Lance's Corner

OCR Issues Two Annual Reports on HIPAA Compliance and HIPAA Breaches

Feb 23, 2024
Per the notice below, the United States Office for Civil Rights (OCR) has issued two annual reports on compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and on HIPAA breaches.

HHS Office for Civil Rights Delivers Annual Reports to Congress on HIPAA Compliance and Breaches of Unsecured Protected Health Information

Reports highlight for regulated entities where to focus HIPAA compliance efforts

On February 14, 2024, the U.S. Department of Health & Human Services Office for Civil Rights issued two Reports to Congress on Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliance and enforcement, specifically, on HIPAA Privacy, Security, and Breach Notification Rule Compliance and Breaches of Unsecured Protected Health Information.  These reports are required to be submitted to Congress annually by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009.  The HIPAA Rules provide the minimum required privacy and security safeguards for protected health information, and give individuals rights with respect to that information, such as the right to access their health information.  These reports, delivered to Congress, help regulated entities (such as most health care providers, health plans, and healthcare clearinghouses) and their business associates in their HIPAA compliance efforts by sharing steps taken by OCR to investigate complaints, breach reports, and compliance reviews regarding potential violations of the HIPAA Rules.  The reports include important data on the number of HIPAA cases investigated, areas of noncompliance, and insights into trends such as cybersecurity readiness.  The action is the latest step by HHS in supporting the privacy and security of health information.  In December 2023, HHS released a department-wide Cybersecurity strategy for the health care sector and in January 2024, HHS released voluntary cybersecurity performance goals to enhance cybersecurity across the health sector.

“OCR’s Reports to Congress provide useful information for everyone on trends in HIPAA complaints and breach reporting,” said OCR Director Melanie Fontes Rainer.  “Our health care systems should take note of these trends and address potential HIPAA compliance issues before they experience a breach or receive notice of an OCR investigation.  My staff and I stand ready to continue to work with Congress and the health care industry to drive compliance and protect against security threats.”

The 2022 Report to Congress on HIPAA Privacy, Security, and Breach Notification Rule Compliance identifies the number of complaints received, the method by which those complaints were resolved, the number of compliance reviews initiated by OCR, and the outcome of each review.  Some highlights include:

  • OCR received 30,435 new complaints alleging violations of the HIPAA Rules
  • OCR resolved 32,250 complaints alleging violations of the HIPAA Rules
  • OCR resolved 17 complaint investigations with Resolution Agreements and Corrective Action Plans (RA/CAPs) and monetary settlements totaling $802,500, and one complaint investigation with a civil money penalty in the amount of $100,000
  • OCR completed 846 compliance reviews and required subject entities to take corrective action or pay a civil money penalty in 80% (674) of these investigations.  Three compliance reviews were resolved with RA/CAPs and monetary payments totaling $2,425,640.

The 2022 Report to Congress on Breaches of Unsecured Protected Health Information identifies the number and nature of breaches of unsecured protected health information (PHI) that were reported to the Secretary of HHS during calendar year 2022 and the actions taken in response to those breaches.  It also highlights the continued need for regulated entities to improve compliance with the HIPAA Security Rule requirements, including:

  • risk analysis and risk management;
  • information system activity review;
  • audit controls;
  • response and reporting; and
  • person or entity authentication.

As in previous years, hacking/IT incidents remain the largest category of breaches occurring in 2022 affecting 500 or more individuals, and affected the most individuals, comprising 77% of the reported breaches.  Network servers continued as the largest category by location for breaches involving 500 or more individuals at 58% of reported large breaches.  OCR’s 2022 Report to Congress on HIPAA Privacy, Security, and Breach Notification Rule Compliance may be found at: https://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/reports-congress/index.html.  OCR’s 2022 Report to Congress on Breaches of Unsecured Protected Health Information may be found at:  https://www.hhs.gov/hipaa/for-professionals/breach-notification/reports-congress/index.html.  OCR is committed to enforcing the HIPAA Rules and supporting the privacy and security of peoples’ health information.  If you believe that your or another person’s health information privacy or civil rights have been violated, you can file a complaint with OCR at: https://www.hhs.gov/ocr/complaints/index.html.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc