Preparing for the New HIPAA Audit Program

Event Information
Product Format
Prerecorded Event
60 Minutes
Product Description

Documentation Is The Key To Survive New HIPAA Audit And Avoid Fines

The random HIPAA Compliance Audit program had a year of trial audits in 2012. The US Department of Health and Human Services has reviewed the results of that work and the HIPAA audit program is being restarted based on what was learned from the 2012 audits. Areas of weakness as shown in the 2012 audits and as shown by breach reports are the likely targets for the next round of audit questions, and HHS is sending out requests for information to 1200 covered entities and business associates to determine their suitability to be audited.

While in the past, audits had been performed only at entities that reported a breach or had a complaint filed against them, the new rule calls for audits whether or not there is a complaint or breach. This means that the HHS Office for Civil Rights (OCR) can show up and ask to perform an audit on short notice, and your organization will need to provide a response in less than fifteen business days. USDHHS has published the protocol used for the 2012 HIPAA audits by the HHS contractors, so it is possible to know much better now how to prepare for an audit.  Knowing what questions are likely to be asked and have been asked at prior HIPAA compliance audits can make preparing for and surviving a HIPAA audit much easier.

If your organization is not ready, the HIPAA rules have new, significantly higher fines, including mandatory minimum fines of $10,000 for willful neglect of compliance. In addition, HIPAA enforcement has taken on a new importance at HHS; officials have publicly stated that enforcement is now a priority, and that means being ready for an audit is more important than ever. The "slap-on-the-wrist" days are over and fines and settlements are being levied, with more on the way – don't let your organization be hit for an audit unprepared.

The HIPAA Audit Protocol is not easy to use in its incarnation as a web-based tool, and it does have several deficiencies because of the changes in the rules that became enforceable September 23, 2013. HIPAA expert Jim Sheldon-Dean will present methods for using the contents of the HIPAA Audit Protocol to build your own compliance plan by extracting and updating the contents and relating your compliance activities directly to the questions that might be asked.

Session highlights:

  • Discuss the HIPAA audit program and how it works, and discuss the areas that caused the most issues in the 2012 audits.  He will also explore what kind of issues and what kind of entities had the most problems, and show where entities need to improve their compliance the most
  • Explore the typical risk issues that lead to breaches of health information and see how those issues may be a target for auditors
  • Review the contents of the HIPAA Audit Protocol used in 2012, to show what documentation needs to be on hand if your organization be selected for an audit
  • Discussion on the HIPAA audit and enforcement regulations and processes, and how they apply to HIPAA covered entities and business associates. Explanation on the enforcement regulations and the recent changes that increase fines and create new penalty levels, including new penalties for willful neglect of compliance that begin at $10,000
  • How to get equipped with documentation in advance for an audit at any time. Sample information request forms and questions asked at prior audits
  • The session will also cover how to know if you may become the subject of an audit or enforcement action, and what you can do to help limit your exposure. How most enforcement actions come about and what can be done to prevent incidents that lead to enforcement activity
  • The HIPAA Privacy, Security, and Breach Notification regulations (and the recent changes to them) and how they will be audited will be explained. Documentation requirements for compliance will be explored and a framework of security policies necessary for compliance will be presented
  • The HIPAA Audit Protocol questions will be explored and ways of using the content to develop a compliance plan will be discussed. The process of exporting the questions will be shown, and a sample spreadsheet showing the results will be presented
  • The results of prior HHS audits (and their penalties) will be discussed, including recent actions involving multi-million dollar fines and settlements. A plan for attaining compliance will be presented. In addition, upcoming trends in information security risks will be discussed so you can start to plan for the work you'll need to do to stay in compliance and keep patient information private and secure 

With this session, you will:

  • Learn how the HIPAA rules have changed and how you may need to change, how you work to keep up with them
  • Find out what HHS OCR is likely to ask you if you are a victim of an audit and what you should be prepared for beforehand
  • Find out what rules & documentation you need to comply with and what policies you can adopt that can help you come into compliance
  • Learn how having a good compliance process can help you stay compliant more easily
  • Learn how to export the contents of the HIPAA Audit Protocol and use them as the foundation of your compliance activities and documentation

Who should attend:

Compliance manager, HIPAA officer, chief information officer, health information manager, medical office manager, medical practice lawyer, CFO, CEO, COO. Privacy officer and information security officer.

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About Our Speaker

Jim Sheldon Dean - HIPAA Compliance & Regulations Expert

Jim Sheldon-Dean is a healthcare compliance and HIPAA expert in the areas of privacy and security regulatory compliance and business process analysis. He 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 healthcare entities. Jim is a frequent speaker regarding HIPAA...   More Info
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