Failing to Implement HIPAA Causes Large Fine

Failing to ImplementFailing to implement HIPAA causes a large fine for a small town North Carolina health services provider. They were fined $25,000 for multiple, easily avoidable, HIPAA violations for “longstanding, systemic noncompliance” with the HIPAA Security Rule. [Note: The provider is a part of a health center which offers discounted medical services to the underserved population in rural NC, and the fines were reduced in consideration of this, but it still resulted in a significant monetary loss].

In 2011, Metropolitan Community Health Services (Metro), doing business as Agape Health Services, filed a breach report regarding “the impermissible disclosure of protected health information to an unknown email account.” The breach affected over 1,200 patients!

In addition to the large monetary penalty, the practice is required to develop and adopt a corrective action plan (which includes two years of thorough monitoring) after the Office for Civil Rights (OCR) discovered that Metro failed to conduct a thorough and comprehensive HIPAA Security Risk Assessment and Analysis. In addition, Metro did not implement a single HIPAA Security Rule Policy and Procedure for the health center. Possibly worst of all, Metro failed to provide workforce members with HIPAA Privacy and Security Awareness training until 2016!

Patients must trust who they share their personal, private, and protected health information with. A breach such as this, is obviously devastating for the patient, in addition to their doctor’s reputation. So, how can physicians ensure that they are meeting the HIPAA requirements and have proper safeguards in place to avoid this sort of breach?

First off, an accurate and thorough Security Risk Assessment and Analysis must be conducted to expose and target any potential administrative, physical, and technical vulnerabilities. Doing so  highlights any major flaws in a practice’s administrative and technical safeguards, and accentuates the policies and procedures that the practice needs to implement.

In addition to that, the designated HIPAA Privacy and Security Officer must ensure that ALL employees complete HIPAA Workforce training. All employees of the practice, including the physicians, must take HIPAA training to ensure employees have a clear understanding of the HIPAA Privacy Rule and actionable policies and procedures.

So, remember, healthcare organizations and their vendors have a responsibility to be HIPAA compliant, and that starts by performing, updating, or reviewing an accurate and thorough Security Risk Assessment covering your technical, administrative, and physical safeguards. This will help uncover any vulnerabilities, and help you understand what information is being transmitted, shared, and how it is being transmitted.

 

TAKE AWAYS AND THINGS TO CONSIDER:

  • Complete a Security Risk Assessment and establish a Corrective Action Plan that is accurate and thorough.
 Remediate any potential risks or vulnerabilities.
  • A Security Risk Assessment will target vulnerabilities related to what is potentially exposing Protected Health Information (PHI)
  • Develop actionable policies and procedures that clearly outline disclosures of PHI
  • Ensure all employees have a clear understanding of the HIPAA Privacy rule and its policies and procedures

 

Live Compliance provides everything you need to become and maintain your organization’s HIPAA compliance requirements. All policies and procedures can be edited and shared directly with staff from your staff portal. Trainings are delivered and monitored within your portal, can be customized, role-based, and be accessed anytime and from anywhere. You can also easily send and monitor HIPAA training with one click.

Failing to implement HIPAA can cause tremendous problems and use precious resources and time to implement. Live Compliance makes it 10X easier than trying to do it on your own.

So, take advantage of Live Compliance’s FREE Organization Needs Assessment to understand your immediate compliance needs. For additional details, e-mail Jim Johnson (at jim@livecompliance.com), call (980) 999-1585, or visit their website at livecompliance.com/oa

Live Compliance is a partner of EZClaim, a medical billing software company. For more details about their solutions, visit their website at ezclaim.com.

[ Written by Jim Johnson, President of Live Compliance ]

The PROS and CONS of Credit Card Collections

Credit Card CollectionsCredit card collections are a BIG part of any successful medical practice, and there has been a shift, in the last decade, that more insurance policies are adding co-pays with higher deductibles—which makes getting paid even more challenging.1 One industry report said that “73% of physicians shared that it typically takes at least one month to collect a payment, and 12% of their patients wait more than three months to pay.”2 With the current trend, more medical practices and their billing departments (or outsourced billing firms) are going the route of processing payment via credit cards, which has its PROS and CONS.

In light of this new information, the following are a few pros and cons for credit card processing that we anticipate in the near future, and some insights for choosing the best billing software that supports the credit card processing needs of medical practices:

  • PRO: To protect against the dangers of stolen data, fraud, or other compromises in security, practices should seek out medical billing software that has credit card processing built-in, which can help safeguard against these dangers.
  • CON: Security is a big risk, and a leak in data leading to stolen funds can end up in a physician paying out-of-pocket for the breach. It is also important to note that breach of credit card data is also considered a violation under the federal Health Insurance Portability and Accountability Act (HIPAA). 
  • PRO: Implementing credit card processing will reduce long waiting periods for payments from the majority of your patients, and will also reduce the additional effort your billing staff has to extend to collect on overdue notices.
  •  CON: Practices cannot require patients to share their credit card information to receive medical care, and even if patients do share their credit card information, physicians cannot continue to charge the credit card without a patient’s consent.
  • PRO: Physicians can end the process of being a “line of credit” to unpaid or underpaid claims, and collect on funds immediately.
  • CON: You will need to implement internal processes that include, but are not limited to proper personal information storage and security, establishing guidelines on maximum percentages charged per bill, and personal consent forms.

Overall, there are definitely MORE ‘PROS’ than cons for implementing credit card processing for your medical practice, and all the trends are pointing to this being the PREFERRED METHOD of payment in the near future.  EZClaim is proud to announce that it will release an integrated credit card processing solution, EZClaimPay, that is backed by a national merchant services vendor.  [ EZClaim will be sharing more details about EZClaimPay in the weeks to come, via their social media platforms, their monthly newsletter, direct communications, and more ]. 

 

In addition to the credit card  collections PROS and CONS above, we reached out to one of our partners, Live Compliance, to gather some regulatory and security advice. They suggested the following:

  • When accessing, transmitting, storing, or receiving any Protected Health Information (PHI), Health and Human Services (HHS) Office of Civil Rights (OCR) mandates that you are to maintain HIPAA compliance. 
  • When accepting, processing, or maintaining credit card information and debit card information, you must ensure that your organization is PCI DSS compliant (Payment Card Industry Data Security Standard).
  • In addition to the above Federal regulatory requirements, most states require privacy and security compliance requirements to be implemented, along with strict adherence to the privacy of Personally Identifiable Information (PII) and Breach Notification requirements.

For more information on your compliance requirements, visit Live Compliance for a Free Organization Assessment to identify and uncover your organization’s vulnerabilities.

 

If you are not a current customer of EZClaim, we would very much like to connect with you.  You can either schedule a one-on-one consultation with our sales team, view a recorded demo, or download a FREE 30-day trial right now. For detailed product features or general information about EZClaim, visit our website at ezclaim.com.

 

[ NOTE: If you would like a quote on the upcoming merchant services, please e-mail sales@ezclaim.com your last three merchant statements.  For more on our ongoing updates and industry news, you can follow EZClaim on Facebook and LinkedIn ].

Source Material:
1 – America’s Health Insurance Plans” report that there were 20.2 million co-pays in 2017, which was up tremendously from just over 1 million in 2005.
2 – Source: From InstaMed’s annual “Trends in Healthcare Payments” report.

> For more on this topic, read a previous article, Why Do I Have A Balance? – Patient Payments”

Lost Laptop = $65,000 Fine

lost laptopLost 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. 

LEARN MORE

If you are enjoyed this article about the lost laptop as well as informative content we’re providing and have a specific topic you would like to see covered, we would love to hear from you! Please feel free to send along your ideas via email to sales@ezclaim.com.

CONTACT INFO

337 S. Main Street
Ste 200
Rochester, MI 48307

877.650.0904

FOLLOW US ON

CONTACT INFO

337 S. Main Street
Ste 200
Rochester, MI 48307

877.650.0904

FOLLOW US ON

CONTACT INFO

337 S. Main Street
Ste 200
Rochester, MI 48307

877.650.0904

FOLLOW US ON

CONTACT INFO

337 S. Main Street
Ste 200
Rochester, MI 48307

877.650.0904

FOLLOW US ON

SALES

337 S. Main Street
Ste 200
Rochester, MI 48307

877.650.0904

CUSTOMER SUPPORT

337 S. Main Street
Ste 200
Rochester, MI 48307

877.650.0904

FOLLOW US ON