At the recent annual conference of the Association of Professional Developmental Disability Administrators (APDDA), we had the pleasure of hearing from administrators from facilities in Corpus Christi and San Antonio, Texas and Miami, Florida who spoke about their experiences preparing for and recovering from Hurricane Harvey and Hurricane Irma last fall. Part of building an emergency preparedness plan includes making provisions to meet the needs of residents with disabilities in the event of an evacuation.

But! Even in an emergency preparedness plan, a resident's health information is still protected by the HIPAA Privacy Rule.

Check it out! The Department of Health and Human Services offers a great interactive tool, The HIPAA Privacy Decision Tool, that through a series of questions helps you determine how the HIPAA Privacy Rule would apply in specific emergency situations (it's available as a flowchart, too!). Other emergency preparedness resources are also available through the HHS site.

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Downloads available for MyHIPAAGuide subscribers include:

  • 2017 Medicare EHR Incentive Program Payment Adjustment Hardship Exception Application. Reference Section 2.3 of the application for the newly defined provision relating to insufficient time for 2015 reporting on Meaningful Use.

  • To apply for a hardship exception, you may download the following applications and other helpful resources on the MyHIPAAGuide.com website. Downloads include:

    • Hardship Applications forms for Providers, Hospitals and the form specific to Critical Access Hospitals (CAHs).

    • New and Updated FAQs on Reporting Requirements for CMS

    • Modified Stage 2 Attestation Worksheet

    • February 2016 Hardship Instructions

    • February 2016 Rule on Returning Overpayments

You can view and download these and more with a MyHIPAAGuide Subscription.

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ProPublicia points to the exceptions to patient privacy regulations, and one women's experience in checking her own paternity test results -- and seeing results for 6,000 others as well:

Read about a privacy case not covered under HIPAA.

Join the MyHIPAA Guide forum discussion.  Submit questions you'd like us to answer relating to HIPAA compliance requirements.

Send us your questions via the forum, and we'll do the reporting to get answers.

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The special healthcare edition of Crain's Cleveland discusses the help available to doctors through  MyHIPAAGuide.com.

The recently launched news & information service covers compliance, including updates in rules; preparation for coming audits; patient education; Meaningful Use reporting and more. Through MyHIPAAGuide.com, a seasoned journalist shows a clear path through the government maze of rules and reporting requirements.


Read about MyHIPAAGuide.com in the special healthcare edition of Crain's Cleveland.

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AHIMA survey results on errors in matching patients to their electronic health records:

Read the key findings

The Director of Infomatics at the University of South California points to patient risks as a result of duplicate records in Electronic Health Records systems:

Read more

Join the MyHIPAA Guide forum discussion here.

Send us your questions relating to HIPAA compliance requirements via the forum, and we'll do the reporting to get answers.

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This is the full text Medicare's Andy Slavitt, speaking in San Francisco about an overall of Meaningful Use criteria.

Read more about the future of Meaningful Use rules under HIPAA

Join the MyHIPAA Guide forum discussion and submit your questions on HIPAA compliance issues.

Send us your questions via the forum, and we'll do the reporting to get answers.

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This newly released tip sheet documents requirements for doctors to report on so-called "Clinical Decision Support" benchmarks:

View PDF

Join the MyHIPAA Guide forum discussion. Submit your questions about HIPAA compliance requirements

Send us your questions via the forum, and we'll do the reporting to get answers.

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This article in Healthcare IT News addresses the varying definitions of population health.

Read more about population health, which is still an elusive concept.

Join the MyHIPAA Guide forum discussion here.

Send us your questions via the forum on HIPAA compliance issues, and we'll do the reporting to get answers.

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Politico tells the story of gag clauses in contracts between EHR companies and healthcare providers:

Read what we don't know about HIPAA security issues within EHR systems

Join the MyHIPAA Guide forum discussion. Submit your questions relating to HIPAA compliance.

Send us your questions via the forum, and we'll do the reporting to get answers.

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crumbling healthcare

By Diane Evans

Publisher, MyHIPPAGuide.com

On the road to healthcare reform, let’s not forget the basics: Americans still need affordable, fast access to doctors. By steamrolling too much change at one time, the risk is that basic needs will go unmet amid reforms that aren’t even widely understood and that ultimately will result in patient care determined by government-approved treatment plans.

It is important that average Americans be aware of what’s happening, and what’s at stake, while there is still time to preserve stability in our current healthcare system as it transitions to high technology.

A major problem is that too much of healthcare reform is being planned and executed in a vacuum – apart from important considerations such as the potential for mass retirements of aging doctors, leading to severe shortages and longer wait times for patients, all at a time of increased demand on the system due to aging baby boomers. Curiously, doctors must focus now on entering patient data into electronic devices, when by the federal government’s own timetable, the necessary technology to accomplish healthcare reform won’t be in place until 2024.

One of the less publicized priorities of the reform push: A plan to move toward what the government calls “population health,” which would marginalize the discretion of doctors in favor of formulas to determine care dispensed to patients. If your eyes glazed over that last sentence, read it again.

With population health, patient care – and payer reimbursement – would be determined by statistical averages based on data analysis. The data that doctors must report to the government would be used to determine standard forms of treatment that qualifies for reimbursement.

That is a concept far beyond the more widely understood goals, such as developing technology to easily share patient health records among providers, say from doctor offices to hospitals.

Population health holds out the ideal that data analysis could identify treatments and procedures that become standardized care methods for Americans. If accomplished through transparent and meaningful data analysis, best practices could indeed emerge that would improve overall healthcare for all. But this is a huge undertaking for the nation, and it should not be coupled with the development of an information superhighway for the sharing of healthcare records from one healthcare provider to another.

Probably under any circumstances, the goal of building an information highway for health records, plus creating standardized, data-driven patient care, would be unrealistic to achieve simultaneously.

However, coupled with other disrupting factors, the stage is set for chaos. Consider:

  • Physicians and other are working with clunky Electronic Records Systems that were not built for reporting on patient outcomes. In a letter to the federal government earlier this year, 36 medical associations called attention to the poor quality of EHR systems, with functionality issues exacerbated by new, unanticipated demands on how the systems are being used. The letter also pointed to inadequate government oversight to ensure the safety of patient information.

  • Changes in Medicare reimbursements have increased financial pressure on doctors, especially in primary care, leaving less money for investment in new technology.

  • With one in four doctors over age 60, mass retirements could drain the system of needed manpower. In a 2014 survey of 20,000 physicians by The Physicians Foundation, 39 percent indicated plans to accelerate retirement.

  • Increased wait times to see a doctor, as reported by the New York Times and others, are already becoming a new norm, and not just in traditionally under-served rural areas. One study found weeks of waiting in some cities.

  • Insurance plan deductibles are rising at a faster pace than wages, as documented in an analysis by the Kaiser Family Foundation. This makes healthcare less affordable to average people.

Do we need healthcare reform? Absolutely.Numerous studies show the United States outspending other developed nations on healthcare, but with inferior outcomes. In addition, as dentists leave teeth cleaning to hygienists, some patient care really should be dispensed by nurse practitioners and assistants. The question is how we migrate to a better system during a period when necessary technology is still a long way off.

At the very least, the debate needs to ramp up, and voices large and small need to be heard. Last month, the American Medical Association (AMA) sponsored a tweet fest on this issue. In inviting participation to chat about a “the physician’s role in the evolution of digital medicine,” an AMA blog post described the “potential impact of digital technology on healthcare (as) simultaneously undeniable and unexplainable.

True, we can’t foresee the future of technology. But as a nation, we do need to understand and debate the potential impact of regulations now being developed.

Through Dec. 15, 2015, federal regulators will accept public comments on the next set of rules that will define details of healthcare reform in 2016 and beyond.

MYHIPAA Guide, a news and information service, is hosting a forum discussion through the Dec. 15 deadline, open to all who would like to share insights on key points that should be conveyed to government regulators. If participants need more information, we will do the research and report back on the forum board. Professional associations, we invite you, your leaders and members to join.

Diane Evans is Publisher of MyHIPAAGuide.com and a former editorial writer and columnist for the Akron Beacon Journal.

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10 Step HIPAA Plan

  • Step 1: Make Sure you Must Comply with HIPAA +

    What's Inside:
    Lists of who is generally covered and who is not, plus contact for inquiries.
  • Step 2: Designate Team Leaders +

    What's Inside:
    • 7-page HIPAA basics
    • 62-page guide to security and privacy of ePHI
    • Compliance Charter Template
  • Step 3: Develop Security Policies & Procedures +

    What's Inside:
    Templates for Security Policies and Procedures
  • Step 4: Conduct a security risk analysis +

    What's Inside:
    INTRODUCTORY:
    • Guides
    • Short videos
    • Interactive quizzes on risk assessment and contingency preparation
    • 10 common myths

    ADVANCED:
    Interactive tutorial – 156 questions with fill-able PDFs for Windows or iPad. All material from federal sources.
  • Step 5: Develop an action plan +

    What's Inside:
    INTRODUCTORY:
    • 11-page overview on ePHI for small practices
    • 4-page Q&A addresses email with patients
    • Checklists

    ADVANCED:
    Toolkit on 45 implementation specifications
  • Step 6: Reduce Risks of a Breach +

    What's Inside:
    • Overview of expectations
    • Annual Work Plan Template
  • Step 7: Train the Team +

    What's Inside:
    • Form for reporting breach notification
    • Links to details on the notification process and what constitutes a breach.
    • Suite of Training Materials
  • Step 8: Customize Privacy Notices +

    What's Inside:
    FOR ALL:
    • Privacy notice templates to help achieve meaningful consent, in English & Spanish.

    INTRODUCTORY:
    • Professionals' guide covering 2013 updates on communications.

    ADVANCED:
    • Electronic toolkit with patient education and meaningful consent sample materials.
  • Step 9: Execute Business Associate Agreements +

    What's Inside:
    • Sample Business Associate Agreement (BAA) provisions
    • Suite of BA Management Tools
  • Step 10: Verify Compliance with HIPAA +

    What's Inside:
    INTRODUCTORY:
    • Tip sheets
    • Short videos
    • Overviews

    ADVANCED:
    • 94-page guide on the EHR incentive program
    • Beginners' toolkit on reporting to the government

    All from federal sources.
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