HITECH ACT for starters
Posted By: ChiquitaBanana on 2009-09-24
In Reply to: Why would they sue us? Nothing to gain. - mt
Have you been keeping up on the laws that are going to start in Feb 2010?
Granted, the excerpt below that I took from the MT Herald speaks of transcriptionists off-shore, it is applicable to transcriptionists ON-SHORE as well.
As you might be knowing that HITECH act has given more teeth to HIPAA with heavy penalties and imprisonment for “willful neglect” and “non-compliance.” The penalties range from $100 to $1,500,000 per calendar year. Apart from these civil penalties, criminal punishments could include imprisonment up to 10 years. All these come into effect from February 18, 2010. Furthermore, HIPAA regulations insist that compliance means “a not do once and forget issue” but an “ongoing dynamic process.” In case of a breach at your end even if you are a medical Transcriptionist offshore, the octopussy hands of HIPAA could narrow down on you through the onshore covered entity/business associate and depending on the intensity and repercussion of the breach and depending on the treaties existing between the US and the offshored country (say like the India-US Extradition Treaty).
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Have any MTSOs said anyting about the HITECH Act?
If you think you are micromanaged now, just wait until the HITECH Act (Title XIII of the American Recovery and Reinvestment Act) goes into effect for all MTSOs on February 17, 2010. President Obama signed the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the Stimulus package on February 17, 2009, and the MTSO requirements go into effect in February of 2010. This concerns Protected Health Information (PHI).
AHDI had a PowerPoint presentation at its Convention (the link is below or search for “HITECH Act MTSO” if it does not work for you). I just picked out some of the highlights as pertains to MTSOs and, ultimately, the MTs that work for them.
http://www.ahdionline.org/portals/0/downloads/ACE09_PowerPoint/ScottEdelstein.pdf
Page 3
Transcription Industry at Crossroads
*Image tarnished
-Transparency
-Accountability
*Relevancy
-EMR
-SR
*Increased regulation
Page 7
New HIPAA
*Before 2/2010 – Does not directly apply MTSOs
*Effective 2/2010 – Applies directly to MTSOs
*Requires healthcare providers to take certain actions when entrusting medical information to vendors (outsource firms, etc.)
Page 8
Business Associate Rules
*General Rule: Covered Entity may not disclose PHI to a business associate without “satisfactory assurance” that the PHI will be appropriately safeguarded
*Satisfactory assurance requires a written contract with specific provisions
*If Covered Entity learns of breach of privacy provisions of contract, it must take reasonable steps: cure breach, terminate or report conduct to HHS
MY COMMENT: If you are an employee or IC working for an MTSO, they will be in your computer constantly to upgrade security, make sure you have the latest anti-virus software, and make sure you are not accidently saving any “unauthorized” information.
Page 9
*Business Associates directly subject to HIPAA (new)
*Business Associates include MTSOs, HIEs, RHIOs, HER/PHR vendors
Page 10
MTSO Safeguards to Look For
*Secured data center
*Audit trail for access
*Automatic document destruction
*Control over home-based personnel
MY COMMENT: “Control over home-based personnel.” What the heck could that mean?
Page 13
New Security Obligations for MTSOs
*Implement written policies and procedures to address each administrative, technical and physical safeguard standard
*Implement a security awareness and training program for workforce members
*Designate a security official
*Conduct an “accurate and thorough” security risk analysis
MY COMMENT: “Security awareness and training program” and “security official.” Are they going to install Spyware and track every keystroke we make and every website we visit?
Page 15
Restrictions on Sale of PHI
*HITECH Act prohibits MTSOs from directly or indirectly receiving remuneration in exchange for any PHI
*Exceptions for –
- Remuneration paid by Covered Entity to Business Associate related to Business Associate’s services
MY COMMENT: “…prohibits MTSOs from … receiving remuneration.” They would not feel the need to put this restriction in if there had not been questionable sale or reimbursement for PHI information in the past. Better believe, thought, that EVERY MTSO will start charging for demographic information if they can, but will NOT pay the MTs for inserting that information.
Page 21
HIPAA Risks of Medical Transcription Systems
*Computerization enables storage of large amounts of data in small spaces.
*Networked information is accessible from anywhere at any time.
*New databases and different types of data sets are more easily created.
*Information is easily gathered, exchanged and transmitted.
Page 22
Enforcing Patient Privacy Overseas
*Injunction difficulties
*Damage award enforcement
*Jurisdiction issues
*Foreign attorneys
*Applicable law issues
Page 23
*EU Privacy Directive (10/24/95)
*Canadian Privacy Law (4/00)
*New Zealand Privacy Act
*Australian Health Privacy Guidelines (1/02)
*Argentina Health Privacy Law (10/00)
*India – No formal data privacy laws
*Other Countries
- Chile, Mexico, Paraguay, Peru, Brazil
MY COMMENT: India currently has no formal data privacy law and probably does not plan to have one soon. That could open up a whole new can of worms for the MTSOs who off-shore there. Will they stop using Indian MTs or simply move the headquarters to India and, thus, not have to deal with any of these regulations? Food for thought!!!
Page 31
Anti-kickback Statute
Scenarios
*HIM Director and his family receive an all-expense paid trip to India
*Paying hospital administrator a “consulting fee” to recommend MTSO
*Providing free PDA or laptop to Director of Medical Records
MY COMMENT: “consulting fee” Must be happening already or they would not specifically prohibit it. Wonder how that will affect current contracts between hospitals and MTSOs. There could be a major shakeup. Some MTSOs may lose and some may gain. Unfortunately, those that lose cannot continue giving work to employees with no hospital contracts.
Page 33
False Claims Act (FCA)
*Applies to any person or company that directly bills a Federal healthcare program (e.g., hospitals, ASCs, imaging center, nursing homes, physician offices)
*Also applies to Subcontractors that indirectly bill a Federal healthcare program (e.g., MTSOs, billing companies, coding companies, medical device companies, pharmaceutical companies)
Page 35
*Hospital pays Transcription Company/Subcontractor with Federal money.
*Thus, False Claims Act applies to Transcription Company/Subcontractor.
Page 36
Definition of “False Claim”
*A claim which the billing person or company actually knows to be false.
*A claim, the accuracy of which was deliberately ignored by the person or company making the claim.
*A claim, the accuracy of which was recklessly disregarded by the person or company making the claim.
*ADVICE – Check and double-check the accuracy of a bill for services prior to presenting it to your customers.
MY COMMENT: ICs are going to have their bills scrutinized to death.
Page 37
False Claims Act
Scenarios
*MTSO submits invoices with inflated line counts to hospital
*Ambiguous line definitions
*HIM Director fails to independently verify line counts
*MTSO bills for STAT when normal TAT was requested
MY COMMENT: “Ambiguous line definitions.” Sounds like the perfect time for MTSOs to say: “Sorry, due to government regulations, we are being FORCED to pay by VBC.” Or ICs that work for MTSOs may become extinct because the MTSO does not want to pay their billing company to double and triple check IC submissions.
Page 38
Penalties
*Between $5,500 and $11,000 per claim, plus 3 times the amount of damages sustained by the Government for each claim.
*The penalties can add up very quickly.
Page 39
Qui Tam Provisions of the FCA
The qui tam provisions of the FCA allow private persons, called “relators,” (a.k.a. whistleblowers) to bring civil false claims actions on behalf of the government.
Page 42
Other Legal Issues
*Labor issues
-Employees v. independent contractors
*Tax
*Healthcare reform
MY COMMENT: “Employees v. independent contractors.” Again, it sounds like IC positions may be in jeopardy.
Hope I am interpreting these changes wrong, but I have a feeling there are going to be some major changes in the Medical Transcription business in the next 12 months. Of course, they will never tell their employees what they are planning until they decide to fire all of us.
How to you interpret this information?
What does HITECH act have to do with errors in reports?
nm
Well for starters . . .
How about the email that the CEO or whatever he is sent out company-wide to cover their tracks when they got caught red-handed outsourcing while they were denying it?
And how about the way people remember the email introducing the new QA manager, who just 2 years ago was described in a company wide email as someone who is learning to do MT well enough to work at home unsupervised.
I got those mass emails when I was an employee and so did everyone else. They also got posted to this board by former employees. Can't argue with the information when it comes straight from the horse's mouth!
If ad said they wanted self-starters, this could be a way
x
You have to be in Michigan for starters. sm
Preferably the west side of the state as you have one day of training at their home office in Cadillac. They provide everything you need including the computer. They use Vianeta and their tech support people are great. They give you a mentor to start with and expect you to be off corrections within a week or two. And they always answer emails and/or phone calls.
Hope this helps.
Doesn't sound very American for starters. I think you know where this is headed. nm
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