HIPAA-Covered Entities Must Comply With New Data Breach Rules Issued by Office for Civil Rights
On August 19, 2009, the Office for Civil Rights (OCR) at the federal Department of Health and Human Services (HHS) released new regulations for an interim final rule requiring health care providers, health plans, and other entities covered by the Health Insurance Portability and Accountability Act (HIPAA) of 1996 to notify individuals when their health information is breached. Covered entities must comply by September 24, 2009. On July 27, 2009, authority for enforcing HIPAA security provisions was officially moved to OCR from the Centers for Medicare and Medicaid Services, which had enforced HIPAA since 2003.
The move combines the authority for administration and enforcement of new federal standards for health information privacy and existing HIPAA security provisions. OCR will have the following responsibilities:
- Investigate federal civil rights discrimination and health information security statutes
- Impose civil money penalties on covered entities that fail to adhere to HIPAA security standards for the protection of electronic health information
- Issue subpoenas for testimony and evidence related to any matter under investigation or compliance review for failure to comply with HIPAA requirements and security standards
- Make exception determinations when provisions of state laws are contrary to federal standards, but not preempted by federal provisions
CMS retains its enforcement authority for other HIPAA rules. Consumers will be able to continue submitting HIPAA security complaints on-line through the Administrative Simplification Enforcement Tool at https://htct.hhs.gov/aset (accessed August 17, 2009).
In announcing the release of the interim final rule, OCR clarified that security breaches affecting fewer than 500 individuals will be reported to the HHS Secretary on an annual basis. The regulations also require business associates of covered entities to notify the covered entity of breaches at or by the business associate. The Federal Trade Commission (FTC) has issued companion breach notification regulations that apply to vendors of personal health records and certain others not covered by HIPAA. The interim final rule also includes guidance to determine if information is “unsecured” and notification is required. Entities subject to the HHS and FTC regulations that secure health information as specified by the guidance through encryption or destruction are relieved from having to notify in the event of a breach of such information. Once the interim final rule is published in the Federal Register it will take effect within 30 days. Public comments will be accepted for 60 days after publication.
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Insurance Agents, U.S. Chamber Unhappy with Healthcare Reform
March 22, 2010
Independent insurance agents are among those today expressing their disappointment with the health care reform bill passed by the U.S. House of Representatives. The House approved the Senate-passed bill and also approved a separate bill that makes changes agreed to by President Barack Obama and Democrats in both the House and Senate.
The agents say they feel the bill does not do enough to control healthcare costs and they oppose the new taxes contained in the bill.
Meanwhile, the U.S. Chamber of Commerce is vowing to launch its largest outreach program ever to hold lawmakers who voted for the bill accountable.
“The Big ‘I’ is greatly disappointed that after months of negotiations, hearings, debates and votes in multiple Senate and House committees we seem to be back on square one: a bill that does little to stem the skyrocketing cost of health care and will be financed on the backs of small business during one of the most delicate financial periods in American history,” said Robert Rusbuldt, president and CEO of the Independent Insurance Agents & Brokers of America (IIABA or the Big “I”).
“Health care reform must first and foremost address the rising costs of health insurance and this bill does nothing in this regard,” said Charles Symington, Big “I” senior vice president of government affairs.
The Big “I” said that according to the Congressional Budget Office (CBO), small businesses will see little to no decrease in their monthly premiums and individuals will see an increase of 10 to 13 percent.
Starting in 2018, under the bill there would be a tax on health plans costing $10,200 or more for individuals and $27,500 or more for families. The bill also increases the Medicare payroll tax and applies it to investment income as well as wages for individuals making more than $200,000, or married couples above $250,000. The tax on investment income would be 3.8 percent.
Under the bill, employers are not required to offer health insurance coverage but companies with 50 or more employees would be charged a $2,000 per-employee fee if the government subsidizes their employees’ coverage.
“A tax increase, especially during today’s tough economic climate, will put many small businesses in the untenable position of deciding between job cuts, employee pay cuts, or shutting their doors,” said Symington.
The Big “I” also said it was disappointed there is no medical malpractice reform in the bill. The Obama Administration is funding pilot projects on alternatives to litigation instead.
Janet Trautwein, CEO of the National Association of Health Underwriters (NAHU), which also represents health insurance brokers, said the high cost of healthcare is the primary problem and agrees that the legislation does little to rein them in.
“Health care costs are rising at an unsustainable rate, and if we don’t get these costs under control, we will no longer be able to pay for the top-notch medical care that most Americans enjoy today,” she said when the president unveiled the plan.
The NAHU leader has also criticized the cuts in Medicare, the individual mandate and the taxes and fees.
“We don’t need to jeopardize the Medicare program by making cuts in the wrong areas. We don’t need to jeopardize job growth and economic prosperity by burdening our employers with a new mandate to provide the government’s idea of appropriate health care coverage to those the government decides it should be provided to and at a cost determined by the government. We don’t need new market reforms that come at a cost so high that no one can afford to buy the reformed coverage. And we most certainly do not need tens of billions of dollars in new taxes and insurer fees that will result in increased premium costs for all privately insured Americans,” she said.
The agents’ criticisms are in line with those of the nation’s health insurers, although they support an even stronger individual mandate.
“The access expansions are a significant step forward, but this legislation will exacerbate the health care costs crisis facing many working families and small businesses, said America’s Health Insurance Plans (AHIP) President and CEO Karen Ignagni in a statement.
AHIP has said a $70 billion premiums tax on insurers in the bill would be passed on to patients, raising the cost of coverage.
Also, the legislation imposes $200 billion in cuts to Medicare Advantage that Ignagni said “will cause massive disruption for the more than 10 million seniors enrolled in the program.”
The U.S. Chamber of Commerce blasted the bill and vowed to work to unseat lawmakers who voted for it.
“The House made a wrong and unfortunate decision that ignores the will of the American people. Americans will not be fooled. This $900 billion, 2800 page bill is not health care reform. It fails to fix what is broken and risks breaking what already works,” said Chamber President and CEO Thomas J. Donohue.
Donohue said this organization will work to “fix its flaws and minimize its potentially harmful impacts.” And he vowed that through the “largest issue advocacy and voter education program” in its history, the Chamber will “encourage citizens to hold their elected officials accountable when they choose a new Congress this November.”
Features of the reforms have also upset some state lawmakers. More than 36 states have weighed resolutions or bills that oppose various aspects of the reform plan, according to the National Conference of State Legislatures
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Plug Could Be Pulled from Flood Insurance Program Again This Weekend
By Andrew G. Simpson
March 25, 2010
Insurance and real estate agents are being advised to prepare their clients for another possible interruption of the federal flood insurance program in three days, which could be longer than the one that happened last month.
The Senate is expected to vote today or tomorrow to extend it but there is concern this may not happen and, if it doesn’t, the program could be down for weeks.
The National Flood Insurance Program (NFIP) is currently on schedule to expire at midnight on March 28. The Senate has voted to extend it until the end of the year, while the House has agreed to extend it just one more month, until the end of April. If the Senate, which has been preoccupied with healthcare legislation, does not act quickly to adopt the House measure, the program will expire Sunday night.
The program ran into down-to-the-wire problems last month also. The NFIP extension was incorporated into a bill that extended unemployment benefits and COBRA subsidies. But a vote was delayed for several days by Sen. Jim Bunning, R- Kentucky, over job insurance funding issues unrelated to the flood program. Since there was no vote, the NFIP expired on Feb. 28 for a few days. The night of March 2, the Senate passed an extension of the program until March 28 and President Obama signed the measure right away.
Some fear politics could again get in the way of a Senate vote before the March 28 deadline.
“As we’ve seen, these short term extensions create situations where the NFIP is allowed to lapse because of unrelated political or legislative issues. Hopefully, the program will be extended again and lawmakers will use that time to pass legislation reforming the program and extending it for a longer term,” said Matt Brady, spokesman for the National Association of Mutual Insurance Companies.
“We still believe the extension will pass, but given recent history I think it’s always a good idea for agents and brokers to be prepared for a hiatus,” he said.
John Prible is also concerned about the possibility of delaying tactics in the Senate since the NFIP provision is again tied to a bill on unemployment benefits and COBRA subsidies. Prible is vice president of federal government affairs for the Independent Insurance Agents and Brokers (the Big “I”). But Prible said Senate staffers he spoke with today are “optimistic” the Senate will act this afternoon or tomorrow.
What really concerns Prible is that if the Senate does not act, the program could be out of operation for two weeks because Congress goes on a recess for that long.
“That’s scary,” Prible said.
While not perfect, the longer Senate extension until Dec. 31, 2010 would have at least kept the program running through the hurricane season, NAMIC’s Brady noted.
The possible hiatus comes at a time when the Federal Emergency Management Administration (FEMA), which administers NFIP, state regulators and the industry are trying to get more people to buy flood insurance. March 15-19 was designated National Flood Insurance Awareness Week and state insurance departments have been issuing advisories urging consumers to purchase coverage.
According to the National Weather Service, more than one-third of the country is in danger of flooding this time of year.
The NFIP sunset last month caused headaches for insurance agents and their customers as well as delays for some consumers waiting to close on the sale of a property within a flood hazard area.
While no new policies can be issued during a lapse in authorization, consumers with current policies remain covered by the federal program, according to the National Association of Insurance Commissioners. Claims payments are not affected.
Insurance agent and company lobbyists have for years been pressing for a multi-year renewal along with broader reforms to the NFIP to no avail thus far.Bob Rusbuldt, Big “I” CEO and president, the Independent Insurance Agents and Brokers of America, has criticized Congress for letting NFIP lapse and not tending to reforms for NFIP.
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My colleagues and I developed the five pillars of management competency several years ago because we sought to identify and evaluate the administrative and management capabilities that leaders of organizations need in order to realize success in a dynamic market environment that keeps changing. Here is a quick breakdown of the OPEN MINDS five pillars of management competency:
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Leadership and governance—board composition and board performance management; board meeting and governance management; executive team composition, performance management, and succession planning
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Financial management—budgeting and financial management; financial risk management; long-term financing and capital planning
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Marketing and innovation—government, regulatory, and legislative relations; communications, public relations, and media management; marketing planning, strategic alliances, and community collaborations; service line development
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Technology and information management—organizational performance metrics management and information management infrastructure
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Strategic management—strategic planning and leadership of organizational evolution; service line management and corporate compliance; talent management
Because provider organizations in the behavioral health and social services market need be delivering sound clinical products to excel in meeting customer needs and expectations, I think we can apply the five pillars to managers at all levels, including those overseeing clinical staff. In clinical management settings, The five pillars are embodied in the ability for a manager to measure and manage staff performance; to ensure that systems collecting patient data and consumer outcomes and treatment effectiveness are protected and secure. And, all things aside, just being able to lead a team through challenge to success is a competency meant for all levels.
Because primary care, behavioral health, and social service delivery systems are becoming so closely interwoven, take the leadership and governance pillar and make sure that every level of leadership in your organization existing or prospective aligns with the competencies you identify as most important.
Joe Naughton-Travers, Ed.M.
Senior Associate, OPEN MINDS
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Memory Care presents challenges that aren’t found in other health care related fields. Take a minute to read the New York Times article on some of the issues faced by these providers.
SAFE IN BED
The use of bed rails can increase the risk of patient injury by up to 20 percent when confused Alzheimer’s or dementia patients attempt to climb over the rails. Injury or even death can even occur when a patient rolls into the bed rail and the mattress shifts to the opposite side of the bed, pinning the patient between the mattress and rail. The FDA has collected data for the last 24+ years and notes 480 deaths, 138 injuries and 185 close calls involving hospital beds with rails in that time.
Read More…
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