The Cost Of A HIPAA Violation
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The fines and penalties for even one data breach or HIPAA violation of personal health information (PHI) that a hospital, private practice, or any other type of medical facility has can cost millions, but the actual cost are even higher.
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Health care providers continue to experience significant levels of scrutiny from CMS, OIG, audit and recovery contractors, as well as state and federal law enforcement agencies. As a result of heightened enforcement activity, health care providers may be at risk. To update you on the current regulatory and enforcement environment, this presentation focusing on fraud and abuse will cover:
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HIPAAThe day after the medication error, B. Moore’s mother signs.docx
HIPAA
The day after the medication error, B. Moore’s mother signs in at the front desk to get her visitation pass. As she is standing at the front desk, she overhears an inappropriate conversation between Ida Feeney, the unit secretary, and a nurse from a different unit of the hospital.
Ida Feeney and Brenda Turner
Ida Feeney: Did you hear about the Moore kid? It’s a good thing they caught that right away. She’s small for her age, and that insulin could have really done a number on her.
Brenda Turner: Jeez, how much did they give her?
Ida Feeney: Well, she wasn’t supposed to have any. But I forget the actual dose. I’ll look in the EHR later, but I think it was pretty high.
Brenda Turner: Wait, is it Belinda Moore?
Ida Feeney: Yes, why?
Brenda Turner: I think she’s in a gymnastics class with my daughters!
Now that you have observed this inappropriate conversation, answer the following questions about HIPAA regulations.
Question 1: Which regulatory agency is responsible for overseeing the HIPAA privacy and security rule?
Your response:
This question has not been answered yet.
Incorrect.
Correct Answer: U.S Department of Health and Human Services.
The Joint Commission is an independent regulatory agency. It is not part of the U.S. government, and it does not have the authority or responsibility to enforce privacy and security rules.
Incorrect.
Correct Answer: U.S Department of Health and Human Services.
While the DEA is a U.S. government regulatory agency, its purpose is not to oversee the HIPAA privacy and security rules. Its primary responsibility is to enforce controlled substances laws.
Correct!
The U.S Department of Health and Human Services Office of Civil Rights is responsible for enforcing the HIPAA privacy and security rules.
Incorrect.
Correct Answer: U.S Department of Health and Human Services.
While CLIA is a U.S. government regulatory body, its purpose is not to enforce the HIPAA privacy and security rules. CLIA’s purpose is to ensure laboratory testing quality.
Question 2: How would the health care organization’s privacy officer determine whether others who were not involved in the patient’s care had viewed her medical record?
Your response:
This question has not been answered yet.
Expert Response: Health care experts on the HIPAA privacy and security rules indicate the best way to determine whether a patient’s medical record was accessed inappropriately is to conduct file audits. These audits may include, but are not limited to:
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· Reviews of business associate contracts.
· Audits of disclosures in accordance with the privacy notice, along with the organization’s adherence to confidential communications protocols.
Question 3: Health care experts on the HIPAA privacy and security rules indicate the following as the most appropriate sequence to follow in addressing the potential HIPAA violation.
1. Meet with B. Mo ...
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HIPAA is a federal law that protects patients' medical information and sets rules for who can access it. It requires health plans, providers, and clearinghouses to protect oral, written and electronic protected health information. It gives patients rights over their information, such as access and request for amendments. Violations can result in civil penalties up to $1.5 million and criminal penalties including prison time, depending on the severity and intent of the violation. Healthcare workers must carefully protect patient privacy and only share information with those directly involved in their care.
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The Cost Of A HIPAA Violation
- 1. + DoesYour Practice Know The Cost? The Cost Of A: HIPAA Violation Fines Lawsuit Reputation Recovery
- 2. + In The Last 2Years… % Of Health Care Organizations Have Had: One Or More Breaches Photo: Chuck Coker
- 3. + Have Had More Than 5 Breaches And…
- 4. + Government Fines & Penalties Range From $100 To $50,000 Per Health Record!!! With A Maximum Annual Fine Of… $1.5 Million Photo: 401(K) 2012
- 5. + But There’s More… Photo: Steve Davis Photo: Gayla Baer-Taylor Photo: One Way Stock
- 6. + Investigation & Recovery n $$$ Hire Cyber Security Firm To Investigate The Cause n Take Action Based On The Findings How did it happen # of Records Exposed Stop The Bleeding Enforce Policies
- 7. + Lawsuits HIPAA Award Upheld After Walgreen’s Pharmacist Shared Patient’s Data $1.44 Million
- 8. + PR Nightmare – Angry Customers Every Affected Individual Must Be Notified!! And If The Breach Involves 500 Or More Records…
- 9. + Then You Must Alert… n The Media n The Department of Health & Human Services
- 10. +How Much Time WillYou Waste? n Crafting A Message & Alerting n Patients Whose Records Were Exposed n The Media n Department of Health & Human Services n Answering Phone Calls From Angry Patients n Responding To Media Inquiries n Responding To HHS Follow Up Questions & Paperwork
- 11. +In Other Words… n Family n Patients Yet MORE TIME For… LESS TIME With… n Doing Paper Work n Dealing With Oversight From Gov’t Agencies
- 12. + The Largest Cost ForYour Company: Photo: MSLGroup Global
- 13. + The $$ Over A 10-Year Period n Healthcare Industry - $398 Per Record n Pharmaceutical Industry - $298 Per Record n 48% of the Cost Is Lost Revenue Ponemon Institute: 2015 Cost of Data Breach Study: United States
- 14. + With The $$$ Of A Single Data Breach Likely Being In The… MILLIONS $$$ Photo: 401(K) 2012
- 15. + It’s No Wonder That… Of Small Businesses Go Out Of Business After A Data Breach National Cyber Security Alliance: Small Business Survey
- 16. + For More Information On Cyber Liability & The Ways To Prevent, Protect, & Rescue Your Business Visit…
- 17. + www.affenix.com Cyber Sherpas Preparing, Guiding, & Protec8ng Businesses In A Digital Age