HIPPA - Security Risk Analysis
Government entities like HHS, OCR, and CMS conduct random but thorough audits to assess HIPAA compliance. We advise proactive preparation and suggest engaging ClaimsCareMD to conduct a risk analysis in advance to mitigate the risk of penalties. While the likelihood of being audited is relatively low, non-compliance with safety and risk regulations could result in legal consequences or fines. Consider the following odds:
Audits focus on verifying compliance with HIPAA privacy, security, and OMNIBUS rules. Violation penalties vary based on negligence levels and can range from $100 to $50,000 per violation or per patient record, with a maximum penalty of $1.5 million annually. Criminal charges leading to jail time are possible.
Penalties fall into two categories: “Reasonable Cause” and “Willful Neglect.” “Reasonable Cause” penalties range from $100 to $50,000 per incident and do not entail jail time. “Willful Neglect” penalties range from $10,000 to $50,000 per incident and may result in criminal charges.
What is HIPAA and ePHI?
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the Secretary of the U.S. Department of Health and Human Services (HHS) to develop regulations safeguarding certain health information. In response, HHS issued the HIPAA Privacy Rule and the HIPAA Security Rule. The Privacy Rule, also known as the Standards for Privacy of Individually Identifiable Health Information, sets national standards for protecting specific health data. The Security Rule establishes a set of national security standards for safeguarding certain health information transmitted or stored electronically. It operationalizes the Privacy Rule’s protections by delineating technical and non-technical safeguards that “covered entities” must implement to secure individuals’ Electronic Protected Health Information (e-PHI). The Office for Civil Rights (OCR) within HHS enforces the Privacy and Security Rules through voluntary compliance initiatives and civil monetary penalties. (Source: Summary of the HIPAA rules and ePHI)
ClaimsCareMD Risk Analysis Process: To pass an OCR audit, covered entities must conduct a thorough, documented Security Risk Analysis to safeguard Electronic Patient Health Information. ClaimsCareMD diligently undertakes this task and conducts a security risk analysis in collaboration with providers, with the timeframe depending on the size of your practice. Some of our services include: – Appointing a privacy and security officer within the service location – Developing written policies and procedures – Providing HIPAA-related employee training (uncapped) – Conducting comprehensive module-based Risk Assessments – Establishing disaster recovery plans – Maintaining PHI disposal logs – Implementing security incident monitors and incident reporting guidelines When conducting a Security Risk Analysis (SRA), ClaimsCareMD adheres to Security Rule mandates. As such, the SRA is based on three cores:
Technical Safeguards: – Access and audit controls for software handling ePHI (Electronic Health Records, Revenue Cycle Management), and access to prescriptions and other documents containing PHI – Measures to prevent unauthorized destruction of PHI Physical Safeguards: – Control of facility access – Controls over devices and media Administrative Safeguards: – Regulation of workforce access to PHI and security measures – Contingency plans Risk assessments for each module consider: – Probability of potential breach – Severity of potential breach If you receive an audit, we advise consulting a professional. While online tools offer convenience, they may present risky shortcuts. Remember, having documentation does not equate to having good documentation. Auditors prioritize quality over quantity, focusing on whether the documentation contains appropriate information.
What is HIPAA and ePHI?
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the Secretary of the U.S. Department of Health and Human Services (HHS) to develop regulations safeguarding certain health information. In response, HHS issued the HIPAA Privacy Rule and the HIPAA Security Rule. The Privacy Rule, also known as the Standards for Privacy of Individually Identifiable Health Information, sets national standards for protecting specific health data. The Security Rule establishes a set of national security standards for safeguarding certain health information transmitted or stored electronically. It operationalizes the Privacy Rule’s protections by delineating technical and non-technical safeguards that “covered entities” must implement to secure individuals’ Electronic Protected Health Information (e-PHI). The Office for Civil Rights (OCR) within HHS enforces the Privacy and Security Rules through voluntary compliance initiatives and civil monetary penalties. (Source: Summary of the HIPAA rules and ePHI)
ClaimsCareMD Risk Analysis Process: To pass an OCR audit, covered entities must conduct a thorough, documented Security Risk Analysis to safeguard Electronic Patient Health Information. ClaimsCareMD diligently undertakes this task and conducts a security risk analysis in collaboration with providers, with the timeframe depending on the size of your practice. Some of our services include: – Appointing a privacy and security officer within the service location – Developing written policies and procedures – Providing HIPAA-related employee training (uncapped) – Conducting comprehensive module-based Risk Assessments – Establishing disaster recovery plans – Maintaining PHI disposal logs – Implementing security incident monitors and incident reporting guidelines When conducting a Security Risk Analysis (SRA), ClaimsCareMD adheres to Security Rule mandates. As such, the SRA is based on three cores:
Technical Safeguards: – Access and audit controls for software handling ePHI (Electronic Health Records, Revenue Cycle Management), and access to prescriptions and other documents containing PHI – Measures to prevent unauthorized destruction of PHI Physical Safeguards: – Control of facility access – Controls over devices and media Administrative Safeguards: – Regulation of workforce access to PHI and security measures – Contingency plans Risk assessments for each module consider: – Probability of potential breach – Severity of potential breach If you receive an audit, we advise consulting a professional. While online tools offer convenience, they may present risky shortcuts. Remember, having documentation does not equate to having good documentation. Auditors prioritize quality over quantity, focusing on whether the documentation contains appropriate information.