Lance's Corner

OCR Highlights 2024 HIPAA Accomplishments

Jan 8, 2025

Per the notice below, the United States Office for Civil Rights (OCR) is highlighting its 2024 accomplishments under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

2024 HIPAA Accomplishments and Wrap-Up

2024 was a historic year filled with tremendous activities and accomplishments for OCR on Health Insurance Portability and Accountability Act of 1996 (HIPAA) rulemakings, enforcement actions, conferences, webinars, videos, and newsletters for the health care sector on HIPAA privacy and cybersecurity.

Rulemakings

For the first time in OCR’s history, OCR issued three HIPAA rulemakings in one year.  In February, OCR published a final rule on the Confidentiality of Substance Use Disorder Patient Records, to increase coordination among providers treating patients with substance use disorders, strengthen patient confidentiality protections through civil enforcement, and enhance integration of behavioral health information with other medical records to improve patient health outcomes.  This rulemaking was completed pursuant to the bipartisan Coronavirus Aid, Relief, and Economic Security Act (CARES Act) that, among other things, required HHS to bring the Part 2 program into closer alignment with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Breach Notification, and Enforcement Rules.

In April, OCR published a final rule modifying the HIPAA Privacy Rule to support reproductive health care privacy.  The Final Rule strengthens the HIPAA Privacy Rule by prohibiting the use and disclosure of protected health information (PHI) in certain circumstances.  The Final Rule includes the following changes:

  • Prohibits the use or disclosure of PHI when it is sought to investigate or impose liability on individuals, health care providers, or others who seek, obtain, provide, or facilitate lawful reproductive health care, or to identify persons for such activities.
  • Requires covered entities (health plans, health care clearinghouses, and most health care providers) or business associates to obtain a signed attestation that certain requests (health oversight activities, judicial and administrative proceedings, law enforcement purposes, and disclosures about decedents to coroners and medical examiners) for PHI potentially related to reproductive health care are not for these prohibited purposes.
  • Requires covered entities to modify their Notice of Privacy Practices to support reproductive health care privacy.

In December, OCR issued a proposed rule to modify the HIPAA Security Rule to strengthen cybersecurity in health care.  The proposed rule would require covered entities and their business associates to better protect individuals’ electronic protected health information against both external and internal threats.  It would clarify and provide more specific instruction about what covered entities and their business associates must do to protect the security of electronic protected health information.  The proposed rule would also require that policies and procedures be in writing, reviewed, tested, and updated on a regular basis.  Additionally, it would better align the Security Rule with modern best practices in cybersecurity.  These proposals address:

  • Changes in the environment in which health care is provided.
  • Significant increases in breaches and cyberattacks.
  • Common deficiencies OCR has observed in investigations into Security Rule compliance by covered entities and their business associates.
  • Other cybersecurity guidelines, best practices, methodologies, procedures, and processes.
  • Court decisions that affect enforcement of the Security Rule.

Enforcement

OCR was very active with HIPAA Enforcement.  OCR completed 22 HIPAA enforcement actions (2nd highest in OCR history) and collected over $9.9 million in settlements and civil money penalties.  HIPAA issues resolved included ransomware, phishing, health information left unsecured on the internet, impermissible access to electronic PHI, reproductive health information impermissibly disclosed, and untimely patient access to PHI.  OCR press releases on announced resolutions of HIPAA enforcement action can be found at: https://www.hhs.gov/ocr/newsroom/index.html.

Cybersecurity Resources

OCR focused on information sharing through convenings and the publication of resources to improve the health care sector’s cybersecurity of health information.  In October, OCR and the National Institute of Standards and Technology (NIST) held a cybersecurity conference that featured numerous presenters across government including the HHS Deputy Secretary and senior representatives from the Health Sector Cybersecurity Coordination Center, the Food and Drug Administration, Office of the National Coordinator for Health Information Technology, Federal Trade Commission, OCR, NIST, and many more.

Throughout the year, OCR published cybersecurity resources including a video on ransomware and the HIPAA Security Rule that analyzes trends that OCR is seeing in ransomware investigations and how compliance with the HIPAA Security Rule can assist regulated entities to prevent, detect, respond to, and recover from ransomware attacks.  OCR also published two cybersecurity newsletters on facility access controls addressing contingency plans to respond to emergencies and other events (such as hacking and ransomware) that damage information systems containing health information, and social engineering attacks such as phishing, smishing (texting-based attacks), baiting, and deepfakes with Artificial Intelligence.

OCR also held two webinars to support the two final rules issued this year on the HIPAA Privacy Rule to Support Reproductive Health Care Privacy, and Part 2 Final Rule Modifying Confidentiality Provisions for SUD Patient Records.  Both videos are on OCR’s YouTube Channel at: https://www.youtube.com/@USGovHHSOCR.

We are proud of OCR’s hardworking and dedicated teams of public servants who work day in and day out on behalf of the American people to advance HIPAA and keep our health information safe and secure.

As we look ahead, we encourage you to stay informed, use OCR’s free cybersecurity resources readily available online at www.hhs.gov/hipaa, sign up for OCR’s HIPAA listservs to receive updates, and re-up your efforts to keep your organizations compliant with HIPAA.  OCR will continue to work toward strengthening health information privacy and security.

HHS Blog Post: https://www.hhs.gov/blog/2025/01/07/2024-hipaa-accomplishments-wrap-up.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