April 20, 2021 We’ve all heard the saying ‘sharing is caring’ but sometimes doing a good deed could actually steer you into some consequences later down the road. Let’s say, for example, you just loaned your car to your best bud whose “quick trip to the store” actually consisted of running red lights and racking up parking tickets. Though you might not have been the one in the driver’s seat – your name will be the one on all of the lovely fines that wind up in your mailbox, not your BFF’s. Now you’re probably wondering where we’re going with all of this. And while cars and protected health information (PHI) might not have a whole lot in common, it goes to show how certain situations in life require additional precautions to minimize the risk of being responsible for another’s wrongful actions. This idea rings especially true when it comes to working with and sharing something as valuable as sensitive health information. HIPAA law provides a pretty specific roadmap for how your practice should be safeguarding PHI and outlines certain standards that if not met – could result in a hefty fine. But with all the government requirements, advancements in technology, and changing patient needs – it’s impossible today to run a practice without the help of third-party vendors. So whether it be an outside medical billing company, IT support, or document shredding company – any vendor that comes into contact with PHI is a business associate (BA) of your practice and requires their own set of directions for proper handling. Just as covered entities have obligations under HIPAA law, so do business associates – with one of the most important being a documented and signed Business Associate Agreement (BAA). A BAA is essentially a written agreement between your organization and the business associate, specifying each party’s responsibilities when accessing and maintaining PHI and it offsets the liability so that your practice can take a backseat if any incidents were to occur. As you probably wouldn’t hand over your keys to just anyone without laying down some ground rules first, the same goes for providing access to patients’ sensitive health information. Like most contracts, the terms and conditions in a proper BAA can be pretty lengthy and may vary based on the type of vendor you’re working with – but here are some of the basic HIPAA requirements that should be outlined: Permitted uses and disclosures of PHI Specific safeguards that the BA is expected to establish Breach Notification requirements Policies and procedures for providing PHI access at your practice’s or patient’s request Business Associate Training requirements Guidelines for how PHI should be returned or destroyed upon termination of the BAA Meeting all the requirements for what should be included in a BAA is just the first stretch of the drive, and something we’re often asked is, “What if one of my vendors refuses to sign?” Given the fact that having a signed BAA with all vendors you work with is a HIPAA requirement, it’s probably a good idea to put the brakes on any working relationship with a vendor who can’t agree to your terms and conditions. Just last year a medical practice found itself a victim of a HIPAA hit and run after filing a breach report stating that their EHR company was blocking access to the practices’ ePHI in exchange for $50,000 to be paid by the practice. While it might seem pretty obvious that the business associate was the driving force of the incident, because there was no BAA in place – the $100,000 in damage fell solely on the provider. A Business Associate Agreement not only lays out the rules of the road for how PHI should be handled but holds the BA directly liable for any non-compliance that happens when they’re behind the wheel. Having a proper agreement in place with each and every vendor you work with ensures that they’re best protecting your patients’ PHI and means that your practice can steer clear of the hefty HIPAA fines if they don’t.
Missing Business Associate Agreement with EHR Vendor Leads to $100,000 Fine
March 3, 2020 Announced today, a medical practice in Utah has come to a $100,000 settlement with the OCR for their failure to meet HIPAA requirements under the Security Rule. The practice of Steven A. Porter, M.D. received the $100,000 monetary settlement in addition to submitting to a corrective action plan over the next two years after a breach report led to the OCR’s investigation of the practice’s HIPAA compliance program. The investigation began after the practice filed a breach report regarding a complaint against a Business Associate of the practice’s EHR company. The Business Associate (BA) was blocking access to the practices’ patient’s electronic protected health information in exchange for $50,000 to be paid by the practice. While the original complaint was against the BA, once the investigation was initiated by the Office for Civil Rights, it was the practice that found themselves in the government’s crosshairs. Within the compliance review, the OCR had found that the practice had failed to do the following: Unfortunately for the practice, their lack of proper safeguarding and documentation of compliance cost them a hefty fine and put their patient’s PHI at risk. This breach, and corresponding financial settlement, highlights that even when working with typical healthcare vendors, such as EHR providers, the right Business Associate Agreements and HIPAA-compliant policies are required to prevent impermissible safeguarding or access to PHI. OCR Director, Roger Severino, included a statement in the HHS press release regarding the incident. “All health care providers, large and small, need to take their HIPAA obligations seriously, the failure to implement basic HIPAA requirements, such as an accurate and thorough risk analysis and risk management plan, continues to be an unacceptable and disturbing trend within the healthcare industry.” This fine follows a recent article highlighting the OCR’s focus on “low hanging fruit” and commitment to address an ongoing lack of HIPAA compliance among covered entities. As these violations continue to see costly outcomes, it is more important now than ever to ensure your practice has a full HIPAA program in place.