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By Robert Hudock, on March 1st, 2010 Print This Post
Under the HITECH breach notification requirements, covered entities must notify HHS of all reportable breaches. HHS recently released a list of breaches, including the covered entity, the business associate, number of individuals affected, and the location of the information lost. More than 35 HIPAA covered entities have reported breaches involving more than 500 individuals’ PHI since September 2009. The theft/loss of laptops, desktop and portable media by far represent the majority of the security breaches reported thus far. A summary of breaches reported thus far appears [...]
By Robert Hudock, on March 1st, 2010 Print This Post
On February 25, 2009, at a Health Information Technology Policy Committee Adoption/Certification Workgroup meeting, Dr. Jeffrey Shuren, Director of FDA’s Center for Devices and Radiological highlighted concerns with the current state of regulation around Health Information Systems which are not currently actively regulated by FDA. Dr. Shuren’s testimony highlighted three areas of concern: (1) the FDA’s legal and regulatory authorities over medical devices and the approach we have taken with respect to HIT to date; (2) a Review of various safety issues that have been reported to the FDA and other unique challenges presented by HIT; and (3) Possible approaches the FDA could take in the future to help address these [...]
By Robert Hudock, on December 10th, 2009 Print This Post
On December 1st, 2009 the Office of the Secretary of the Office of the National Coordinator (ONC) for Health Information Technology announced the creation of a new Chief Privacy Office and the Office of Economic Modeling and Analysis (among three others including the Office of Chief Scientist, Deputy National Coordinator for Programs & Policy, and Deputy National Coordinator for Operations). The New Chief Privacy Officer is a necessary creation under the ARRA (and the HITECH Act). This role is different from the other positions that seem to be a re-organization of roles and responsibilities that already existed to some extent just with more specificity around functions and duties. Aside from the Chief Privacy Officer the New Economic Modeling and Analysis Position seems like a timely creation given recent articles discussing whether Health Information Technology and more specifically Electronic Health Record Systems (EHRs) actually reduce the cost of care and/or increase the quality of care. Also of note, the new Office of the Deputy National Coordinator for Programs and Policy will be responsible for the open source Connect initiative and the National Health Information [...]
By Robert Hudock, on November 29th, 2009 Print This Post
This article discusses techniques for implementing the updated requirements of the HIPAA Security Rule, with particular focus on strategies for assessing the effectiveness of implemented security controls to support compliance and audit, as well as a covered entity’s (or business associate) overarching risk management program in the context of HIPAA Compliance. Covered entities are becoming more pro-active in monitoring their business associate compliance with HIPAA privacy and security regulations and the recent changes largely the product of the HITECH Act. In the past I have used a series of questions to ascertain the compliance status of business associates to comply with HIPAA privacy and security rules. I find it useful to map security controls to NIST Special Publication 800-53. The National Institute of Standards and Technology has collaborated with the military and intelligence communities to produce the first set of security controls for all government information systems, including national security systems. The controls are included in the final version of Special Publication 800-53, Revision 3 “Recommended Security Controls for Federal Information Systems and Organizations,” released in August of 2009. (Available at http://csrc.nist.gov/publications/nistpubs/800-53-Rev3/sp800-53-rev3-final.pdf). [...]
By Robert Hudock, on November 17th, 2009 Print This Post
Next year should be interesting. From Red Flag compliance, federal breach reporting requirements, significantly augmented HIPAA penalties, and HIPAA security standards that are based on NIST guidelines will change the traditional compliance model for Covered Entities and Business Associates. Hot topics for enforcement next year (based on recent CMS audits of their business partners) will likely be in the areas encryption of portable media devices, remote access by employees to protected health information, and failure to document a rational risk management [...]
By Robert Hudock, on August 31st, 2009 Print This Post
On August 27th open source programmers met at HHS to work on developing CONNECT, an open-source solution, written in Java, for the development and implementation of HIE gateways and interfaces to join NHIN and/or interface multiple systems with incompatible communication protocols. The goal of an HIE is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, equitable, patient-centered care. HIEs are also useful for public health authorities to assist in analysis of the health of a population. Federal Health Architecture is intended to deliver free, scalable solution to help organizations to tie health information systems into the NHIN. Thus far the project has yielded at least one success (outside of the federal government) where data have been successfully transferred between a civilian hospital and the [...]
By Robert Hudock, on August 24th, 2009 Print This Post
The Office of the National Coordinator for Health Information Technology (ONC) has recently release more information on two grant programs. The HITECH Act authorizes two grant programs: (1) a Health Information Technology Extension Program (Extension Program) and (2) the State Health Information Exchange Coopertive Agreement Program (Agreement Program). This program provides grants for the establishment of Health Information Technology Regional Extension Centers that will offer technical assistance, guidance and information on best practices to support and accelerate health care providers’ efforts to become meaningful users of Electronic Health Records (EHRs). The consistent, nationwide adoption and use of secure EHRs will ultimately enhance the quality and value of health care. The State Health Information Exchange Cooperative Agreement Program supports states and/or State Designated Entities (SDEs) in establishing health information exchange (HIE) capacity among health care providers and hospitals in their [...]
By Robert Hudock, on July 30th, 2009 Print This Post
Office of the National Coordinator (“ONC”) for Health Information Technology health IT policy committee voted on July 16, 2009 to accept itsworkgroup’s matrix of qualifications that will be used to define “meaningful use” of health IT. Compliance with ONC’s definition of “meaningful use” is essential to reimbursement bonuses and avoiding penalties under the American Recovery and Reinvestment Act of 2009 (ARRA). Bonuses will begin in 2011 (maximum bonus payments for the implementation of a qualified EHR can be collected where an EHR is implemented no later 2012) thereafter the amount of bonus payments will be reduced with each subsequent year. Penalties will begin accruing 2017 for Medicare and Medicaid providers who have failed to implement a qualified EHR. A qualified EHR under ARA is essentially an EHR that meets the Government’s tortured definition of meaningful [...]
By Robert Hudock, on April 26th, 2009 Print This Post
On April 23rd Senator John Rockefeller IV introduced the Health Information Technology Public Utility Act of 2009 to to build upon open the source electronic health record (eleconic medical record) solution developed by the Department of Veterans Affairs (called VistA) and other open source software (e.g. OpenEMR). Unlike proprietary “closed source” software solutions, open source software allows unrestricted access to the source code and does not prohibit the use or re-distribution of [...]
By Robert Hudock, on April 20th, 2009 Print This Post
Stimulus Update – HIPAA
This alert provides a brief overview of privacy and security provisions included within “The American Recovery and Reinvestment Act of 2009” (H.R.1, S.1) (the “Stimulus”). The Stimulus also includes funding for health information technology (“HIT”) and funding for comparative effectiveness research. These provisions will be the subject of future alerts. Future [...]
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Content of the Notice to the Secretary of HHS for a Reportable Security Breach
Under the HITECH breach notification requirements, covered entities must notify HHS of all reportable breaches. HHS recently released a list of breaches, including the covered entity, the business associate, number of individuals affected, and the location of the information lost. More than 35 HIPAA covered entities have reported breaches involving more than 500 individuals’ PHI since September 2009. The theft/loss of laptops, desktop and portable media by far represent the majority of the security breaches reported thus far. A summary of breaches reported thus far appears [...]