All Posts Tagged: hipaa compliance los angeles

small hipaa violations

Small HIPAA Violations Can Cause BIG Problems

The large data breaches that compromise the protected health information (PHI) of thousands of people are the ones that receive all the attention, but the smaller violations of the Health Insurance Portability and Accountability Act (HIPAA) can be just as harmful, if not more so, to those involved. Healthcare leaders too often devote most of their attention to the large breaches and not enough to the more common, smaller violations, experts say.

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ransomware hackers steal hospital

Ransomware Hackers Steal A Hospital. Again.

A month after a hospital in Hollywood was shut down by a ransomware infection that encrypted all the files on its computers and computer-controlled instruments and systems, another hospital, this one in Kentucky, has suffered a similar fate.

The hacker who stole Hollywood Presbyterian asked for $3.6 million, but settled for a piddling $17,000 (40 bitcoin), presumably after they realized that their random infectious agent had kidnapped a giant, high-profile institution that would be able to motivate serious law-enforcement investigations that would move ever-closer to their true identity the longer the ransom negotiations continued.

Ransomware Hackers Steal Hospital Information, Again

Henderson, Kentucky’s Methodist Hospital has declared an “Internal State of Emergency,” having been shut down by a piece of ransomware called “Locky.” The hospital’s spokeslawyer, David Park, said that they’re addressing the ransomware attack using plans designed to help the hospital weather a tornado or other natural disaster.

The attackers are only asking for $1,600 (4 bitcoin) to unlock the hospital’s files.

Brian Krebs speculates that the attackers didn’t set out to hold a hospital to ransom, and have no real appreciation of how much they could be asking for (though the Kentucky hospital seems to have been less compromised than the one in Hollywood). He warns that in future, ransomware creeps will start targeting their attacks, aiming for victims who have more to lose, and more to spend, when their data is taken from them.

“We haven’t yet made decision on that, we’re working through the process,” with the FBI, he said. “I think it’s our position that we’re not going to pay it unless we absolutely have to.”

The attackers are demanding a mere four bitcoins in exchange for a key to unlock the encrypted files; that’s a little more than USD $1,600 at today’s exchange rate.

Park said the administration hasn’t ruled out paying the ransom.

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hipaa audits underway

HIPAA Audits Underway! OCR’s Phase 2 Has Begun

On Monday, the HHS Office for Civil Rights (OCR) announced it has rolled out Phase 2 of its HIPAA audits, and entities have already begun receiving initial emails from OCR seeking audit contact information. The Phase 2 Audit Program is aimed at reviewing the policies and procedures of selected covered entities and their business associates to evaluate compliance with the HIPAA Privacy, Security and Breach Notification Rules. OCR’s announcement comes after data breaches in the health care industry compromised over 112 million records in 2015, according to OCR.

Phase 1 Audits

The HITECH Act required OCR to conduct periodic audits of covered entities and their business associates. Beginning in late 2011, OCR implemented a pilot audit program to assess the privacy and security controls and processes implemented by 115 covered entities across the country. Auditors then made site visits to each covered entity to evaluate compliance efforts. Following the site visits, auditors drafted a report describing how the audit was conducted, the compliance findings, and what actions the covered entity had taken in response to those findings. The covered entity then had an opportunity to develop corrective actions to address any identified concerns. The final report submitted to OCR incorporated the steps the covered entity took to resolve any compliance issues.

OCR reviewed the final reports to better understand compliance efforts with respect to the HIPAA Privacy, Security and Breach Notification Rules. In particular, OCR studied the final reports to ascertain what types of technical assistance should be developed and what forms of corrective action are the most effective. In reviewing the final reports, OCR determined several common shortcomings among covered entities, including inadequate risk analysis, outdated policies and procedures, and non-existent contingency plans.

OCR then announced its intentions to initiate a permanent audit program that was originally slated to begin in 2014. However, due to a lack of funding, OCR delayed the program. In May 2015, OCR began sending pre-audit screening surveys to covered entities classified as potential candidates for a Phase 2 Audit Program. In late 2015, OCR confirmed Phase 2 audits would begin in early 2016.

Phase 2 Audits

In the Phase 2 Audit Program, there will be a few significant changes from Phase 1 audits. First, business associates will be included in this round of audits. Additionally, most of the audits will be desk audits while only a few may ultimately result in more extensive on-site audits.

Phase 2 has already begun, with OCR sending out emails to covered entities to verify contact information. Every covered entity and business associate is eligible for an audit. Once OCR confirms an entity’s contact information, it will transmit a pre-audit questionnaire to gather data that will be used to create potential audit subject pools. OCR will then identify pools of covered entities and business associates who represent a wide range of organizations subject to the HIPAA Rules.

The Phase 2 Audit Program will be a three step audit process. The first set of audits will be desk audits of covered entities followed by a second round of desk audits of business associates. The desk audits will examine specific compliance requirements of the Privacy, Security and Breach Notification Rules. According to OCR, all desk audits will be completed by the end of December 2016. Finally, while OCR states there will be fewer in-person audits than in the Phase 1 Audit Program, a third set of audits may be conducted onsite, which will be more comprehensive than desk audits and cover a broader range of HIPAA requirements.

In an effort to promote transparency, OCR will post audit protocols on its website closer to the 2016 audits. OCR has also announced the procedures used and results found in the Phase 2 audits will be evaluated so as to develop a permanent HIPAA audit program.

Implications for Health Care Entities

The launch of the Phase 2 Audit Program confirms OCR’s commitment to the evaluation of compliance with and enforcement of the HIPAA Privacy, Security and Breach Notification Rules.

If you are an entity subject to the HIPAA Rules, be on the lookout for emails from OCR and review your HIPAA policies and procedures, risk analysis, and other compliance documents.

OCR’s announcement regarding the launch of Phase 2 of the HIPAA Audit Program can be found here.

If you need Risk Assessments, Managed Services, or just IT Support, give us a call at (818) 356-7188.

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Prepare for 2016 HIPAA Audits

7 Ways to Prepare for 2016 HIPAA Audits

Phase two of audits for the Health Insurance Portability and Accountability Act (HIPAA) are coming this year as the Office of Civil Rights looks to crack down on violations.

HIPAA was signed into law in August of 1996, and the Privacy and Security Rules were both implemented over a decade ago. Moreover, the Health Information Technology for Economic and Clinical Health Act (HITECH Act), which made significant changes to a variety of facets of HIPAA, passed in 2009. Section 13411 of the HITECH Act requires the Office of Civil Rights (OCR)–which is part of the U.S. Department of Health and Human Services (HHS)–to conduct periodic HIPAA audits.

Why is there so much emphasis on meeting standards that have been required for two decades in some instances? It’s due mainly to the increased use of technology in healthcare and accompanying cybersecurity risks. The purpose of this article is to provide an overview of the OCR audit program (phase 2), identify key areas of risk and provide suggestions on how to mitigate adverse findings.

Prepare for 2016 HIPAA Audits

OCR Audit Program

In 2011, OCR launched the requisite OCR Pilot Privacy, Security, and Breach Notification Audit Program. For the first phase, only covered entities were audited. This second phase includes business associates of covered entities.

Regardless of the type of entity, the time frames for the audit are the same. From the time the audit notification letter is sent from OCR, organizations should plan on a 30 day to 90 day process. Analogous to a Recovery Audit Contractor (RAC) audit, an entity has a certain period of time to produce the requested information. The information may be requested either on-site or as a desk audit, which is described below.

Next, OCR reviews the information provided and drafts a report. The entity then has the opportunity to review and respond to the draft report, after which OCR finalizes the report.
The scope of the phase 1 audits was limited to the federal Privacy, Security and Breach Notification Rules. This does not mean that a state law or international law provision may have been violated-it just was not addressed in the phase I audits.

Phase 2 audits will be more robust, in part due to a $4 million increase in OCR’s 2016 budget. Another area of difference will be the number of on site versus desk audits. During the phase 1 audits, covered entities were evaluated by a third party, who visited them on-site. Phase two audits will include a greater number of desk audits – entities responding to the audits from their desks by providing policies and documentation of privacy policies and procedures to HHS.

This serves as a signal —a key administrative area that will be looked at during the audits are the adequacy of policies and procedures. Therefore, the number of administrative and security violations could increase significantly.

Key Areas of Risk

A good place for practices to start is to look at the findings from phase 1, as well as recent penalties that were assessed by HHS for HIPAA violations. Violations occurred in the administrative, technical and physical realms. Primarily, policies and procedures were found to be inadequate; encryption of USB drives, laptops and email was found to be lacking; and inadequate employee security awareness and training were some of the major areas of vulnerability.

Suggestions to Mitigate Adverse Findings

The most prudent approach is to be prepared ahead of time, much like an IRS or Joint Commission audit. Whatever aspect of HIPAA compliance an organization is addressing, a good vantage point from which to start is the patient information. Every action should take into account the confidentiality, integrity and availability of the information. The way to make employees and contractors aware is through training. While the required way to hold business associates and subcontractors accountable is through the contractual obligations in a business associate agreement (BAA). Moreover, an annual risk assessment is a must. And, the HHS website is the ideal place to find explanations of what is set out in the laws and regulations.

Here are some tips to make sure that the practice is HIPAA compliant and avoid an adverse audit outcome:

  1. Begin compliance efforts from the vantage point of the government, who may “review pertinent policies, procedures, or practices of the covered entity or business associate and of the circumstances regarding any alleged violation”;
  2. Read Section 164.316 for what is required in relation to policies and procedures from an administrative, technical and physical aspect;
  3. Curtail policies and procedures to your individual practice;
  4. Know where the external and internal sources of protected health information are located;
  5. Encrypt everything both at rest and in transit and make sure that the level of encryption utilized is adequate;
  6. Train employees– Trustwave is a reputable vendor that has online training or various organizations offer live courses; and
  7. Perform due diligence on various third party risk assessors for expertise, price and quality.

OCR audits and HIPAA compliance should not be taken lightly. RAC audits also started with a pilot program more than a decade ago and now generate a substantial amount of revenue for the government, as well as serving as a check on providers’ claims submissions. Those submission, by the way, are also required to be HIPAA-compliant.

Conclusion

The overall goal of the phase 2 audits is to raise awareness and provide the opportunity for entities to correct their practices surrounding the creation, receipt, transmission and maintenance of protected health information.

The flip side, however, is that OCR may assess a penalty. Given that there are going to be more on site and business associate audits, the findings may translate into increased scrutiny by OCR on other fronts. Therefore, organizations of all types should look at the OCR audit like an IRS audit: a practice should be prepared for an audit. Failure to do so could be costly.

Original content by Modern Medicine Network

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Feds Wont Punish URMC

Feds Wont Punish URMC for Last Year’s HIPAA Violation

The University of Rochester Medical Center will not face any action by the federal government after a breach of patient privacy last year involving a nurse practitioner who was leaving for a new job.

URMC was fined $15,000 by the office of New York state Attorney General Eric Schneiderman and required to take other action to ensure compliance with the Health Insurance Portability and Accountability Act after the practitioner shared protected patient information with her new employer, Greater Rochester Neurology.

URMC had to report the breach to the federal Department of Health and Human Services, whose Office for Civil Rights investigates HIPAA breaches. Violations fall into four categories with corresponding penalties. The maximum fine is $1.5 million.

HHS neither confirms nor denies investigations, but URMC officials acknowledged in December that the agency was looking into the violation.

Feds Wont Punish URMC

Asked to provide an update, associate vice president for communications Christopher DiFrancesco wrote in an email, “HHS is aware of the resolution reached with the New York State Attorney General, and they informed us last month that they do not plan to take any further action regarding this matter.”

The attorney general’s office declined comment on whether it was investigating Greater Rochester Neurology. A call to the practice about any action taken against it was not immediately returned.

Last May, URMC officials announced a breach involving a nurse practitioner in the department of neurology.

An investigation by the attorney general found that on March 27, the nurse practitioner asked URMC for list of patients she had treated and received a spreadsheet of patient names, addresses and diagnoses.

The nurse practitioner, whom URMC eventually confirmed as Martha Smith-Lightfoot, shared the information with her new employer, Greater Rochester Neurology.

URMC said it learned of the breach on April 24 by patients who said they received letters from Greater Rochester Neurology.

URMC said Smith-Lightfoot requested the list to help ensure the continuity of care for patients she was leaving. URMC received assurance from Greater Rochester Neurology that the information had been returned or deleted.

In addition to paying the fine, URMC had to train staff on HIPAA policies, including how patient information is handled when employees leave or join the system, and for three years has to report breaches to the attorney general.

Original content by Democrat & Chronicle

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interoperability hurdles restrain acos

Interoperability Hurdles Restrain ACOs

For accountable care organizations, a lack of interoperability between their health information technology systems and those of providers outside their ACO is the No. 1 challenge they face, cited by 79% of respondents to a survey of 68 ACOs by group purchaser and performance-improvement company Premier and health IT collaborative eHealth Initiative.

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