What Every Organization Needs to Know about Basic HIPAA Compliance and Technology. April 21, 2015

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "What Every Organization Needs to Know about Basic HIPAA Compliance and Technology. April 21, 2015"

Transcription

1 What Every Organization Needs to Know about Basic HIPAA Compliance and Technology April 21, 2015

2 Who are these handsome fellas? Jamie Wolbeck (VP Of Operations) Ron Shelby (Sr. Account Manager)

3 Who Are You?

4 Outline Brief Overview of HIPAA and HITECH Why Should You Care? How can a HIPAA violation impact your organization? What can I do? Your Top 10 areas of focus Q&A

5 What s important to you? Any other topics you want covered?

6 Acronym Heaven

7 Review of HIPAA and Terms HIPAA - is the federal Health Insurance Portability and Accountability Act of The primary goal of the law is to make it easier for people to keep health insurance, protect the confidentiality and security of healthcare information and help the healthcare industry control administrative costs.

8 Review of HIPAA and Terms HHS (The U.S. Department of Health and Human Services) U.S. government s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. HHS is responsible for almost a quarter of all federal outlays and administers more grant dollars than all other federal agencies combined. OCR (Office of Civil Rights) The Office for Civil Rights enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information

9 Review of HIPAA and Terms PHI and ephi - electronic Protected Health Information. EMR Electronic Medical Records - digital version of the paper charts in the clinician s office. EHR Electronic Health Records - systematic collection of electronic health information about an individual patient or population that can be shared across different providers. Covered Entity - any organization or corporation that directly handles Personal Health Information or Personal Health Records. Business Associate - is a person or entity that performs certain functions that involve the use of PHI on behalf of, or provides services to, a covered entity. (e.g. SUCCESS is a BA) BAA Business Associate Agreement mandatory contract for a contractor who provides functions involving use of PHI.

10 Review of HIPAA and Terms ACO Accountable Care Organizations - are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. CMS Centers for Medicaid and Medicare Services - federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and works in partnership with state governments to administer SIM State Innovation Models - Initiative for providing financial and technical support to states for the development and testing of state-led, multi-payer health care payment and service delivery models that will improve health system performance and decrease costs (MN has received $45 Million). Minnesota Accountable Health Model - The goal of this model is to ensure that every citizen of the state of Minnesota has the option to receive team-based, coordinated, patient-centered care that increases and facilitates access to medical care, behavioral health care, long term care, and other services ($45M) Minnesota ACH MN Accountable Communities for Health - work to address health problems within communities by coordinating support systems to keep people healthy Support systems include: local public health, behavioral health, social services, long term care, primary care (15 ACH s formed).

11 History of HIPAA 1996: HIPAA Enacted by Congress Required HHS to propose standards protecting the privacy of individually identifiable health information by August 21, : Privacy Rules, 45 CFR Requires covered entities to protect privacy of patient info. Gives patients certain rights concerning their info. 2005: Security Rules, 45 CFR Requires covered entities to implement safeguards to protect electronic protected info. 2009: HITECH Act Expanded and strengthened HIPAA. 2009: Breach Notification Rule, 45 CFR Requires covered entities to report breaches of unsecured info. 2013: HIPAA Omnibus Rule, 78 FR 5566 (1/25/13) Implemented and finalized HITECH Act requirements.

12 Why Should You Care? Because of the financial impact to your organization or company. Ability to be part of ACO or ACH SIM Grants Medicare/Medicaid funding Referrals from other providers Return (happy) clients

13 Why Should You Care? Because of the penalties that can be imposed against you due to a breach! Civil fines Criminal penalties Adverse employment action Loss of licensure Personal injury damages

14 Why Should You Care?

15 Why Should You Care?

16 Civil Penalties Conduct Did not know and should not have known of violation Violation due to reasonable cause Willful neglect, but correct w/in 30 days Willful neglect, but do not correct w/in 30 days Penalty $100 to $50,000 per violation Up to $1.5 million per type per year No penalty if correct w/in 30 days OCR may waive or reduce penalty $1000 to $50,000 per violation Up to $1.5 million per type per year No penalty if correct w/in 30 days OCR may waive or reduce penalty $10,000 to $50,000 per violation Up to $1.5 million per type per year Penalty is mandatory At least $50,000 per violation Up to $1.5 million per type per year Penalty is mandatory

17 How can this impact you? Story of an audited organization What does the audit process look like? Who is auditing my business? What can they do? Why might I get audited? Culpability, and why it s important

18 Sample info for audit walk-through SECURITY WALK-THROUGH CHECKLIST Employee Conduct: Yes No Comments Employees and visitors wear ID badges. Employees challenge persons who are not wearing badges. X X Employees protect security of PHI by speaking softly and, when appropriate, using nonpublic areas. Workstation Use: Yes No Comments Workstations and computer monitors are positioned to prevent unauthorized persons from viewing EPHI. Employees protect user IDs and passwords, and don t share them. Employees don t share workstations while logged in. User IDs and passwords are not posted on or near workstations. Documents with PHI are face down or concealed, especially in public areas and when employees leave their workstations. When documents with PHI are not in use, they are stored or filed so as to avoid observation or access by unauthorized persons. Unattended computers are returned to the logon screen (automatically or by user) or have password-enabled screen savers when not in use.

19 Top 10 areas of focus 1. Passwords Still one of these most common areas of breaches is shared passwords or passwords stolen or distributed incorrectly. Change your password every 60 days, minimum Never share accounts/passwords it s a violation of HIPAA Complexity requirements, at least 8 characters Multifactor is encouraged and in some cases, required

20 Top 10 areas of focus 2. Security tools Anti-virus, required Firewall, required Segmented Guest traffic, required Web-Blocker/Web Filtering, strongly encouraged Encryption, encouraged (in the case of a lost device that may contain data locally stored) SPAM Blocker, encouraged (common source of infection) Windows and 3 rd Party Patching/Software Updates

21 Top 10 areas of focus 3. Permissions Review your permissions ensure no one has access to ephi folders/data unless they are supposed to Remove admin access for everyone ACLs Access Control Lists

22 Top 10 areas of focus 4. Physical Access Locked access to cabinets Monitors with screen view protectors or placed so people cannot see or snap pictures Guest books Controlled access to building/server room Employee and Guest badges

23 Top 10 areas of focus 5. Disaster Recovery Planning Strong backup routine Data stored offsite Automation in the backup process Emergency Planning

24 Top 10 areas of focus 6. Training New Employee training on HIPAA, for all employees Annual refresher training for all employees Compliance Officer keeping regular logs of who and when trainings occurred that can be used in the event of an audit Training on how to interact with the ERP/EHR systems

25 Top 10 areas of focus 7. Annual HIPAA Compliance scans Reviews Group Policies passwords, auto-lock, secure traffic ( and otherwise) Keeping an up to date log of scan results and improvements made Reviewing any policy changes and needs within the IT infrastructure (out of date Operating Systems, Firewall policies, Antivirus policies)

26 Top 10 areas of focus 8. How you use your devices No texting or messaging! Stop installing games and toolbars Make sure you re rebooting regularly and locking your workstation and phone when you re away Clean off old data as soon as you re done If you do not need to store it locally, don t!

27 Top 10 areas of focus 9. Managing Mobile Devices Any mobile device needs a password Data can only be viewed, not stored, on personal devices Encrypt whenever you can No working from a coffee shop or public wireless without using encryption protocols Mobile Device Management (MDM) software when you can allows you to track and remotely wipe devices if misplaced

28 Top 10 areas of focus 10. Updating Security Policies and Practice Review your internal policies manual now, and every year after Build HIPAA into your manual and on-boarding documents, employees need to sign off Have a lawyer review the documents that require employee signature (make sure that you and your employees are protected) Keep training!

29 References and Resources Department of Health and Human Services (HHS) HIPAA.com HealthIT.gov MN Health Reform

30 Any questions?

Nationwide Review of CMS s HIPAA Oversight. Brian C. Johnson, CPA, CISA. Wednesday, January 19, 2011

Nationwide Review of CMS s HIPAA Oversight. Brian C. Johnson, CPA, CISA. Wednesday, January 19, 2011 Nationwide Review of CMS s HIPAA Oversight Brian C. Johnson, CPA, CISA Wednesday, January 19, 2011 1 WHAT I DO Manage Region IV IT Audit and Advance Audit Technique Staff (AATS) IT Audit consists of 8

More information

Understanding HIPAA Privacy and Security Helping Your Practice Select a HIPAA- Compliant IT Provider A White Paper by CMIT Solutions

Understanding HIPAA Privacy and Security Helping Your Practice Select a HIPAA- Compliant IT Provider A White Paper by CMIT Solutions Understanding HIPAA Privacy and Security Helping Your Practice Select a HIPAA- Compliant IT Provider A White Paper by CMIT Solutions Table of Contents Understanding HIPAA Privacy and Security... 1 What

More information

HIPAA Secure Now! How MSPs Can Profit From Selling HIPAA security services

HIPAA Secure Now! How MSPs Can Profit From Selling HIPAA security services HIPAA Secure Now! How MSPs Can Profit From Selling HIPAA security services How MSPs can profit from selling HIPAA security services Managed Service Providers (MSP) can use the Health Insurance Portability

More information

Heather L. Hughes, J.D. HIPAA Privacy Officer U.S. Legal Support, Inc. hhughes@uslegalsupport.com www.uslegalsupport.com

Heather L. Hughes, J.D. HIPAA Privacy Officer U.S. Legal Support, Inc. hhughes@uslegalsupport.com www.uslegalsupport.com Heather L. Hughes, J.D. HIPAA Privacy Officer U.S. Legal Support, Inc. hhughes@uslegalsupport.com www.uslegalsupport.com HIPAA Privacy Rule Sets standards for confidentiality and privacy of individually

More information

The Basics of HIPAA Privacy and Security and HITECH

The Basics of HIPAA Privacy and Security and HITECH The Basics of HIPAA Privacy and Security and HITECH Protecting Patient Privacy Disclaimer The content of this webinar is to introduce the principles associated with HIPAA and HITECH regulations and is

More information

2011 2012 Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April May-Dec.

2011 2012 Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April May-Dec. The OCR Auditors are coming - Are you next? What to Expect and How to Prepare On June 10, 2011, the U.S. Department of Health and Human Services Office for Civil Rights ( OCR ) awarded KPMG a $9.2 million

More information

Ethics, Privilege, and Practical Issues in Cloud Computing, Privacy, and Data Protection: HIPAA February 13, 2015

Ethics, Privilege, and Practical Issues in Cloud Computing, Privacy, and Data Protection: HIPAA February 13, 2015 Ethics, Privilege, and Practical Issues in Cloud Computing, Privacy, and Data Protection: HIPAA February 13, 2015 Katherine M. Layman Cozen O Connor 1900 Market Street Philadelphia, PA 19103 (215) 665-2746

More information

HIPAA Security Rule Compliance

HIPAA Security Rule Compliance HIPAA Security Rule Compliance Caryn Reiker MAXIS360 HIPAA Security Rule Compliance what is it and why you should be concerned about it Table of Contents About HIPAA... 2 Who Must Comply... 2 The HIPAA

More information

HIPAA PRIVACY AND SECURITY AWARENESS

HIPAA PRIVACY AND SECURITY AWARENESS HIPAA PRIVACY AND SECURITY AWARENESS Introduction The Health Insurance Portability and Accountability Act (known as HIPAA) was enacted by Congress in 1996. HIPAA serves three main purposes: To protect

More information

HIPAA Security Overview of the Regulations

HIPAA Security Overview of the Regulations HIPAA Security Overview of the Regulations Presenter: Anna Drachenberg Anna Drachenberg has been assisting healthcare providers and hospitals comply with HIPAA and other federal regulations since 2008.

More information

HIPAA and HITECH Compliance for Cloud Applications

HIPAA and HITECH Compliance for Cloud Applications What Is HIPAA? The healthcare industry is rapidly moving towards increasing use of electronic information systems - including public and private cloud services - to provide electronic protected health

More information

HIPAA Compliance Guide

HIPAA Compliance Guide HIPAA Compliance Guide Important Terms Covered Entities (CAs) The HIPAA Privacy Rule refers to three specific groups as covered entities, including health plans, healthcare clearinghouses, and health care

More information

HIPAA Happenings in Hospital Systems. Donna J Brock, RHIT System HIM Audit & Privacy Coordinator

HIPAA Happenings in Hospital Systems. Donna J Brock, RHIT System HIM Audit & Privacy Coordinator HIPAA Happenings in Hospital Systems Donna J Brock, RHIT System HIM Audit & Privacy Coordinator HIPAA Health Insurance Portability and Accountability Act of 1996 Title 1 Title II Title III Title IV Title

More information

HIPAA COMPLIANCE PLAN FOR 2013

HIPAA COMPLIANCE PLAN FOR 2013 HIPAA COMPLIANCE PLAN FOR 2013 Welcome! Presentor is Rebecca Morehead, Practice Manager Strategist www.practicemanagersolutions.com Meaningful Use? As a way to encourage hospitals and providers to adopt

More information

HIPAA Privacy, Security, Breach, and Meaningful Use. CHUG October 2012

HIPAA Privacy, Security, Breach, and Meaningful Use. CHUG October 2012 HIPAA Privacy, Security, Breach, and Meaningful Use Practice Requirements for 2012 CHUG October 2012 The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Standards for Privacy of Individually

More information

HIPAA Compliance Guide

HIPAA Compliance Guide HIPAA Compliance Guide Important Terms Covered Entities (CAs) The HIPAA Privacy Rule refers to three specific groups as covered entities, including health plans, healthcare clearinghouses, and health care

More information

HITRUST CSF Assurance Program You Need a HITRUST CSF Assessment Now What?

HITRUST CSF Assurance Program You Need a HITRUST CSF Assessment Now What? HITRUST CSF Assurance Program You Need a HITRUST CSF Assessment Now What? Introduction This material is designed to answer some of the commonly asked questions by business associates and other organizations

More information

Data Security and Integrity of e-phi. MLCHC Annual Clinical Conference Worcester, MA Wednesday, November 12, 2014 2:15pm 3:30pm

Data Security and Integrity of e-phi. MLCHC Annual Clinical Conference Worcester, MA Wednesday, November 12, 2014 2:15pm 3:30pm Electronic Health Records: Data Security and Integrity of e-phi Worcester, MA Wednesday, 2:15pm 3:30pm Agenda Introduction Learning Objectives Overview of HIPAA HIPAA: Privacy and Security HIPAA: The Security

More information

Welcome to the Privacy and Security PowerPoint presentation in the Data Analytics Toolkit. This presentation will provide introductory information

Welcome to the Privacy and Security PowerPoint presentation in the Data Analytics Toolkit. This presentation will provide introductory information Welcome to the Privacy and Security PowerPoint presentation in the Data Analytics Toolkit. This presentation will provide introductory information about HIPAA, the HITECH-HIPAA Omnibus Privacy Act, how

More information

HIPAA PRIVACY AND SECURITY AWARENESS. Covering Kids and Families of Indiana April 10, 2014

HIPAA PRIVACY AND SECURITY AWARENESS. Covering Kids and Families of Indiana April 10, 2014 HIPAA PRIVACY AND SECURITY AWARENESS Covering Kids and Families of Indiana April 10, 2014 GOALS AND OBJECTIVES The goal is to provide information to you to promote personal responsibility and behaviors

More information

How to use the Alertsec Service to Achieve HIPAA Compliance for Your Organization

How to use the Alertsec Service to Achieve HIPAA Compliance for Your Organization How to use the Alertsec Service to Achieve HIPAA Compliance for Your Organization Alertsec offers Cloud Managed - Policy Controlled - Security Modules for Ensuring Compliance at the Endpoints Contents

More information

HIPAA Employee Compliance Program TRAINING MANUAL

HIPAA Employee Compliance Program TRAINING MANUAL HIPAA Employee Compliance Program TRAINING MANUAL Training Manual to Assist Employees in HIPAA Compliance January 2013 Program For HIPAA Compliance Plan Goal The purpose of this manual is to instruct our

More information

Health Information Privacy Refresher Training. March 2013

Health Information Privacy Refresher Training. March 2013 Health Information Privacy Refresher Training March 2013 1 Disclosure There are no significant or relevant financial relationships to disclose. 2 Topics for Today State health information privacy law Federal

More information

HIPAA Privacy and Security Risk Assessment and Action Planning

HIPAA Privacy and Security Risk Assessment and Action Planning HIPAA Privacy and Security Risk Assessment and Action Planning Practice Name: Participants: Date: MU Stage: EHR Vendor: Access Control Unique ID and PW for Users (TVS016) Role Based Access (TVS023) Account

More information

Health Care Information Privacy The HIPAA Regulations What Has Changed and What You Need to Know

Health Care Information Privacy The HIPAA Regulations What Has Changed and What You Need to Know Health Care Information Privacy The HIPAA Regulations What Has Changed and What You Need to Know Note: Information provided to NCRA by Melodi Gates, Associate with Patton Boggs, LLC Privacy and data protection

More information

ACCOUNTABLE HEALTHCARE IPA HIPAA PRIVACY AND SECURITY TRAINING. By: Jerry Jackson Compliance and Privacy Officer

ACCOUNTABLE HEALTHCARE IPA HIPAA PRIVACY AND SECURITY TRAINING. By: Jerry Jackson Compliance and Privacy Officer ACCOUNTABLE HEALTHCARE IPA HIPAA PRIVACY AND SECURITY TRAINING By: Jerry Jackson Compliance and Privacy Officer 1 1 Introduction Welcome to Privacy and Security Training course. This course will help you

More information

HIPAA for Business Associates

HIPAA for Business Associates HIPAA for Business Associates February 11, 2015 Teresa D. Locke This presentation is similar to any other legal education materials designed to provide general information on pertinent legal topics. The

More information

Art Gross President & CEO HIPAA Secure Now! How to Prepare for the 2015 HIPAA Audits and Avoid Data Breaches

Art Gross President & CEO HIPAA Secure Now! How to Prepare for the 2015 HIPAA Audits and Avoid Data Breaches Art Gross President & CEO HIPAA Secure Now! How to Prepare for the 2015 HIPAA Audits and Avoid Data Breaches Speakers Phillip Long CEO at Business Information Solutions Art Gross President & CEO of HIPAA

More information

HIPAA Audits: How to Be Prepared. Lindsey Wiley, MHA, CHTS-IM, CHTS-TS HIT Manager Oklahoma Foundation for Medical Quality

HIPAA Audits: How to Be Prepared. Lindsey Wiley, MHA, CHTS-IM, CHTS-TS HIT Manager Oklahoma Foundation for Medical Quality HIPAA Audits: How to Be Prepared Lindsey Wiley, MHA, CHTS-IM, CHTS-TS HIT Manager Oklahoma Foundation for Medical Quality An Important Reminder For audio, you must use your phone: Step 1: Call (866) 906-0123.

More information

HIPAA 101. March 18, 2015 Webinar

HIPAA 101. March 18, 2015 Webinar HIPAA 101 March 18, 2015 Webinar Agenda Acronyms to Know HIPAA Basics What is HIPAA and to whom does it apply? What is protected by HIPAA? Privacy Rule Security Rule HITECH Basics Breaches and Responses

More information

Getting Hip to the HIPAA and HITECH Act Compliance

Getting Hip to the HIPAA and HITECH Act Compliance Getting Hip to the HIPAA and HITECH Act Compliance NaNotchka M. Chumley, D.O., M.P.H. Family Medicine Physician Los Angeles, CA Integrating Global Trade & Logistic and Cybersecurity Westin St. Francis,

More information

HIPAA ephi Security Guidance for Researchers

HIPAA ephi Security Guidance for Researchers What is ephi? ephi stands for Electronic Protected Health Information (PHI). It is any PHI that is stored, accessed, transmitted or received electronically. 1 PHI under HIPAA means any information that

More information

OCR/HHS HIPAA/HITECH Audit Preparation

OCR/HHS HIPAA/HITECH Audit Preparation OCR/HHS HIPAA/HITECH Audit Preparation 1 Who are we EHR 2.0 Mission: To assist healthcare organizations develop and implement practices to secure IT systems and comply with HIPAA/HITECH regulations. Education

More information

HIPAA and the HITECH Act Privacy and Security of Health Information in 2009

HIPAA and the HITECH Act Privacy and Security of Health Information in 2009 HIPAA and the HITECH Act Privacy and Security of Health Information in 2009 What is HIPAA? Health Insurance Portability & Accountability Act of 1996 Effective April 13, 2003 Federal Law HIPAA Purpose:

More information

Dissecting New HIPAA Rules and What Compliance Means For You

Dissecting New HIPAA Rules and What Compliance Means For You Dissecting New HIPAA Rules and What Compliance Means For You A White Paper by Cindy Phillips of CMIT Solutions and Kelly McClendon of CompliancePro Solutions TABLE OF CONTENTS Introduction 3 What Are the

More information

Datto Compliance 101 1

Datto Compliance 101 1 Datto Compliance 101 1 Overview Overview This document provides a general overview of the Health Insurance Portability and Accounting Act (HIPAA) compliance requirements for Managed Service Providers (MSPs)

More information

Overview of the HIPAA Security Rule

Overview of the HIPAA Security Rule Office of the Secretary Office for Civil Rights () Overview of the HIPAA Security Rule Office for Civil Rights Region IX Alicia Cornish, EOS Sheila Fischer, Supervisory EOS Topics Upon completion of this

More information

Privacy Officer Job Description 4/28/2014. HIPAA Privacy Officer Orientation. Cathy Montgomery, RN. Presented by:

Privacy Officer Job Description 4/28/2014. HIPAA Privacy Officer Orientation. Cathy Montgomery, RN. Presented by: HIPAA Privacy Officer Orientation Presented by: Cathy Montgomery, RN Privacy Officer Job Description Serve as leader Develop Policies and Procedures Train staff Monitor activities Manage Business Associates

More information

HIPAA Compliance and the Protection of Patient Health Information

HIPAA Compliance and the Protection of Patient Health Information HIPAA Compliance and the Protection of Patient Health Information WHITE PAPER By Swift Systems Inc. April 2015 Swift Systems Inc. 7340 Executive Way, Ste M Frederick MD 21704 1 Contents HIPAA Compliance

More information

HIPAA: Understanding The Omnibus Rule and Keeping Your Business Compliant

HIPAA: Understanding The Omnibus Rule and Keeping Your Business Compliant 1 HIPAA: Understanding The Omnibus Rule and Keeping Your Business Compliant Introduction U.S. healthcare laws intended to protect patient information (Protected Health Information or PHI) and the myriad

More information

OCRA Spring Convention ~ 2014 Phyllis Craver Lykken, RPR, CLR, CCR 2463. Court Reporters and HIPAA

OCRA Spring Convention ~ 2014 Phyllis Craver Lykken, RPR, CLR, CCR 2463. Court Reporters and HIPAA Court Reporters and HIPAA OCRA Spring Convention ~ 2014 Phyllis Craver Lykken, RPR, CLR, CCR 2463 1 What Exactly is HIPAA? HIPAA is an acronym for the Health Insurance Portability and Accountability Act

More information

InfoGard Healthcare Services. 2015 InfoGard Laboratories Inc.

InfoGard Healthcare Services. 2015 InfoGard Laboratories Inc. InfoGard Healthcare Services 10 Steps To Protect My Covered Entity From Breach Your Presenters Alan Martin Account Manger Marvin Byrd Security Engineer Test and Certification Laboratory Healthcare Payment

More information

Welcome to ChiroCare s Fourth Annual Fall Business Summit. October 3, 2013

Welcome to ChiroCare s Fourth Annual Fall Business Summit. October 3, 2013 Welcome to ChiroCare s Fourth Annual Fall Business Summit October 3, 2013 HIPAA Compliance Regulatory Overview & Implementation Tips for Providers Agenda Green packet Overview of general HIPAA terms and

More information

Information Security and Privacy. WHAT are the Guidelines? HOW is it to be done? WHY is it done?

Information Security and Privacy. WHAT are the Guidelines? HOW is it to be done? WHY is it done? Information Security and Privacy WHAT are the Guidelines? HOW is it to be done? WHY is it done? 1 WHAT are the guidelines O Be in compliance of Federal/State Laws O Federal: O HIPAA 1996 2 3 WHAT are the

More information

HIPAA Security Compliance Reviews

HIPAA Security Compliance Reviews HIPAA Security Compliance Reviews Elizabeth S. Holland, MPA Office of E-Health Standards and Services Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services 1 2 What is HIPAA?

More information

HIPAA Overview and updates since HITECH and PPACA

HIPAA Overview and updates since HITECH and PPACA HIPAA Overview and updates since HITECH and PPACA Presented by: Angela Miller, CMC, CHC Medical Auditing Solutions LLC 2013 (c)2013 Medical Auditing Solutions LLC 1 Learning Objectives Overview the high

More information

Why Lawyers? Why Now?

Why Lawyers? Why Now? TODAY S PRESENTERS Why Lawyers? Why Now? New HIPAA regulations go into effect September 23, 2013 Expands HIPAA safeguarding and breach liabilities for business associates (BAs) Lawyer is considered a business

More information

HIPAA/HITECH PRIVACY & SECURITY CHECKLIST SELF ASSESSMENT INSTRUCTIONS

HIPAA/HITECH PRIVACY & SECURITY CHECKLIST SELF ASSESSMENT INSTRUCTIONS HIPAA/HITECH PRIVACY & SECURITY CHECKLIST SELF ASSESSMENT INSTRUCTIONS Thank you for taking the time to fill out the privacy & security checklist. Once completed, this checklist will help us get a better

More information

ELECTRONIC HEALTH RECORDS

ELECTRONIC HEALTH RECORDS ELECTRONIC HEALTH RECORDS Understanding and Using Computerized Medical Records CHAPTER TEN LESSON ONE Privacy and Security of Health Records Understanding HIPAA HIPAA: acronym for Health Insurance Portability

More information

6/17/2013 PRESENTED BY: Updates on HIPAA, Data, IT and Security Technology. June 25, 2013

6/17/2013 PRESENTED BY: Updates on HIPAA, Data, IT and Security Technology. June 25, 2013 Updates on HIPAA, Data, IT and Security Technology June 25, 2013 1 The material appearing in this presentation is for informational purposes only and should not be construed as advice of any kind, including,

More information

Joe Dylewski President, ATMP Solutions

Joe Dylewski President, ATMP Solutions Joe Dylewski President, ATMP Solutions Joe Dylewski President, ATMP Solutions Assistant Professor, Madonna University 20 Years, Technology and Application Implementation Experience Served as Michigan Healthcare

More information

HIPAA Compliance: Are you prepared for the new regulatory changes?

HIPAA Compliance: Are you prepared for the new regulatory changes? HIPAA Compliance: Are you prepared for the new regulatory changes? Baker Tilly CARIS Innovation, Inc. April 30, 2013 Baker Tilly refers to Baker Tilly Virchow Krause, LLP, an independently owned and managed

More information

What s new In the News Data Breach Discussion The 5 W s Risk Analysis: Why, What, how, When, and Who Common Issues Observed Q / A Session Purdue

What s new In the News Data Breach Discussion The 5 W s Risk Analysis: Why, What, how, When, and Who Common Issues Observed Q / A Session Purdue What s new In the News Data Breach Discussion The 5 W s Risk Analysis: Why, What, how, When, and Who Common Issues Observed Q / A Session Purdue Healthcare Advisors The # of data breaches is climbing The

More information

Sunday March 30, 2014, 9am noon HCCA Conference, San Diego

Sunday March 30, 2014, 9am noon HCCA Conference, San Diego Meaningful Use as it Relates to HIPAA Compliance Sunday March 30, 2014, 9am noon HCCA Conference, San Diego CLAconnect.com Objectives and Agenda Understand the statutory and regulatory background and purpose

More information

HIPAA Myths. WEDI Regional Affiliates. Chris Apgar, CISSP Apgar & Associates

HIPAA Myths. WEDI Regional Affiliates. Chris Apgar, CISSP Apgar & Associates HIPAA Myths WEDI Regional Affiliates Chris Apgar, CISSP Apgar & Associates Overview Missed Regulatory Requirements Common HIPAA Privacy Myths Common HIPAA Security Myths Other Related Myths Finding the

More information

Ensuring Privacy & Security of Patient Information

Ensuring Privacy & Security of Patient Information Ensuring Privacy & Security of Patient Information Danika Brinda, Assistant Professor and REACH P&S Subject Matter Expert Jane McGrath, Program Manager REACH/Stratis Health Session 12, Thursday, June 12,

More information

SECURITY RISK ASSESSMENT SUMMARY

SECURITY RISK ASSESSMENT SUMMARY Providers Business Name: Providers Business Address: City, State, Zip Acronyms NIST FIPS PHI EPHI BA CE EHR HHS IS National Institute of Standards and Technology Federal Information Process Standards Protected

More information

Appendix 4-2: Sample HIPAA Security Risk Assessment For a Small Physician Practice

Appendix 4-2: Sample HIPAA Security Risk Assessment For a Small Physician Practice Appendix 4-2: Administrative, Physical, and Technical Safeguards Breach Notification Rule How Use this Assessment The following sample risk assessment provides you with a series of sample questions help

More information

HIPAA TRAINING. A training course for Shiawassee County Community Mental Health Authority Employees

HIPAA TRAINING. A training course for Shiawassee County Community Mental Health Authority Employees HIPAA TRAINING A training course for Shiawassee County Community Mental Health Authority Employees WHAT IS HIPAA? HIPAA is an acronym that stands for Health Insurance Portability and Accountability Act.

More information

Policies and Procedures Audit Checklist for HIPAA Privacy, Security, and Breach Notification

Policies and Procedures Audit Checklist for HIPAA Privacy, Security, and Breach Notification Policies and Procedures Audit Checklist for HIPAA Privacy, Security, and Breach Notification Type of Policy and Procedure Comments Completed Privacy Policy to Maintain and Update Notice of Privacy Practices

More information

Decrypting the Security Risk Assessment (SRA) Requirement for Meaningful Use

Decrypting the Security Risk Assessment (SRA) Requirement for Meaningful Use Click to edit Master title style Decrypting the Security Risk Assessment (SRA) Requirement for Meaningful Use Andy Petrovich, MHSA, MPH M-CEITA / Altarum Institute April 8, 2015 4/8/2015 1 1 Who is M-CEITA?

More information

HIPAA and Cloud IT: What You Need to Know

HIPAA and Cloud IT: What You Need to Know HIPAA and Cloud IT: What You Need to Know A Guide for Healthcare Providers and Their Business Associates GDS WHITE PAPER HIPAA and Cloud IT: What You Need to Know As a health care provider or business

More information

What Virginia s Free Clinics Need to Know About HIPAA and HITECH

What Virginia s Free Clinics Need to Know About HIPAA and HITECH What Virginia s Free Clinics Need to Know About HIPAA and HITECH This document is one in a series of tools and white papers produced by the Virginia Health Care Foundation to help Virginia s free clinics

More information

The HIPAA Security Rule Primer A Guide For Mental Health Practitioners

The HIPAA Security Rule Primer A Guide For Mental Health Practitioners The HIPAA Security Rule Primer A Guide For Mental Health Practitioners Distributed by NASW Printer-friendly PDF 2006 APAPO 1 Contents Click on any title below to jump to that page. 1 What is HIPAA? 3 2

More information

University Healthcare Physicians Compliance and Privacy Policy

University Healthcare Physicians Compliance and Privacy Policy Page 1 of 11 POLICY University Healthcare Physicians (UHP) will enter into business associate agreements in compliance with the provisions of the Health Insurance Portability and Accountability Act of

More information

Network Detective. HIPAA Compliance Module. 2015 RapidFire Tools, Inc. All rights reserved V20150201

Network Detective. HIPAA Compliance Module. 2015 RapidFire Tools, Inc. All rights reserved V20150201 Network Detective 2015 RapidFire Tools, Inc. All rights reserved V20150201 Contents Purpose of this Guide... 3 About Network Detective... 3 Overview... 4 Creating a Site... 5 Starting a HIPAA Assessment...

More information

HIPAA Compliance The Time is Now Changes on the Horizon: The Final Regulations on Privacy and Security. May 7, 2013

HIPAA Compliance The Time is Now Changes on the Horizon: The Final Regulations on Privacy and Security. May 7, 2013 HIPAA Compliance The Time is Now Changes on the Horizon: The Final Regulations on Privacy and Security May 7, 2013 Presenters James Clay President Employee Benefits & HR Consulting The Miller Group jimc@millercares.com

More information

HIPAA SECURITY RISK ASSESSMENT SMALL PHYSICIAN PRACTICE

HIPAA SECURITY RISK ASSESSMENT SMALL PHYSICIAN PRACTICE HIPAA SECURITY RISK ASSESSMENT SMALL PHYSICIAN PRACTICE How to Use this Assessment The following risk assessment provides you with a series of questions to help you prioritize the development and implementation

More information

HIPAA Omnibus Compliance How A Data Loss Prevention Solution Can Help

HIPAA Omnibus Compliance How A Data Loss Prevention Solution Can Help HIPAA Omnibus Compliance How A Data Loss Prevention Solution Can Help The Health Information Portability and Accountability Act (HIPAA) Omnibus Rule which will begin to be enforced September 23, 2013,

More information

What Health Care Entities Need to Know about HIPAA and the American Recovery and Reinvestment Act

What Health Care Entities Need to Know about HIPAA and the American Recovery and Reinvestment Act What Health Care Entities Need to Know about HIPAA and the American Recovery and Reinvestment Act by Lane W. Staines and Cheri D. Green On February 17, 2009, The American Recovery and Reinvestment Act

More information

Are You Still HIPAA Compliant? Staying Protected in the Wake of the Omnibus Final Rule Click to edit Master title style.

Are You Still HIPAA Compliant? Staying Protected in the Wake of the Omnibus Final Rule Click to edit Master title style. Are You Still HIPAA Compliant? Staying Protected in the Wake of the Omnibus Final Rule Click to edit Master title style March 27, 2013 www.mcguirewoods.com Introductions Holly Carnell McGuireWoods LLP

More information

HIPAA Omnibus Rule Overview. Presented by: Crystal Stanton MicroMD Marketing Communication Specialist

HIPAA Omnibus Rule Overview. Presented by: Crystal Stanton MicroMD Marketing Communication Specialist HIPAA Omnibus Rule Overview Presented by: Crystal Stanton MicroMD Marketing Communication Specialist 1 HIPAA Omnibus Rule - Agenda History of the Omnibus Rule What is the HIPAA Omnibus Rule and its various

More information

Part 14: USB Port Security 2015

Part 14: USB Port Security 2015 Part 14: USB Port Security This article is part of an information series provided by the American Institute of Healthcare Compliance in response to questions we receive related to Meaningful Use and CEHRT

More information

Somansa Data Security and Regulatory Compliance for Healthcare

Somansa Data Security and Regulatory Compliance for Healthcare Somansa White Paper Somansa Data Security and Regulatory Compliance for Healthcare How Somansa can protect ephi- electronic patient health information and meet the requirements for healthcare compliances,

More information

The HIPAA Security Rule Primer Compliance Date: April 20, 2005

The HIPAA Security Rule Primer Compliance Date: April 20, 2005 AMERICAN PSYCHOLOGICAL ASSOCIATION PRACTICE ORGANIZATION Practice Working for You The HIPAA Security Rule Primer Compliance Date: April 20, 2005 Printer-friendly PDF 1 Contents Click on any title below

More information

HIPAA, HIPAA Hi-TECH and HIPAA Omnibus Rule

HIPAA, HIPAA Hi-TECH and HIPAA Omnibus Rule HIPAA, HIPAA Hi-TECH and HIPAA Omnibus Rule NYCR-245157 HIPPA, HIPAA HiTECH& the Omnibus Rule A. HIPAA IIHI and PHI Privacy & Security Rule Covered Entities and Business Associates B. HIPAA Hi-TECH Why

More information

Procedure Title: TennDent HIPAA Security Awareness and Training

Procedure Title: TennDent HIPAA Security Awareness and Training Procedure Title: TennDent HIPAA Security Awareness and Training Number: TD-QMP-P-7011 Subject: Security Awareness and Training Primary Department: TennDent Effective Date of Procedure: 9/23/2011 Secondary

More information

HIPAA COMPLIANCE AND DATA PROTECTION. sales@eaglenetworks.it +39 030 201.08.25 Page 1

HIPAA COMPLIANCE AND DATA PROTECTION. sales@eaglenetworks.it +39 030 201.08.25 Page 1 HIPAA COMPLIANCE AND DATA PROTECTION sales@eaglenetworks.it +39 030 201.08.25 Page 1 CONTENTS Introduction..... 3 The HIPAA Security Rule... 4 The HIPAA Omnibus Rule... 6 HIPAA Compliance and EagleHeaps

More information

White Paper THE HIPAA FINAL OMNIBUS RULE: NEW CHANGES IMPACTING BUSINESS ASSOCIATES

White Paper THE HIPAA FINAL OMNIBUS RULE: NEW CHANGES IMPACTING BUSINESS ASSOCIATES White Paper THE HIPAA FINAL OMNIBUS RULE: NEW CHANGES IMPACTING BUSINESS ASSOCIATES CONTENTS Introduction 3 Brief Overview of HIPPA Final Omnibus Rule 3 Changes to the Definition of Business Associate

More information

Security Compliance, Vendor Questions, a Word on Encryption

Security Compliance, Vendor Questions, a Word on Encryption Security Compliance, Vendor Questions, a Word on Encryption Alexis Parsons, RHIT, CPC, MA Director, Health Information Services Security/Privacy Officer Shasta Community Health Center aparsons@shastahealth.org

More information

HIPAA Omnibus Rule Practice Impact. Kristen Heffernan MicroMD Director of Prod Mgt and Marketing

HIPAA Omnibus Rule Practice Impact. Kristen Heffernan MicroMD Director of Prod Mgt and Marketing HIPAA Omnibus Rule Practice Impact Kristen Heffernan MicroMD Director of Prod Mgt and Marketing 1 HIPAA Omnibus Rule Agenda History of the Rule HIPAA Stats Rule Overview Use of Personal Health Information

More information

HIPAA Compliance Review Analysis and Summary of Results

HIPAA Compliance Review Analysis and Summary of Results HIPAA Compliance Review Analysis and Summary of Results Centers for Medicare & Medicaid Services (CMS) Office of E-Health Standards and Services (OESS) Reviews 2008 Table of Contents Introduction 1 Risk

More information

HIPAA BUSINESS ASSOCIATE AGREEMENT

HIPAA BUSINESS ASSOCIATE AGREEMENT HIPAA BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ( BAA ) is effective ( Effective Date ) by and between ( Covered Entity ) and Egnyte, Inc. ( Egnyte or Business Associate ). RECITALS

More information

Healthcare Compliance Solutions

Healthcare Compliance Solutions Healthcare Compliance Solutions Let Protected Trust be your Safe Harbor In the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH), the U.S. Department of Health and Human

More information

COMPLIANCE ALERT 10-12

COMPLIANCE ALERT 10-12 HAWAII HEALTH SYSTEMS C O R P O R A T I O N "Touching Lives Every Day COMPLIANCE ALERT 10-12 HIPAA Expansion under the American Recovery and Reinvestment Act of 2009 The American Recovery and Reinvestment

More information

Industry leading Education Todays Webinar

Industry leading Education Todays Webinar Compliance Simplified Achieve, Illustrate, Maintain Industry leading Education Todays Webinar Please ask questions Todays slides are available http://compliancy- group.com/slides023/ Certified Partner

More information

Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH)

Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH) Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH) Table of Contents Introduction... 1 1. Administrative Safeguards...

More information

NCHICA HITECH Act Breach Notification Risk Assessment Tool. Prepared by the NCHICA Privacy, Security & Legal Officials Workgroup

NCHICA HITECH Act Breach Notification Risk Assessment Tool. Prepared by the NCHICA Privacy, Security & Legal Officials Workgroup NCHICA HITECH Act Breach Notification Risk Assessment Tool Prepared by the NCHICA Privacy, Security & Legal Officials Workgroup NORTH CAROLINA HEALTHCARE INFORMATION AND COMMUNICATIONS ALLIANCE, INC August

More information

Please Read. Apgar & Associates, LLC apgarandassoc.com P. O. Box 80278 Portland, OR 97280 503-384-2538 877-376-1981 503-384-2539 Fax

Please Read. Apgar & Associates, LLC apgarandassoc.com P. O. Box 80278 Portland, OR 97280 503-384-2538 877-376-1981 503-384-2539 Fax Please Read This business associate audit questionnaire is part of Apgar & Associates, LLC s healthcare compliance resources, Copyright 2014. This questionnaire should be viewed as a tool to aid in evaluating

More information

OCR UPDATE Breach Notification Rule & Business Associates (BA)

OCR UPDATE Breach Notification Rule & Business Associates (BA) OCR UPDATE Breach Notification Rule & Business Associates (BA) Alicia Galan Supervisory Equal Opportunity Specialist March 7, 2014 HITECH OMNIBUS A Reminder of What s Included: Final Modifications of the

More information

Faster, Smarter, More Secure: IT Services Geared for the Health Care Industry A White Paper by CMIT Solutions

Faster, Smarter, More Secure: IT Services Geared for the Health Care Industry A White Paper by CMIT Solutions Faster, Smarter, More Secure: IT Services Geared for the Health Care Industry A White Paper by CMIT Solutions Table of Contents Introduction... 3 1. Data Backup: The Most Critical Part of any IT Strategy...

More information

Compliance HIPAA Training. Steve M. McCarty, Esq. General Counsel Sound Physicians

Compliance HIPAA Training. Steve M. McCarty, Esq. General Counsel Sound Physicians Compliance HIPAA Training Steve M. McCarty, Esq. General Counsel Sound Physicians 1 Overview of HIPAA HIPAA contains provisions that address: The privacy of protected health information or PHI The security

More information

SUBJECT: SECURITY OF ELECTRONIC MEDICAL RECORDS COMPLIANCE WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA)

SUBJECT: SECURITY OF ELECTRONIC MEDICAL RECORDS COMPLIANCE WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA) UNIVERSITY OF PITTSBURGH POLICY SUBJECT: SECURITY OF ELECTRONIC MEDICAL RECORDS COMPLIANCE WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA) DATE: March 18, 2005 I. SCOPE This

More information

HIPAA in an Omnibus World. Presented by

HIPAA in an Omnibus World. Presented by HIPAA in an Omnibus World Presented by HITECH COMPLIANCE ASSOCIATES IS NOT A LAW FIRM The information given is not intended to be a substitute for legal advice or consultation. As always in legal matters

More information

HIPAA Security. assistance with implementation of the. security standards. This series aims to

HIPAA Security. assistance with implementation of the. security standards. This series aims to HIPAA Security SERIES Security Topics 1. Security 101 for Covered Entities 2. Security Standards - Administrative Safeguards 3. Security Standards - Physical Safeguards 4. Security Standards - Technical

More information

Joseph Suchocki HIPAA Compliance 2015

Joseph Suchocki HIPAA Compliance 2015 Joseph Suchocki HIPAA Compliance 2015 Sponsored by Eagle Associates, Inc. Eagle Associates provides compliance services for over 1,200 practices nation wide. Services provided by Eagle Associates address

More information

HIPAA MYTHS: DON T ALWAYS BELIEVE WHAT YOU HEAR. Chris Apgar, CISSP

HIPAA MYTHS: DON T ALWAYS BELIEVE WHAT YOU HEAR. Chris Apgar, CISSP HIPAA MYTHS: DON T ALWAYS BELIEVE WHAT YOU HEAR Chris Apgar, CISSP 2015 OVERVIEW Missed Regulatory Requirements Common HIPAA Privacy Myths Common HIPAA Security Myths Other Related Myths Finding the Right

More information

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Health Insurance Portability and Accountability Act of 1996 (HIPAA) HIPAA Privacy Rule Health Insurance Portability and Accountability Act of 1996 (HIPAA) Transactions Standards 1. Health claims 2. Health claim attachments 3. Healthcare payment and remittance advice 4.

More information