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Are You Ready for a HIPAA Audit?

Author: Wiedemann, Lou Ann

Source: Journal of AHIMA

Publication Date: April 2017



Editor’s Note: The following is an excerpt from the new “External HIPAA Audit Readiness Toolkit” developed by AHIMA. The full toolkit is free for AHIMA members.


THE HITECH OMNIBUS Rule mandated that the US Department of Health and Human Services (HHS) condu....

How Small Organizations Handle HIPAA Compliance

Author: Primeau, Debra

Source: Journal of AHIMA

Publication Date: April 2017



Smaller healthcare facilities typically lack the resources and expertise to address the constant flow of competing priorities, forcing leadership to wear many hats in a fragmented environment. Few have a designated privacy, security, or compliance officer, let alone the corporate support s....

RAC Audit Underpayments: Does CMS Owe You Money?

Author: Eramo, Lisa A

Source: Journal of AHIMA

Publication Date: February 2017



Anxiety—it’s the emotion that looms over most patient financial services (PFS) directors and those working in health information management (HIM) when they discover that their organization’s claims are subject to a Centers for Medicare and Medicaid Services (CMS) Recovery....

What to Expect When Phase 2 HIPAA Audits Begin

Author: Rose, Angela Dinh

Source: Journal of AHIMA

Publication Date: June 2016



The HITECH Omnibus Rule mandated that the US Department of Health and Human Services (HHS) conduct periodic audits on the privacy and security compliance of covered entities and business associates. It was during the Office for Civil Rights (OCR) update session on March 21, 2016 at the 20....

OCR Clarifies Policy on Medical Record Request Fees

Author: Greene, Adam H

Source: Journal of AHIMA

Publication Date: April 2016



In 2009, CONGRESS passed the Health Information Technology for Economic and Clinical Health (HITECH) Act, which granted individuals a right to have a copy of their records sent to a third party, according to 42 U.S.C. § 17935(e) of the regulation.


Unfortunately, many attorn....

What Lies Ahead in 2016?

Author: Hedges, Ron

Source: AHIMA blog post | Journal of AHIMA - website

Publication Date: December 18, 2015





This is the last Legal e-Speaking post of 2015. I thought I would use it to predict what 2016 might bring in litigation and beyond. When looking ahead to the next year, there are many possible things that HIM professionals should keep an eye out for, but five stand out to m....

Evaluating the Information Governance Principles for Healthcare: Compliance and Availability

Author: Datskovsky, Galina; Hedges, Ron; Empel, Sofia; Washington, Lydia

Source: Journal of AHIMA

Publication Date: June 2015



Editor’s Note: This is the third in a series of four articles that discuss the eight Information Governance Principles for Healthcare.


AHIMA’s new Information Governance Principles for Healthcare (IGPHC) provide a framework for healthcare organizations to leverage informati....

Privacy Holes in the 'Hidden Healthcare System': Students' PHI-laden Education Records that are Stored and Shared Electronically Don’t Have the Same Safeguards as most EHRs

Author: DuBravec, Daniel A; Daigle, Matt

Source: Journal of AHIMA

Publication Date: June 2015



With student safety and privacy an increasing parental concern, school administrators nationwide are sitting on a powder keg of potential backlash because of a gray area of student privacy protections that Julia Lear, senior advisor for the Center of Health and Health Care in Schools at G....

Clearing the HIPAA Cobwebs: New ONC Chief Privacy Officer Lucia Savage Focuses on Balancing Privacy and Security with Expanding Interoperable EHR Exchange

Author: Dimick, Chris

Source: Journal of AHIMA

Publication Date: April 2015



The spiders of time have been hard at work on the US healthcare privacy and security rules, to the point that their place in health IT interoperability has become fogged and is inhibiting their proper role in the meaningful exchange of health information, according to Lucia Savage, JD, th....

ABCs of Health Plan Audits

Author: Crump, Dawn; Hennum, Jeannie

Source: Journal of AHIMA - website

Publication Date: March 2015



The Affordable Care Act (ACA) has a dramatic ripple effect on the healthcare industry—and will continue to create seismic shifts for many years to come. One important change for health information management (HIM) professionals to understand is the impact of ACA on health plan audits. Alre....

Recovery Audit Program Changes

Author: Wilson, Donna D

Source: CodeWrite

Publication Date: February 2015



Editor's note: The Centers for Medicare and Medicaid Services (CMS) has delayed the commencement of work under the Recovery Audit contract for durable medical equipment (DME), home health (HH), and hospice reviews. For more information and further updates on this new development, please s....

Industry Awaits Phase 2 of HIPAA Audit Program

Author: Asmonga, Donald D.

Source: Journal of AHIMA

Publication Date: January 2015



The wait for the second round of mandated privacy and security audits from the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) continues. OCR is currently working through final details for the revised audit plan as they await finalization of new technolog....

Evaluation of PHI Hunter in Natural Language Processing Research

Author: Redd, Andrew; Pickard, Steve; Meystre, Stephane; Scehnet, Jeffrey; Bolton, Dan; Heavirland, Julia; Weaver, Allison Lynn ; Hope, Carol; Garvin, Jennifer Hornung

Source: Perspectives in Health Information Management

Publication Date: January 2015


Abstract


Objectives: We introduce and evaluate a new, easily accessible tool using a common statistical analysis and business analytics software suite, SAS, which can be programmed to remove specific protected health information (PHI) from a text document. Removal of PHI is import....

Work Plan Fiscal Year 2015

Author: U.S. Department of Health and Human Services. Office of the Inspector General

Source: Government (U.S.)

Publication Date: October 2014

This report forecasts areas of OIG focus based on the results of OIG’s risk assessments and have been identified as significant management and performance challenges facing HHS. In FY 2015 and beyond, we will continue to focus on emerging payment, eligibility, management, and IT systems security vulnerabilities in health care reform programs, such as the health insurance marketplaces.

Coping with Government Audits

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: August 2014





The HIM Problem: Medicare Auditor Scrutiny of Inpatient Claims


This spring, the Centers for Medicare and Medicaid Services (CMS) issued its “two midnight rule” which was intended to define and clarify what Medicare considers to be criteria justifying an inpatient st....

HIPAA Breach Enforcement Roundup

Author: Cacciatore, Victoria; Downing, Katherine

Source: Journal of AHIMA

Publication Date: July 2014



Criminal attacks on healthcare systems have risen 100 percent since 2010, according to a recent Ponemon study.1 This makes it obvious that the privacy and security of patient health information is vulnerable and highly susceptible to data breach. The HIPAA Breach Notification Rule became e....

Navigating a Compliant Breach Management Process

Author: Downing, Katherine

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: June 2014

The purpose of AHIMA’s new Breach Management Toolkit is to provide a comprehensive collection of resources and best practices to help healthcare organizations and health information management (HIM) professionals navigate their way through the Health Insurance Portability and Accountability Act (HIPAA) Breach Notification Rule and the overall breach management process. The toolkit is intended to raise awareness of the importance and responsibility of everyone within the organization to report HIPAA breaches to the appropriate designated personnel, as well as provide breach prevention education and training.

On the HIPAA Hook

Author: Hicks, Andrew

Source: Journal of AHIMA

Publication Date: April 2014



Some healthcare business associates are still asking if HITECH-HIPAA impacts them. The answer is just as important to their affiliated healthcare providers.


Thousands of companies are now legally obligated to comply with the HITECH-HIPAA regulations because of their busines....

Privacy and Security Audits of Electronic Health Information (2014 update)

Author: Walsh, Tom; Miaoulis, William M

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: March 2014

In a perfect world, access controls alone would ensure the privacy and security of electronic protected health information (ePHI). However, the complexities of today’s healthcare environment make it extremely challenging to limit access to the minimum information necessary that members of the workforce require in order to perform their jobs.

HITECH Frequently Asked Privacy, Security Questions: Part 3

Author: Rose, Angela Dinh; Greene, Adam H

Source: Journal of AHIMA | AHIMA Q and A

Publication Date: March 2014

This article concludes a three-part series discussing the most commonly asked questions regarding compliance requirements surrounding the final HITECH Omnibus Rule, released in January 2013. It highlights the updated requirements and provides answers to questions regarding decedent protected health information (PHI), the release of immunization records to schools, and the enhanced request for restrictions requirements.

RAC Reform Awaits Government Action

Author: AHIMA Advocacy and Policy Team

Source: Journal of AHIMA

Publication Date: November 2013



Although the First session of the 113th Congress is coming to a close, plenty of work remains for the members of Congress to accomplish in the coming year. AHIMA has worked closely with federal legislators to raise awareness on key initiatives that affect health information management (HIM....

Adapting BA Practices to Meet the Omnibus Rule

Author: McSteen, Thomas

Source: Journal of AHIMA

Publication Date: September 2013



The 2013 HIPAA Omnibus Rule marks a key milestone for implementation of the 2009 Health Information Technology for Economic and Clinical Health Act (HITECH). One of the most far-reaching impacts of HITECH and the Omnibus Rule is that business associates (BA) and their subcontractors now mu....

HIPAA Changes Call for Revising BA Agreements

Author: McDavid, Jan P

Source: Journal of AHIMA

Publication Date: May 2013



Business associates (BAs) of HIPAA-covered entities like hospitals and doctor's offices should already be intimately acquainted with HIPAA's privacy and security regulations. BAs should already have business associate agreements with every covered entity with whom they work and assume resp....

De-identification and the Sharing of Big Data

Author: White, Susan E

Source: Journal of AHIMA

Publication Date: April 2013



One of the newest buzz words in data analytics is “Big Data,” and the data created through the healthcare industry is some of the “biggest” around. The widespread implementation of electronic health records (EHRs) and the need to share data to measure quality and ma....

HIM Staff RACing Up Record Requests

Author: AHIMA

Source: Journal of AHIMA

Publication Date: April 2013


Healthcare claims auditors have inundated release of information staff and vendors this year with record requests, in part due to the aggressive Centers for Medicare and Medicaid Services’ (CMS) Recovery Audit Contractor (RAC) initiative. RACs review provider bills and medical records to....

Top RAC Target Areas

Author: AHIMA

Source: Journal of AHIMA

Publication Date: July 2012


If you bill fee-for-service programs, your claims will be subject to review by the Recovery Audit Contractor Program (RAC). That was the promise made by the Centers for Medicare and Medicaid Services when it expanded its once-experimental program to all 50 states in 2010. The RAC's mission....

HIPAA Compliance for Clinician Texting

Author: Greene, Adam H

Source: Journal of AHIMA

Publication Date: April 2012



The HIPAA privacy and security rules need not act as an obstacle to efficient communications, but keeping texting compliant requires planning and diligence.

Text (or SMS) messaging has become nearly ubiquitous on mobile devices. According to one survey, approximately 72 perce....

The New Privacy Officer

Author: Dimick, Chris

Source: Journal of AHIMA

Publication Date: April 2012



It has been a decade since the first privacy officers took their jobs in response to the HIPAA privacy rule. A slew of changes since then have added more responsibility, required more skills, and demanded more time of them than anyone could have imagined.

When Nancy Davis, R....

Busy Year for the RACs

Author: Easterling, Sharon

Source: Journal of AHIMA

Publication Date: March 2012



Learning from last year's denials and preparing for what's ahead will help providers avoid being stung in 2012.


When the Recovery Audit Contractor (RAC) permanent program began in 2009, providers were hopeful that the process for identifying underpayments and overpayments w....

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