On March 26, 2020 Washington D.C significantly amended its Data Breach Notification Law (D.C. Act 23-268), to expand the definition of personal information and require businesses obtaining such information to implement “reasonable security safeguards”. The new law took effect on May 19, 2020 in the midst of dramatic societal change. Indeed, COVID-19 has accelerated the digital transition and hastened the need for security and privacy issues to be at the forefront of state legislature. So, what are the major changes and updates under the D.C Act 23-268?
A Broader Definition of Personal Information
The definition of personal information has been significantly expanded and includes several new elements. Previously, the law only considered personal information to be a person’s first name (or initial) and surname and sensitive identifying numbers i.e. social security number, driver’s license number, D.C identification card number or credit card number.
Personal information also included a combination of a person’s name and any codes that would enable access to a person’s individual financial or credit account. The current update expands the definition of what is classified as personal information to the following:
- Unique Identification Numbers: passport number, taxpayer identification number or any other identification number issued on a government document.
- Medical Information: DNA profile or genetic, biometric or health insurance information.
- Financial information: Account number or any numbers or codes allowing access to an individual’s financial or credit account.
- Other Data: Any listed data that would allow an individual to carry out identity theft. The new legal definition also includes any username or email address combined with any information allowing access to another’s personal account.
Mandatory Breach Notification
- C Attorney General Notification Notices:
The law previously only required the D.C Attorney General to be notified if over 1,000 residents were affected by a data security breach. It now requires the D.C Attorney General to be notified when a qualifying data breach affects 50 D.C residents or more. The notice must include the nature and cause of the data breach, the number of affected residents, types of personal information compromised and corrective steps that have been taken.
- Individual Breach Notification Notices:
Affected residents must also be notified ‘’in the most expedient manner possible, without unreasonable delay’’. New content requirements for individual breach notification notices include the types of data compromised and toll-free numbers for credit reporting agencies and the D.C Attorney General.
Business and Service Provider Security Requirements
Businesses and service providers are now subject to more stringent security protection requirements. Any organization handling D.C residents’ personal information must “implement and maintain reasonable security safeguards”. The amended law also stipulates that any entity using a third-party service provider must have a written agreement in place requiring the latter to “implement and maintain reasonable security safeguards”.
Failure to comply with the new legal requirements of the new Data Breach Notification Law and to implement and ensure “reasonable security safeguards’, there could be significant economic and reputational loss.
To assist you in identifying the extent to which your organization is at risk of a data breach, Life Compliance is offering a FREE Organization Assessment to determine your company’s specific vulnerabilities and risk exposure to cyber crime. This will ensure you have the best possible insight and protection as you guide your company into the digital future.
Live Compliance provides all of your HIPAA privacy, security requirements, and measures. HIPAA compliance is a requirement for Covered Entities and Business Associates to safeguard personal, private, and protected health information. Organizations can excel in health care without the struggle of compliance requirements.
Live Compliance is a preferred partner of EZClaim, and their software is integrated into our medical billing software. For detailed product features or general information about EZClaim medical billing solutions, visit our website, contact us via e-mail, or call our support team directly at 877.650.0904.
[ Written by Jim Johnson, President of Live Compliance ]
Ransomware Targeting Medical Billing Companies
As the number of healthcare providers taking advantage of Telehealth increases during this uncertain time, the number of ransomware attacks continues to increase as well.
Ransomware is a type of malicious software designed to block access to a computer system until a sum of money is paid. Microsoft says, “Multiple ransomware groups that have been accumulating access and maintaining persistence on target networks for several months activated dozens of ransomware deployments in the first two weeks of April 2020.”
The attacks are targeted towards aid organizations, medical billing companies, manufacturing, transport, government institutions, and educational software providers, however, Microsoft says that it doesn’t stop with critical service groups and suggests all networks are aware of these attacks and taking necessary steps to limit risk. NetWalker ransomware, for example, gained notoriety for targeting hospitals and healthcare providers with e-mails claiming to provide information about COVID-19.
Have you had an Accurate and Thorough Security Risk Assessment and/or penetration testing?
If you haven’t completed an accurate and thorough security risk assessment, you could also be penalized under ‘willful neglect’ (this category alone is $50,000 per violation!) in addition to the higher risk of ransomware attacks. What we do is keep this from ever being a worry for you! We perform your security risk assessment and manage all of your requirements, in a clean, organized cloud-based portal.
Don’t risk your company’s future, especially when we are offering a FREE Organization Assessment to help determine your company’s status.
It’s easy! Call us at (980) 999-1585, or email me, Jim Johnson at jim@LiveCompliance.com or visit
Live Compliance has partnered with EZClaim medical billing software to strengthen what they can provide for you. It provides all of your HIPAA Privacy, Security Requirements, and Measures. HIPAA compliance is a requirement for Covered Entities and Business Associates to safeguard personal, private, and protected health information—allowing organizations to relinquish the struggle of compliance requirements.
You can investigate the EZClaim medical billing software by either downloading a FREE DEMO, or just contact our knowledgeable sales staff to answer any and all of your questions by phone at (877) 650-0904 or by e-mail at email@example.com.
[Contributed by Jim Johnson of Live Compliance]
Since CMS HHS just updated their Telehealth regulations to adjust to the COVID-19 environment—including having a remote workforce—we wanted to provide a clear update to independent physicians and billers to advise them of the fast moving changes of many regulations, and what to expect in the near future.
It is important to note that CMS has recently announced that new and established patients have availability to Telehealth, and HHS OIG is providing flexibility for healthcare providers to reduce or waive cost sharing for Telehealth visits paid by federal healthcare programs. CMS is also expanding Telehealth services to people with medicare.
As a result, please see the below video from CMS which highlights the Medicare Coverage and Payment of Virtual Services and Telehealth.
In addition, we’ve included a few key questions and answers below. If you have further questions about Telehealth and your compliance, contact Jim Johnson with Live Compliance at Jim@LiveCompliance.com or (980) 999-1585.
1. Who can provide Telehealth services?
- Nurse Practitioners
- Physician assistants
- Nurse midwives
- Certified nurse anesthetists
- Clinical psychologists
- Registered dietitians
- Nutrition professionals
2. What services can a medicare beneficiary receive through Telehealth?
- Evaluation and management visits (common office visits)
- Mental health counseling
- Preventive health screenings
- More than 80 additional services
3. What are the types of virtual services?
- Medicare Telehealth visits
- Virtual check ins
- Telephone services
Live Compliance is an EZclaim premier partner for HIPAA compliance, and is integrated into EZclaim’s billing solution.
If you have any further questions about Telehealth regulations and your compliance, e-mail Jim Johnson at Live Compliance at Jim@LiveCompliance.com, or phone him at (980) 999-1585.
[Contribution by Jim Johnson with the Live Compliance]
Whether you are a person new to medical billing or someone who’s been in the business for years, launching a new medical billing practice can be hard. Understanding the market, connecting with new clients and knowing how to master your processes are challenges that you often learn as you go. Despite these challenges, it is rewarding to be out on your own growing a new company. Before you jump, let us help you understand some essential keys that you can research upfront and prepare yourself to get one step closer to being successful.
1. ONE BILLING PLATFORM VERSUS MULTIPLE PLATFORMS: First and foremost you must make a conscious decision to either focus on being an expert on an individual medical billing platform, like EZClaim, or tackling multiple platforms. There are pros and cons of both: being an expert can make you extremely efficient in your use of the software’s billing and, scheduling features, however, it can also limit your client base to only one set of software users. Whereas having a basic understanding of multiple platforms can allow you a larger base of medical offices while limiting your ability to truly understand how best to serve each individual client’s needs.
Pro tip: Start and master one trusted billing program, and grow your options as your billing business grows.
2. GET CLEAR ON THE CLEARINGHOUSE: A new billing company owner does not want to be held to just one clearinghouse as options are key here. Having the ability to work with any or many would be an essential piece to your billing services, however, you still want to know the best clearinghouses in the business. Understanding which clearinghouses provide the best products and services and being able to recommend those services to your client upfront will make your life easier and their business run smoother. For this very reason, EZClaim has built its software around partnerships and integrations with the best clearinghouses to make working with the one you need easy.
3. COMPLY OR DIE (HIPAA Compliance): The third key to any start-up is first understanding the importance of HIPAA Compliance. Medical billing firms literally can come crashing down with any missteps, mistakes, or misunderstandings of this essential piece of the puzzle. It goes without saying that if you are going to choose a billing software be sure that they have partnerships built around making sure you are protected. You are also responsible to make sure the data is protected so your customer and their patient’s data is safe.
HIPAA Hint: Check out Live Compliance for further details on the topic.
There are many options available out there for your new medical billing practice, and we recommend doing your research. Within that research, you will find that EZClaim ranks very high in performance and comes in at a great price.
To learn about EZClaim go to our about page, sign up for a demo and/or download a trial for free today!
An independent physician gastroenterology practice in Utah had to report a breach related to a dispute with a Business Associate to the Office for Civil Rights department of HHS.
After the investigation into the breach, it was determined that the practice of Steven A. Porter, MD “had failed to complete an accurate and thorough risk analysis, and failed to implement security measures sufficient to reduce risks and vulnerabilities to a reasonable and appropriate level” and therefore, has agreed to pay a $100,000 fine.
In addition to the monetary penalty, the practice is required to implement a Corrective Action Plan (CAP). According to the investigation resolution agreement, the practice agreed to conduct a thorough Risk Analysis, the Practice must develop a complete inventory of all its categories of electronic equipment, data systems, and applications that contain or store ePHI, which will then be incorporated into its Risk Analysis, and must complete a Risk Management plan. They must also revise and implement actionable policies and procedures, all of which should have been in place prior to the breach incident.
Have you ever read such headlines and doubted whether a small Billing Company or independent physician practice actually ever face penalties?
According to the Resolution Agreement, the practice must also completely reinvent their Business Associate process, and implement a strict protocol to ensure it’s Business Associates are HIPAA Compliant. In addition to ensuring their Business Associate relationships are accurate, the entire staff must undergo security and privacy training that stresses the use of Business Associate services and applications, disclosures to Business Associates that require a Business Associates agreement or other reasonable assurances in place to ensure that the Business Associate will and can safeguard the PHI and/or the ePHI. This puts immense pressure on the Business Associates, such as Billing Companies, to ensure that they are HIPAA Compliant, but also independent physician practices to ensure their Business Associates, “down the chain” are also compliant. This is also known as gaining Satisfactory Assurance of vendor HIPAA compliance.
What can you do?
As we have stressed before, it is important for you to understand that every complaint or potential breach must be investigated by HHS/OCR. If you, a billing company, or other vendor, suspects a breach you must inform the covered entity (your client) and have a breach risk assessment completed to determine key factors and take action. Keep in mind, a business associate is a ‘person’ or ‘entity’. This means there is no Billing Company too small or too large to comply with the Federal HIPAA regulations. Again, if you haven’t completed an accurate and thorough security risk assessment prior to that, you could also be penalized under ‘willful neglect’. This category alone is $50,000 per violation!
What we do is keep this from ever being a worry for you! In fact, we have a 100% audit pass rate! For example, Live Compliance has easy to understand HIPAA breach notification training. We perform your security risk assessment and manage all your requirements, including business associates, in a clean, organized cloud-based portal. Don’t risk your company’s future, especially when we are offering a FREE Organization Assessment to help determine your company’s status. It’s easy, call us at (980) 999-1585, email me jim@LiveCompliance.com or visit LiveCompliance.com
[ Contributed by Jim Johnson, President of Live Compliance ].
Lost laptop = $65,000 fine. Have you ever read such headlines and doubted whether a small billing company or independent physician practice would ever face such seemingly insurmountable penalties?
What happened? Most recently, an ambulance company out of Georgia paid $65,000 for a lost laptop that happened to be unencrypted. More often, small businesses and practices are taking work outside of the office, so this kind of violation is one that can occur to anyone.
The laptop contained 500 individual’s Protected Health Information. As a result of the investigation, the ambulance company will undergo a Technical Security Risk Assessment and is required to adopt a Corrective Action Plan. This is a great example of why it is important and mandatory to conduct a Technical and Objective Security Risk Assessment at least annually on all devices.
Following the investigation, it was uncovered that West Georgia Ambulance never provided a security awareness and training program for its employees! You and your workforce are your first line of defense. This reinforces the importance that both you, and your employees must understand what a breach is and the breach notification requirements! It was later revealed that West Georgia Ambulance failed to implement HIPAA Security Rule policies and procedures as well.
What can you do? As we have stressed before, it is important for you to understand that every complaint or potential breach must be investigated by HHS/OCR. If you, the Billing Company or independent physician practice, suspects a breach or complaint you must inform the covered entity (your client) and have a breach risk assessment completed to determine key factors and take action. Again, if you haven’t completed an accurate and thorough security risk assessment prior to that, you could also be penalized under ‘willful neglect’. This category alone is $50,000 per violation!
What we do is keep this from ever being a worry for you! In fact, we have a 100% audit pass rate since 2010! For example, Live Compliance has easy to understand HIPAA breach notification training. We perform your security risk assessment and manage all your requirements, including business associates, in a clean, organized cloud-based portal.
Don’t risk your company’s future, especially when we are offering a FREE Organization Assessment to help determine your company’s status.
It’s easy, call us at (980) 999-1585, email me or visit LiveCompliance.com
Keep in mind, a business associate is a ‘person’ or ‘entity’. This means there is no billing company too small or too large to comply with the Federal HIPAA regulations.
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