. Keep yourself safe with network security assessments Employees who work from home are more susceptible to cyber threats than employees who work in the office. The reason is businesses can afford enterprise-level cybersecurity services. The average home not only does not have access to this level of security but may also lack basic security measures. When working from… . . . read more.

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MEDICAL RECORDS

5 lessons learned From 5 HIPAA fines in one day

December 14, 2020 by

By Danika Brinda bio The Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) hit a new record on Sept. 15, 2020—five HIPAA Fines with Corrective Action Plans in one day. The fines and corrective action plans had one main theme in common—not supplying patients with a copy of requested medical records in a timely fashion. The other thing of note from the action of the OCR is that these were not large multi-million dollar fines that are based on data breaches. These were fines that ranged from $3,500–$70,000 and were all based on a patient making a complaint to the federal government, which upon investigation, lead to the findings of noncompliance with HIPAA and patient’s rights defined by HIPAA. 5 lessons learned: Patients have a right… . . . read more.

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COMPLIANCE

How to create a legally sound COVID-19 medical screening policy

October 16, 2020 by

 As essential workplaces, medical offices need to remain open and operating during the pandemic. At the same time, they need to ensure that employees practice social distancing and keep the infected and potentially infected away from the well. Like so many other companies facing the same challenge, you may be considering medically screening your employees each day before letting them into the workplace. While screening is highly problematic in normal times, regulators have grudgingly acknowledged that it may be a justified health and safety measure during the pandemic. The operative phrase is “may be,” which means that limits still apply. As office manager, you need to recognize and ensure keep your facility in compliance with those limits. Here’s how. Three ways COVID-19 screening can get your office into legal hot… . . . read more.

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CORONAVIRUS

AMA puts out telemedicine guide

April 22, 2020 by

The American Medical Association (AMA) has compiled a guide to help physicians get telemedicine up and running so they can safely care for patients. The telemedicine quick guide outlines the first steps to get started and lays out key considerations to implementing telemedicine and explains policy, coding and payment. Even if your practice didn’t use telemedicine before, it may be an option now. Federal government agencies temporarily relaxed certain federal privacy regulations during the COVID-19 crisis and expanded payment policies. For example, the Centers for Medicare & Medicaid Services (CMS) is letting physicians provide beneficiaries a wider range of health care services without having to visit a health care facility. This CMS fact sheet explains more. Also, the Health and Human Services (HHS) Inspector General is waiving Medicare’s cost-sharing requirements for COVID-19 treatment delivered via telehealth from a doctor’s office or hospital emergency department. Learn more with… . . . read more.

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