Provisioning Workforce Access to Electronic Protected Health Information: It May Be ‘Common Sense,’ but Is It Easy to Implement?

Secure and protected medical records. Bar code added to folder, not actual patient information. Concept image. Narrow depth of field.

In December 2018, Pagosa Springs Medical Center settled potential Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rule violations and entered into a corrective action plan with the Office for Civil Rights (OCR) at the U.S. Department of Health & Human Services. The incident involved a former employee who continued to have remote access to Pagosa Springs Medical Center’s web-based scheduling calendar for two months after the employee’s termination, which resulted in 557 individuals’ electronic protected health information (ePHI) being improperly disclosed. Additionally, there was no business associate agreement between Pagosa Springs Medical Center and Google, the web-based scheduling calendar vendor. Pagosa Springs Medical Center, an 11-bed critical access hospital located in rural Colorado, paid $111,400 and entered into a two-year corrective action plan. The corrective action plan includes updates to Pagosa Springs Medical Center’s HIPAA security management, business associate agreement, and policies and procedures, as well as training its workforce in these areas.

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Physician Hospitalist Group Settles with OCR and Enters Into a Resolution Agreement for Failure to Have HIPAA Policies and Business Associate Agreement in Place

On Dec. 5, 2018, the Office for Civil Rights (OCR) of the U. S. Department of Health and Human Services (HHS) announced that Advanced Care Hospitalists PL (ACH) had entered into a $500,000 settlement and resolution agreement (RA) resulting from OCR’s investigation of ACH’s breach notification on April 11, 2014, and subsequent supplemental notification. On Feb. 11, 2014, ACH was initially notified by a local hospital that patient demographic and clinical information, including Social Security numbers, were viewable on the website of Doctor’s First Choice Billing Inc. (First Choice). On April 11, 2014, ACH initially notified 400 patients, and after further investigation, notified an additional 8,855 patients.

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Capitol Hill Healthcare Update

This week’s “Capitol Hill Healthcare Update” includes the latest on a pending Senate vote on opioid legislation as Congress races to enact a response to the crisis before the November election; the Senate votes to expand Sunshine Act disclosure requirements; and a key House Republican backs requiring drug manufacturers to include prices in their ads; and more. (Note: Congress is in recess today and Tuesday in observance of Rosh Hashanah. The House and Senate will reconvene Wednesday for legislative business.)

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Capitol Hill Healthcare Update

This week’s “Capitol Hill Healthcare Update” includes the latest on a series of healthcare bills scheduled for House votes, including one to repeal the medical device tax; Food and Drug Administration (FDA) Commissioner Scott Gottlieb and National Institutes of Health (NIH) Director Francis Collins’ scheduled testimony on before a House committee; reaction from congressional leaders to the Trump administration’s plan to import drugs from other countries; and more.

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Capitol Hill Healthcare Update

HOUSE PANEL TO EXAMINE POTENTIAL CHANGES TO STARK LAW

Senior Health and Human Services (HHS) officials are scheduled to testify this week before a House subcommittee examining whether laws governing physician self-referral are an impediment to coordinated care.

HHS Deputy Secretary Eric Hargan and Deputy General Counsel Kelly Cleary are scheduled to testify Tuesday before the House Ways and Means Health Subcommittee.

Subcommittee Chairman Peter Roskam (R-Ill.) has said the physician self-referral law, or “Stark Law,” impedes value-based reforms that reward better outcomes and higher-value care.

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Capitol Hill Healthcare Update

LAWMAKERS COOL TO TRUMP PLAN ON HHS, GOVERNMENT REORGANIZATION

The response from lawmakers on Capitol Hill to the White House plan to reorganize the federal government – including proposed changes to multiple healthcare agencies – ranged from lukewarm to outright opposition.

President Donald J. Trump’s plan would rebrand Health and Human Services (HHS) as the “Department of Health and Public Welfare.” It would consolidate certain welfare and nutrition assistance programs, now run by the Agriculture Department, into the new department.

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Capitol Hill Healthcare Update

HOUSE OKs DOZENS OF OPIOID-RELATED BILLS; MORE VOTES SCHEDULED

The House last week approved 38 bills that lawmakers hope will stem the opioid epidemic, and it scheduled votes this week on at least a dozen more.

Most bills were noncontroversial, and others thought to be contentious – like giving the Postal Service more tools to track foreign mail shipments into the United States – easily won House approval.

House Republicans plan more votes on opioid bills this week. Then GOP leaders will package the individual bills into one comprehensive measure to send to the Senate.

Meanwhile, the Senate Finance Committee last week approved a combined package with 22 provisions that aim to crack down on opioid abuse and expand access to treatment. The bill would expand telehealth coverage, standardize electronic prior authorizations and remove Medicaid lifetime limits for substance abuse treatment.

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Capitol Hill Healthcare Update

HOUSE TO VOTE ON DOZENS OF OPIOID BILLS WHILE SENATE READIES COMPREHENSIVE MEASURE

The House this week will begin considering some of the 70 different opioid bills that have been approved by eight different committees, focusing on prescribing, enforcement, and Medicare and Medicaid coverage of treatment options.

House Majority Leader Kevin McCarthy (R-Calif.) announced last week that several dozen noncontroversial bills will be considered either by voice vote or under expedited procedures that require supermajorities to pass but allow House leaders to move them quickly. Other bills – like relaxing health privacy rules for drug abuse treatment records and allowing Medicaid to cover in-patient drug rehab costs – will be debated on the House floor, with opportunities for amendments.

Bills receiving votes this week include establishing a new category of synthetic opioids and other drugs under the Controlled Substances Act, allowing low-income housing vouchers to be used to aid recovering addicts, and increasing the tracking of parcels and mail into the United States.

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Capitol Hill Healthcare Update

RYAN SAYS POTENTIAL COMPROMISE COMING ON RISK EVALUATION AND MITIGATION STRATEGY DRUGS

House Speaker Paul Ryan, R-Wis., last week said congressional leaders are trying to hammer out compromise legislation that would make it easier for generic manufacturers to obtain branded drugs that are protected under a Food and Drug Administration (FDA) safety program.

Ryan made the comment about the FDA’s Risk Evaluation and Mitigation Strategies (REMS) safety program during BakerHostetler’s 29th annual Legislative Seminar last week. Ryan didn’t offer specifics but said leaders on the House Energy and Commerce and Judiciary committees were working on compromise language that would speed generic manufacturers’ access to those drugs for bioequivalence testing.

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Proposed IPPS Rule Changes

The Centers for Medicare & Medicaid Services (CMS) recently released its proposed rules for the Hospital Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2019. As discussed below, the proposed rule focuses on promoting interoperability to reduce administrative burdens, increase efficiency and improve patient access while providing high-quality patient care. Comments on the proposed rule are due June 25, 2018.

Electronic Health Records (EHR) Program Update

CMS proposed significant changes to the Medicare and Medicaid Electronic Health Record (EHR) Programs. For starters, it renamed the program to Promoting Interoperability (PI) Programs to better reflect its focus on interoperability and improving patient access to health information. To maintain alignment across programs, CMS noted that the name change applies to the Merit-Based Incentive Payment System Advancing Care Information performance category.

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