HIPAA AUDITS COMING IN 2015

January 6, 2015 at 1:42 pm | Posted in Department of Public Health, ePHI, Health and Human Services, HIPAA | Leave a comment
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The Office of Civil Rights  in the Department of Health and Human Services has announced that, among other entities such as healthcare providers, it will audit approximately 100 employer sponsored health plans and 50 business associates in 2015. It is reported that:

  • Covered entities and business associates will have two weeks following receipt to respond to the initial data requests. OCR will not consider data submitted late.
  • OCR will conduct audits remotely through “desk audits.” Desk audits will be made using an updated audit protocol which OCR has not yet made available.
  • Audit participants will not have an opportunity to provide clarifications or supplemental information after responding to the initial data request.

Within 60 days following their submissions, audit participants will be presented with a draft version of OCR’s final report for review prior to publication. If your health plan has access to an employee’s protected health information (PHI), at a minimum, the following should be done:

  • Adopt written HIPAA policies and procedures addressing the HIPAA privacy, security, and breach notification rules;
  • Designate a HIPAA privacy official and a HIPAA security official;
  • Conduct a detailed analysis of the risks and vulnerabilities of electronic PHI;
  • Train those members of your workforce who have access to PHI.
  • Identify any HIPAA Business Associates, make sure you have a HIPAA Business Associate agreement with them and alert them to your expectations of them in regards to safekeeping your plan’s PHI

 

 

HHS Provides Guidance on HIPAA Privacy Rule and Same Sex Marriages

September 18, 2014 at 8:57 am | Posted in Defense of Marriage Act (DOMA), HIPAA, Marriage, Same Sex Marriage | Leave a comment
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On September 17th HHS formally announced that in light of the Supreme court’s decision in United States v. Windsor. HIPAA privacy protection rights and privileges were expanded to same sex married couples regardless of where they live. The announcement follows:

The HIPAA Privacy Rule contains several provisions that recognize the integral role that family members, such as spouses, often play in a patient’s health care.  For example, the Privacy Rule allows covered entities to share information about the patient’s care with family members in various circumstances.  In addition, the Privacy Rule provides protections against the use of genetic information about an individual, which includes certain information about family members of the individual, for underwriting purposes.  This guidance addresses the effect of the 2013 Supreme Court decision regarding the Defense of Marriage Act (DOMA) on these provisions.

In United States v. Windsor, the Supreme Court held section 3 of DOMA to be unconstitutional. Section 3 of DOMA had provided that federal law would recognize only opposite-sex marriages.  In light of the Windsor ruling, covered entities (and business associates, as applicable) must consider the following regarding lawfully married same-sex spouses and same-sex marriage.

At 45 CFR 160.103, the Privacy Rule includes the terms spouse and marriage in the definition of family member.  Consistent with the Windsor decision, the term spouse includes individuals who are in a legally valid same-sex marriage sanctioned by a state, territory, or foreign jurisdiction (as long as, as to marriages performed in a foreign jurisdiction, a U.S. jurisdiction would also recognize the marriage).  The term marriage includes both same-sex and opposite-sex marriages, and family member includes dependents of those marriages.  All of these terms apply to individuals who are legally married, whether or not they live or receive services in a jurisdiction that recognizes their marriage.

  • The definition of a family member is relevant to the application of §164.510(b) Standard: Uses and disclosures for involvement in the individual’s care and notification purposes.  Under certain circumstances, covered entities are permitted to share an individual’s protected health information with a family member of the individual.  Legally married same-sex spouses, regardless of where they live, are family members for the purposes of applying this provision.
  • The definition of a family member is also relevant to the application of §164.502(a)(5)(i), Use and disclosure of genetic information for underwriting purposes.  This provision prohibits health plans, other than issuers of long-term care policies, from using or disclosing genetic information for underwriting purposes. For example, such plans may not use information regarding the genetic tests of a family member of the individual, or the manifestation of a disease or disorder in a family member of the individual, in making underwriting decisions about the individual.  This includes the genetic tests of a same-sex spouse of the individual, or the manifestation of a disease or disorder in the same-sex spouse of the individual.

This guidance was developed to assist covered entities in understanding how the Windsor decision may affect certain of their Privacy Rule obligations.  In the coming months, the Office of Civil Rights (OCR) intends to issue additional clarifications through guidance or to initiate rulemaking to address same-sex spouses as personal representatives under the Privacy Rule.

Failure to Secure PHI and Two Stolen Laptops Results in $1,975,220 in HIPAA Violation Fines

April 23, 2014 at 1:25 pm | Posted in Compliance, ePHI, Health and Human Services, HIPAA, Regulations | Leave a comment
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The HHS Office of Civil Rights (OCR) announced that is has levied $1,975,220 in HIPAA fines against Concentra Health Services and QCA Health Plan Inc. for their failure to encrypt PHI stored on two laptops that were stolen.

Both Concentra and QCA, who self reported the stolen laptops, had undergone a HIPAA risk analysis and were aware…but did nothing…to secure the PHI stored on the laptops. The Concentra laptop was stolen from an employee’s office. The QCA laptop was stolen from an employee’s car. Concentra was fined $1,725,220 and QCA was fined $250,000.

“Covered entities and business associates must understand that mobile device security is their obligation,” said Susan McAndrew, OCR’s deputy director of health information privacy. “Our message to these organizations is simple: encryption is your best defense against these incidents.”

A copy of the HHS OCR press release is here:
http://www.hhs.gov/news/press/2014pres/04/20140422b.html

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