Patient Access of Medical Records under HIPAA - New HHS Guidance, New Focus for HIPAA Audits

Why Should You Attend:

Individual access of medical records is the focal point for eliminating data blocking today, because there are rules in place under HIPAA today that, if followed properly, would alleviate many of the information blocking issues that have been identified. The HIPAA enforcement action for not providing prompt access to records as required shows that HHS is serious about information blocking, and is using HIPAA to advance goals for better patient access of medical records.

The head of US DHHS has indicated that providing patient access to Protected Health Information is a key priority for improving the nation’s health and guidance from HHS provides detailed information on how best to provide information to patients within the rules. Covered entities, and particularly those that use electronic health records (EHRs), need to address the access and disclosure guidance. The guidance will be explained, so that access can be provided according to the rules and penalties can be avoided. Issues on provision and denial of access, as well as fees and other topics, will be discussed.

HHS has issued guidance on issues relating to access of mental health records and the records of minors, clarifying what information may be provided or not, depending on the information and other circumstances. The guidance also includes information on dealing with law enforcement requests for information on alleged violators of the law. This guidance will be reviewed, as well as the relationship to rules for handling information relating to substance use disorders under 42 CFR Part 2.

The new regulations will be reviewed and their effects on usual practices will be discussed, as will what policies need to be changed and how. We will show what policies and evidence you may need to produce if your compliance is reviewed by the HHS Office of Civil Rights, which has already indicated that compliance with the rules on patient access of records is a significant problem.

The enforcement rules include a four-tier violation schedule with increased fines, and mandatory fines for willful neglect of compliance that start at over $10,000 even if the problem is corrected within 30 days of discovery. Violations that are not promptly corrected carry mandatory fines that can reach into millions of dollars for any particular violation. And any reports of willful neglect are required to be investigated under the law. Even violations for a reasonable cause or with reasonable diligence taken are subject to penalty. We will discuss what is necessary to avoid penalties and make sound compliance decisions.

This Webinar will help health information professionals understand what they have to do, and when, and what to keep in mind as they move forward, in order to be in compliance with the regulations. It will provide a comprehensive look at the emphasis on the rules on access and prepare attendees for the process of incorporating any necessary changes into how they do business in their facilities.

Areas Covered in the Webinar:

• Learn about the latest enforcement action under HIPAA, regarding patient access of records.
• Learn about the access rights under HIPAA and CLIA regulations.
• Learn about the extensive guidance from the HHS Office of Civil Rights on access of PHI.
• Learn about the guidance from HHS regarding access of mental health information and minors' information.
• Find out what the regulations call for and what processes you must have in place for the proper approval and denial of access as appropriate.
• Learn about the required process for the review of certain denials of access.
• Learn how e-mail and texting should be handled, what can go wrong, and what can result when it does.
• Find out about HIPAA requirements for access and patient preferences, as well as the requirements to protect PHI.
• Learn about the training and education that must take place to ensure your staff handles access requests properly.
• Learn about HIPAA audit and enforcement activities and what you need to do to survive a HIPAA audit or enforcement action.

Who Will Benefit:

This webinar will provide valuable assistance to all personnel in medical offices, practice groups, hospitals, academic medical centers, insurers, business associates (shredding, data storage, systems vendors, billing services, etc). Employees who will benefit include:

• Compliance director
• CEO
• CFO
• Privacy Officer
• Security Officer
• Information Systems Manager
• HIPAA Officer
• Chief Information Officer
• Health Information Manager
• Healthcare Counsel/Lawyer
• Office Manager
• Contracts Manager

Recently Asked Questions:

1. Our doctors frequently communicate with the office with PHI via text message. Do we need to report that as a breach?
2. We are prepared to print electronic records to PDF files for our patients who want access their health information - what if they want some other format, like Excel?
3. What if we want to have only limited uses of texting for our patients, just for appointment reminders - do those need to be secure text messages?
4. When we send medical records on paper, we send them in a sturdy envelope and track the shipment - is that enough for sending records on a CD or memory stick?
5. If a patient wants to communicate about their health information using only plain e-mail or plain texting, MUST I comply with their request?

Jim Sheldon-Dean
Principal and Director of Compliance Services, Lewis Creek Systems, LLC

Jim Sheldon-Dean is the founder and director of compliance services at Lewis Creek Systems, LLC, a Vermont-based consulting firm founded in 1982, providing information privacy and security regulatory compliance services to a wide variety of health care entities. He is a frequent speaker regarding HIPAA, including speaking engagements at numerous regional and national healthcare association conferences and conventions and the annual NIST/OCR HIPAA Security Conference.

Sheldon-Dean has more than 16 years of experience specializing in HIPAA compliance, more than 34 years of experience in policy analysis and implementation, business process analysis, information systems and software development, and eight years of experience doing hands-on medical work as a Vermont certified volunteer emergency medical technician.

Sheldon-Dean received his B.S. degree, summa cum laude, from the University of Vermont and his master’s degree from the Massachusetts Institute of Technology.

Topic Background:

Individual access of health information is a top issue at the US Department of Health and Human Services (HHS), as a focal point for enforcement under HIPAA, and in the fight to eliminate “information blocking” under the 21st Century Cures Act. New rules are proposed to require the sharing of Protected Health Information among providers and with patients, and the most recent HIPAA enforcement action is directly focused on ensuring patients are provided the records they request promptly. Improving individual access to medical records is an idea whose time has definitely arrived, and providers that do not follow the rules and guidance from HHS are risking significant penalties.

Over many years, the heads of the US DHHS have indicated that patient access of information is a key priority in order to improve the health of the nation. Patient rights under HIPAA have been expanded to include several new rights of access, and guidance has been issued on access of records. The emphasis on and changes to rules having to do with patient access of records will need to be reflected in every health care-related organization’s policies and procedures. The guidance provides clear and detailed information on how to provide access, what can be charged for in fees, and what the individual’s rights are when it comes to access of information. The rallying cry for easy patient access and transfer of information increases daily and is no longer escapable. HIPAA also provides for individual rights to receive electronic copies of records held electronically, and patients have rights under HIPAA and the Clinical Laboratory Improvement Amendments (CLIA) to directly access test results from the laboratories creating the data.

In addition, there are new explanations from HHS about how to treat access to mental health information and information pertaining to minors, including giving due consideration to patient requests and safety issues of the patient and others, as well as expanded guidance on HIPAA and Opioid Emergencies. The leadership of HHS has indicated that it takes patient access of information very seriously and will make that a regulatory priority.

All HIPAA-covered entities need to review their HIPAA compliance, policies, and procedures to see if they are prepared to be in full compliance and meet the requirements of the rules. Compliance is required and violations for willful neglect of the rules begin at more than $10,000.

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