HIPPA/MIPS Audit & Compliance

Secure Patient Health Information Management and Smarter Healthcare Costs for a Healthier America

The Final Omnibus Rule brought in some significant changes to the HIPAA Security Rule in 2013. It brought many new breach notification clauses of the HITECH Act, which extended the requirement of HIPAA risk assessment to Business Associates as well. Non-compliance with the HIPAA regulations can result in hefty penalties. The severity of the punishment directly depends upon the number of people affected by the non-compliance and the breach of the protected health information (PHI).

A majority of the most recent fines involved “Willful neglect” of HIPAA guidelines that breached patients’ personal information. About $5.5 million fine was issued against the Advocate Health Care Network since the failed to recognize the threats to PHI and patient privacy. Most healthcare organizations in the USA are not digitized. It gives easy access to patient information and better management of the same. At the same time, it poses imminent threats of many code violations by breach of data. Hacking into a digital system is not as difficult as you may like to think right now. As the owner of a company, you should be aware of all the technological challenges and logistical problems your system might have. Smallest of the small issues can cause you a lot of trouble in the long run.

Why is compliance with HIPAA so necessary now?

When a business goes online, the owner should take all the steps possible to stay compliant with HIPAA. If you are unsure about the threats your online world is facing right now, you can easily try our free network risk assessment. American Tech Pros is now offering a 100% free HIPAA risk assessment program for all the clients who are interested in taking a step forward to safe online business. This process is comprehensive and state of the art. It will tell you about all the problems that are hurting your company right now. You will receive a detailed report on the status of your technology and network.

You may not be directly involved in healthcare, but HIPAA can affect you too

The brunt of HIPAA audits does not bear down only upon large medical organizations. Only about 1% of all the companies audited involve over 500 people or more. Most of the medium and smaller businesses are usually in more trouble following such audits since their insurance policies typically do not cover HIPAA breaches. The cost not only stems from the hefty penalty. It also involves the cost of IT specialists who investigate the breach and credit monitoring services for public (patient) records. If you are not sure about the role of HIPAA and MIPS in your business, reach out the American Tech Pros for expert assistance.

In fact, you may not be a healthcare organization, yet you may have to face a HIPAA audit if you deal with the creation, reception, maintenance, and transmission of PHI. If you are working with any Personally Identifiable Information, you need to run a HIPAA risk assessment test. It holds true for all medical consultancies, business associates, and vendors.

Modernizing Medicare for better quality healthcare

As of 9 May 2016, the new MIPS/MACRA proposed rule started the customary 60-day public comment period. It ended back on 8 July 2016, and it brought revolutionary changes in the way clinicians were paid based on volumes of services. The aim is to move away from a size based rewarding process to a quality-based incentive process. The new procedures that comply with the MIPS/MACRA proposed rule should measure the outcome of patient care and information sharing through healthcare information technology (IT). It will ultimately end the Meaningful Use HER Incentive Program for good. It will instead user in an Incentive Payment System based on Merit. The new proposed rule will score clinicians on how they use their EHR and many other metrics.

What is the Quality Payment Program?

As per the Medicare Access and Summary CHIP Reauthorization Act of 2015, the Quality Payment Program applies to healthcare providers who bill the Medicare system over $30,000 in a year and see over 100 Medicare patients in that time. Providers who do not participate in the Quality Payment Program under MIPS can receive up to 4% negative payment adjustments during reimbursements. For any healthcare provider just complying with MIPS is not enough. They need to meet the terms of the HIPAA regulation. It prioritizes patient privacy and security of patient data.

How can we help you?

American Tech Pros can help you find out exactly how your online infrastructure is non-compliant with the MIPS act and the Quality Payment Program under the same. We have healthcare clients from all over the country, who depend on us for assessing their MIPS audit and compliance. We have rigorous tests and analytics to tell us how to improve online sites and digital footprint of healthcare organizations and allied businesses. Especially since 2016, the government has levied almost $40 million in fines; we have improved our services for the citizens and business owners of the country to meet the latest acts and legal requirements.

Here are a few questions almost every business is asking about HIPAA and MIPS –

What should all healthcare organizations and consulting companies do to become HIPAA compliant?

Any organization under the watch should do the following –

  • Identify the location of PHI and identify potential threats to the same.
  • Gauge the current security standards of the stored PHI and find out if they are in action.
  • Determine any potential threat of PHI breach and identify likely potential threats.

Is HIPAA risk assessment a one-time process?

HIPAA risk assessment is a continuing process. Since organizations are spending much time developing new firewalls and multi-authentication systems, hackers are also spending much time building new ways of breaching the security.

What is the goal of an ideal HIPAA risk assessment?

HIPAA risk assessment should be able to reveal all sorts of vulnerabilities in the data storage and data transfer process. The evaluation should report the areas that need immediate expert attention. The risk levels should directly indicate the seriousness of the situation and help the organization prioritize its HIPAA compliance task-list.

What are the tracks of the Quality Payment Program?

You can choose from any of the two tracks of the Quality Payment Program –

  • Merit-based Incentive Payment Program (MIPS)
  • Advanced Alternative Payment Models (APMs)

How is MIPS beneficial for the clinicians as well as the patients?

The MACRA Act 2015 ended the days of Sustainable Growth Rate Formula and is helping clinicians provide better quality healthcare to the patients. It offers new tools and new resources to the doctors to help them lead a quality professional life.

How can American Tech Pros help in HIPAA compliance and MIPS compliance?

At American Tech Pros we assess all possible digital footprints of a healthcare organization and allied companies to find their levels of HIPAA compliance. We use the latest tools in accordance with the new acts that are here to revolutionize Medicare. MIPS compliance assessment is quite similar, and we can help you locate the non-compliant points in your system before the Office for Civil Rights (OCR) reaches you.

Conclusion

You will find a lot of online tools that claim to help businesses with HIPAA compliance and MIPS audits. In truth, they hardly take care of all the nuances. You need expert eyes to look into your services to find the vulnerabilities and discrepancies. Only trained authorities like the American Tech Pros can help you implement new policies and steer clear of hefty penalties in the future.