Two rules both alike in dignity: CMS and ONC release proposed rules to advance interoperability

On Feb. 11, 2019, two Department of Health and Human Services (HHS) agencies, the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS), released their long-awaited proposed rules designed to further HHS’ goal of promoting electronic health information interoperability and implementing many of the provisions mandated under the 21st Century Cures Act (Cures Act). Notably, these proposed rules were released shortly before the HHS Office for Civil Rights deadline for comments about potential changes to improve coordinated care. Taken together, recent HHS rulemakings suggest that interoperability is coming, and significant requirements are in store for providers, payors, health information technology developers and players.

The Cures Act charged ONC with the responsibility of implementing many of the provisions designed to advance interoperability, including the provisions addressing information blocking and certification requirements for health information technology (health IT) developers. The ONC rule also contains widespread revisions to the agency’s Health IT Certification Program and the 2015 edition certification criteria to further support access to, exchange of and use of electronic health information. Continue Reading

Deter Workforce Snooping in Electronic Medical Records Through Education and Training

On March 6, 2019, the U.S. Department of Justice (DOJ) announced that Linda Sue Kalina pled guilty to wrongfully disclosing the protected health information (PHI) of another individual in violation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Kalina was a patient information coordinator with the University of Pittsburgh Medical Center (UPMC) and its affiliate, Tri Rivers Musculoskeletal Centers (TRMC). From March 7, 2016, through June 23, 2017, Kalina improperly accessed the health information of 111 UPMC patients who had never been provided services at TRMC. In her capacity as a patient information coordinator, Kalina was authorized to access patient information contained in UPMC’s electronic medical record system as necessary to provide services to patients. Among others, Kalina accessed and disclosed the health information involving two individuals who worked at Kalina’s former employer. Read more >>

Clearly Defined HIPAA and FERPA Policies May Help Covered Entities in Defending a Claim for Unemployment Compensation

email menu on monitor screenRecently, in Dantry v. Unemployment Compensation Board of Review, No. 1665 C.D. 2017 (Pa. Cmwlth. 2019), the Commonwealth Court of Pennsylvania reversed the order of the Unemployment Compensation Board of Review (Board) which  had affirmed the Unemployment Compensation Referee’s decision that Jami M. Dantry (Dantry) was ineligible for unemployment compensation benefits because Dantry’ s conduct rose to the level of willful misconduct based on a violation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Family Educational Rights and Privacy Act  (FERPA), and for insubordination.  The Commonwealth Court of Pennsylvania remanded the matter to the Board for the issuance of a decision determining whether Dantry’s alleged insubordination constituted willful misconduct.

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Senate Democrats recently introduced the Stop Price Gouging Act

White, blank doctor's prescription pad with an orange prescription medication bottle lying on top of it with pills spilling out of the bottle. The bottle has a blank label on it. Tan colored pills lay on top of prescription. A large "RX" is at the top left corner of the page. Pharmacy, healthcare, drugs, medicine concepts. Desk, table, countertop.Senate Democrats recently introduced the Stop Price Gouging Act (S. 378), which seeks to place an excise tax on pharmaceutical companies in proportion to price spikes on prescription drugs.

The bill generally requires a company to justify to the Department of Health and Human Services (DHHS) any spike in prescription drug prices, but it is short on details regarding the criteria the inspector general of DHHS would have to abide by when analyzing the spike.

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PE Investment in Physician Practice Management ‒ What’s to Come in 2019?

Private equity (PE) investors entered the physician practice management (PPM) market in 2011, and eight years later the PPM sector continues to be a ripe middle market for PE investors looking to diversify their portfolios. However, as the healthcare market continues to change in light of increasing vertical integration between payors and providers and disruption caused by new players such as Amazon, changes may be on the horizon for PE investment in the PPM space. Read more >>

The Use of Smart Speakers in Healthcare

Smart speaker on the table in the living room, 3D

Smart speakers are voice-activated, internet-connected devices with an integrated virtual assistant that can answer questions, follow instructions and control other smart devices. Nearly one in five U.S. adults has access to a smart speaker, and it has been estimated that in 2018, the number of smart speakers installed reached 100 million worldwide. Using voice recognition, a smart speaker’s virtual assistant can understand what is being said and act upon it. Once the system is activated, it records what is being said and sends it over the internet to the main processing service, which deciphers the speech and sends a response back to the smart speaker. Smart speakers can control other smart devices upon verbal command and perform tasks such as controlling music, lights, television and home security systems, as well as playing audible books.

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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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