Banner Graphic

HIPAA and HITECH awareness and compliance

- an opportunity for continuum of care -


HIPAA offers the healthcare industry a significant opportunity to improve administrative efficiency and implement e-business initiatives in healthcare. Achieving compliance with HIPAA regulations is a complex, initially costly, and sizable undertaking.

Professor Steve & Associates, founded by Stephen L. Priest, FHIMSS, CPHMIS, believes HIPAA will ultimately reduce costs and improve quality of care, resulting in patient continuum of care, and administrative and research opportunities. Priest's published article, HIPAA and Consumer Empowerment, describes the benefits achieved in other industries undergoing similar consolidations, and how these experiences can be leveraged in healthcare.

Priest is a healthcare consultant with over 25 years experience in administration and information systems.


What is HIPAA and Where is it now?

To improve the efficiency and effectiveness of the health care system, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) included a series of "administrative simplification" provisions that required the Department of Health and Human Services (DHHS) to adopt national standards for electronic health care transactions. By ensuring electronic consistency and standardization, privacy, and security for protected health information, HIPAA national standards make it easier for health care providers to achieve continuum of care through access to a lifetime (pre-natal to current) consumer/patient health record.  HIPAA also sets electronic standards and codes for more efficient processing of billing claims and other electronic transactions.

In brief, the major components, status, and compliance dates are:

·         Health Information Privacy Rule - Implemented April 14, 2003.

·         Electronic Health Care Transactions Rule - The Center for Medicare and Medicaid Services (CMS) announced it would accept electronic transactions that don't comply with the HIPAA Transaction and Code Set rule after the October 16, 2003 deadline.   Keep in mind that, after October 16th, your organization must continue to demonstrate and document reasonable and diligent efforts to become compliant.  How long this CMS contingency plan will be in place is unknown. 

CMS Slows Legacy Claims Payment in Push for HIPAA TCS Compliance

The Centers for Medicare & Medicaid Services (CMS) on Feb. 27 instructed Medicare carriers and fiscal intermediaries pay electronic claims that are not HIPAA-compliant no earlier than 27 days after receipt. Medicare currently pays electronically submitted claims no earlier than 14 days after receipt. CMS ordered the slowing down of payments on "legacy" claims as "a measured step toward ending the contingency plan completely." The new payment structure, intended to encourage HIPAA transactions and code sets (TCS) compliance as soon as possible, has an implementation date of July 6.

·         National Employer Identifier (EIN) - A unique identification number for employers and employer groups. The final rule has a compliance deadline of July 30, 2004. The employer tax ID number (TIN) assigned by the IRS was adopted as the EIN.

·         Security Rule - April 21, 2005.

·         National Provider Identifier (NPI) -The Centers for Medicare & Medicaid Services (CMS) published on January 23, 2004 the adoption of the National Provider Identifier (NPI) as the standard unique health identifier for health care providers to use in filing and processing health care claims and other transactions.  The effective date of this final rule will be May 23, 2005.

The NPI is a new number that will be issued through the National Provider System, which is being developed by CMS.  The NPI replaces all “legacy” identifiers that are currently being used.

Covered entities must use NPIs in standard transactions no later than the compliance dates.  The
compliance dates for all but small health plans is May 23, 2007.  The compliance date for small health plans is May 23, 2008.

A health care provider will be assigned only one NPI, and that NPI will not change over time.  

The system that will handle the assignment of NPIs will be ready to accept applications for NPIs after the effective date of the final rule, which is May 23, 2005.  Health care providers may begin
applying for NPIs on that date.

·         National Health Plan Identifier (HPIN) - A unique identification number for health plans. DHHS has not published final rules on the HPIN. Once the final rules is effective, covered entities will have 24 months to comply.

·         National Personal Identifier - On hold. - Although HIPAA included a requirement for a unique personal health care identifier, HHS and Congress have put the development of such a standard on hold indefinitely. In 1998, HHS delayed any work on this standard until after comprehensive privacy protections were in place. Since 1999, Congress has adopted budget language to ensure no such standard is adopted without Congress' approval.  HHS has no plans to develop such an identifier.

·         The Interim Enforcement Rule - On April 17, 2003 the DHHS published the first Interim Enforcement Rule in the Federal Register. This interim final rule establishes rules of procedure for the imposition of civil money penalties on entities that violate standards adopted by the Secretary under the Administrative Simplification provisions of HIPAA. The Enforcement Rule, when issued in complete form, will set forth procedural and substantive requirements for imposition of civil money penalties. In the interim, the DHHS has issued  rules of procedure to inform covered entities of their approach to enforcement and to advise covered entities of certain procedures that will be followed as the DHHS enforces HIPAA.

The Interim Enforcement Rule will be modified as necessary and is in effect until September 16, 2004 at which time the Final Enforcement is scheduled to be published. OCR and DHHS has a web site email form available for reporting HIPAA violations and concerns.

HIPAA Security Compliance - a three phase approach

Professor Steve & Associates provides a three phase approach to assist organizations to achieve HIPAA Security compliance for PHI integrity, confidentiality, and availability:

(4) CMS Security FAQs

Physician Practice Questionnaire

Click here for our Physician Office Pre-visit Questionnaire to prepare you for understanding HIPAA through a personal interview.

Achieving compliance with HIPAA regulations is a complex, initially costly, and sizable undertaking. Professor Steve & Associates believes, as does CMS, that HIPAA will ultimately reduce costs and improve quality of care, resulting in patient continuum and administrative and research opportunities.

Email and Internet Model for Physician-Patient Communication

Model Guidelines for the appropriate use of the Internet in medical practice has been published by the Federation of State Medical Boards. Key facets of these email and Internet guidelines include (1) E-mail turnaround times must be established;(2) Copies of all patient communication (e.g. email) should be maintained in the medical record; (3) Licensure must be maintained in the jurisdiction where the patient resides for a patient-physician email relationship.

HIPAA Gap Assessment and Risk Analysis

The steps Professor Steve & Associates recommends to achieve compliance are found by clicking on HIPAA Gap Assessment/Risk Analysis

·         Perform the Gap Analysis

·         Conduct awareness Education.

·         Develop a Compliance Plan and identify the organizational structure to manage this organization-wide task.

Are You a Covered Entity?

A covered entity is a health plan, a health care clearinghouse, or a health care provider who transmits health information in electronic form. The term "health care provider" includes individual physicians, physician group practices, dentists, other health care practitioners, hospitals, nursing facilities, and so on.

HIPAA Supports "Continuum of Care", CPOE and EMR

 

Professor Steve applauds HIPAA as a beginning for continuum of care.  HIPAA is the first real impetus for electronic standards, consumer confidence in the privacy of PHI, and security of the medical record.  We promote HIPAA as the first thrust to obtain continuum of care, and yes, this means initial costs, re-process, and change.  We believe the long term impact of HIPAA will have a significant influence on quality of care; and truly, we can say "yes" to the question,  "Is HIPAA good for the patient?"

Continuum of care needs to be society's healthcare quest to achieve a "birth to earth" consumer health history, regardless of where care is provided.  Continuum of  care includes Computerized Physician Order Entry (CPOE) and the Electronic Medical Record (EMR).   Confidentiality, integrity and availability of PHI come through privacy, security and electronic standards for PHI.  HIPAA must have clinician and consumer support.

Suggested HIPAA References


 

Recent Publications

Outdoor Play "Fun 4 4 Seasons"
Outdoor Enthusiast: Never say, "I wish I had ...."
Using E-Learning Tools to Advance Health Informatics
HIPAA: An Opportunity for Continuum of Care
HIPAA: An Opportunity for Continuity of Care
Leveraging HIPAA to Support Consumer Empowerment
A moment for e-learning: Email
A Crash Course in Systems Analysis
Hidden costs of the $89 upgrade
Building a Better Mousetrap
Education on-line: A Community Preceptor Computer Network

 


 

Press Releases


July 22, 2006 - Stephen L. Priest, Educator at Saint Joseph’s College of Maine, Receives Outstanding Faculty Award

STANDISH , Maine . - Stephen L. Priest of Bedford , NH was presented the Saint Joseph 's College of Maine 2006 Outstanding Faculty Award for the Graduate Health Administration program.  The Health Administration program is a graduate distance learning program preparing health care managers for leadership roles in organizations that deliver, regulate or provide health care services.

Steve teaches various courses including Medical Informatics, Integrating People and Technology into the Office Environment, and the HIPAA Security Rule.

The award was made by Professor John Pratt, Program Director for Health Administration.


August 15, 2004 - HIPAA Security Rule Compliance And The Electronic Medical Record

MANCHESTER, NH - Stephen L. Priest, managing principal of Professor Steve & Associates of Bedford, NH, has been invited to speak at a one-day seminar sponsored by Lorman Education Services on September 28, 2004.  His topic will be The Impact of Emerging Technologies on the Electronic Health Record.  Steve will share the podium with Tom Austin, Internet Business Group, and James Sheldon-Dean, Lewis Creek Systems. 

Attendees will learn how complying with the HIPAA security rule is different from complying with earlier HIPAA mandates, what are the requirements for health information security under HIPAA privacy and security rules, and what's involved with understanding how information flows through your organization and what that's important to health information privacy and security.

Steve is the author of information system textbooks and HIPAA articles detailing HIPAA strategies and implementation.  Steve is a Certified Professional in Healthcare Information and Management Systems (CPHIMS), and has Fellow status in the Healthcare Information Management Systems Society (HIMSS).

Professor Steve & Associates assists medical practices in becoming HIPAA compliant. www.professorsteve.com.


July 28, 2004 - Emerging Technologies and HIPAA at Ninth Annual HIPAA Summit

BEDFORD, NH - Stephen L. Priest, managing principal of Professor Steve & Associates of Bedford, NH, has been invited to speak at the Ninth Annual HIPAA Summit in Baltimore, MD on September 13th.  His topic will be emerging technologies and HIPAA (Health Insurance Portability and Accountability Act).

Steve is the author of information system textbooks and HIPAA articles detailing HIPAA strategies and implementation.  Steve is a Certified Professional in Healthcare Information and Management Systems (CPHIMS), and has Fellow status in the Healthcare Information Management Systems Society (HIMSS).

Professor Steve & Associates assists medical practices in becoming HIPAA compliant www.professorsteve.com.


June 21, 2004 - 30-Hour Master's Level HIPAA Security Course Offered at Saint Joseph's College of Maine

STANDISH, ME - Stephen L. Priest, FHIMSS, CPHIMS, will teach an accredited 30-hour course on HIPAA Security at Saint Joseph's College of Maine from June 21, 2004 through July 2, 2004. This masters level course explores the entire HIPAA security regulation, including its preamble. Through class presentations, case studies, Internet research, and discussion, students will examine approaches and options for covered entities to comply with the rule. Students will consider the flexibility of the rule, its benefits to healthcare providers and payers, and various ways to achieve, monitor, and maintain compliance.


March 18, 2004 - Stephen L. Priest Advocates New Hampshire Healthcare Emerging Technology Taskforce for Increase Quality Care and Reduced Costs

CONCORD, NH - Stephen L. Priest, FHIMSS, CPHIMS, addressed the New Hampshire Health Information Management Association (NHHIMA) on, "The Impact of Emerging Technologies on the Electronic Health Record."   Priest is managing principal in Professor Steve & Associates of Bedford, NH.  (www.professorsteve.com 603-471-0605).

Priest presented the benefits of computerized physician order entry (CPOE), patient-physician e-communication, and the Health Insurance Portability Act (HIPAA). He discussed barriers to "best practice" implementation of these emerging technologies.  Priest  advocates a New Hampshire task force comprised of key stakeholders with a mandate to align the cost burden of implementation with those receiving the financial savings. He spoke of the financial investment by hospitals for CPOE where the benefits do not accrue to the them.  He cited as an example that hospital investments for population health management and medication compliance often accrue to the insurers. Thus hospitals are unlikely to invest their limited resources when they receive no reimbursement and no reward. He promoted a collaborative task force of hospitals, employers, insurers and physicians, along with support from professional health are organizations to eliminate the cost benefit disconnect.


December 10, 2003 - Stephen L. Priest to address University of Massachusetts in HIPAA Compliance

LOWELL, MA - Stephen L. Priest, FHIMSS, CPHIMS, addressed the University of Massachusetts (Lowell) Master's in Health Services Administration students on Health Insurance Portability and Accountability Act (HIPAA) simplification.  The HIPAA Security, Privacy, and Electronic Standards Rules are a comprehensive set of regulations that will change the future in how healthcare information is managed.  Priest is managing principal in Professor Steve & Associates of Bedford, NH.  His firm assists medical practices in becoming HIPAA compliant. (www.professorsteve.com 603-471-0605).

The University of Massachusetts (Lowell) HSA program is coordinated by Vincent C. Pivnicny, PhD.  The goal of the graduate HSA program is to provide health services administrators with the specialized knowledge and skills necessary to administer the delivery of high quality and cost effective health services.


December 1, 2003 - Stephen L. Priest addresses HIPAA and Medical Office Provider Compliance

MANCHESTER, NH - Stephen L. Priest, FHIMSS, CPHIMS, addressed the New Hampshire Medical Group Management Association (NHMGMA) on Health Insurance Portability and Accountability Act (HIPAA) simplification.  The HIPAA Security, Privacy, and Electronic Standards Rules are a comprehensive set of regulations that will change the future in how healthcare information is managed.  Priest is managing principal in Professor Steve & Associates of Bedford, NH.  His firm assists medical practices in becoming HIPAA compliant. (www.professorsteve.com 603-471-0605).

The New Hampshire Medical Group Management Association (NHMGMA) is a non-profit organization of Medical Office Managers, Administrators and other professionals in affiliated organizations with over thirty different medical specialties and subspecialties.


November 15, 2003 - Stephen L. Priest addresses HIPAA and Medical Provider Compliance

BEDFORD, NH - Stephen L. Priest, FHIMSS, CPHIMS, was a featured speaker at the New Hampshire Center for Non-Profits meeting at the Highland Inn in Manchester.  His topic was the Health Insurance Portability and Accountability Act (HIPAA) simplification provisions.  Priest focused on HIPAA Security, Privacy and Electronic Standards Rules.  Priest is managing principal in Professor Steve & Associates (Bedford, NH).

The New Hampshire Center for Nonprofits (NHCN) works to increase public awareness of how indispensable nonprofits are to NH's well being.  NHCN is an advocacy, information and education center, and networking resource for New Hampshire nonprofit organizations


March 1, 2003 - Stephen L. Priest receives award of Certified Professional in Healthcare Information and Management Systems (CPHIMS)

BEDFORD, NH - Stephen L. Priest, a principal in Professor Steve & Associates, has successfully passed the Certified Professional in Healthcare Information and Management Systems (CPHIMS) examination. Passing the CPHIMS exam demonstrates mastery of a well-defined body of knowledge considered important to competent practice in today's' healthcare environment. The exam insures he has met the highest standards of practice and he is among the elite in a critical field of healthcare management. The exam included material on the Healthcare Insurance Portability and Accountability Act (HIPAA)

Priest consults and presents seminars on the Health Insurance Portability and Accountability Act (HIPAA) privacy, security and electronic standards.  He oversees Vision Technologies marketing and application strategies for their Mobile Clip wireless tablet, and has recently been involved in the application of Mobile Clip in the area of Computerized Physician Order Entry (CPOE).  He is a currently adjunct faculty at Saint Joseph's College of Maine developing and teaching online courses in their Masters in Health Administration program.  Steve is the author of information system textbooks and HIPAA articles detailing HIPAA strategies and implementation.  He has Fellow status in the Healthcare Information Management Systems Society (HIMSS). Priest is a national speaker on application of information systems.

Professor Steve & Associates web site is www.ProfessorSteve.com.


December 1, 2002 - Senior managers leverage e-business strategies, e-mail, Internet, and word processing.

BEDFORD, NH - Everyone needs a coach! There are coaches on stress release, coaches on etiquette, coaches on exercise, and coaches to assist in business decisions. Hectic and demanding schedules find many managers behind in integrating technology into their daily routine. Professor Steve provides CEOs and senior managers their own personal electronic-business and electronic-office coach and confidant.

Professor Steve coaches senior managers on e-business concepts, e-mail, word processing, Internet, and presentation formats. Professor Steve is a "behind the scenes" confidant.

Not all senior managers feel comfortable revealing their e-office and e-business insecurities. Some, to the chagrin of their associates, delay e-business decisions, have staff do memos, look for missing papers, distribute information, and draft presentations - all forcing busy staff away from their primary responsibilities.

New executives e-office training is most often secondary to the time demands of a new position. And yet they need to navigate their new organization's "virtual office" to communicate with new associates. Assigning internal technology staff to "train" the manager may compound new position tensions.

The founder of Professor Steve is Stephen L. Priest. His emphasis is on "how to apply" technology within the importance of political and mission awareness. He has twenty years as an academic and senior business administrator, and knows the business value of money, time and deadlines. He provides insights into strategic e-business and tips for effectively using the e-office.

When asked to give examples of ways managers can use Professor Steve's services:

 


 

Fact Sheets

The Imperative for CPOE Feb 2008 MTC-NEHI Study
Escape Fire - LESSONS FOR THE FUTURE OF HEALTHCARE
Microsoft eSecurity Guide for Small Business
Wedi-SNIP Risk Analysis White Paper July 2004
The Electronic Health Record and the Continuity of Care Record
HIMSS Voluntary Patient Identifier Resolution
Older Doctors Try to Keep Up
IT & Evidence Based Medicine
Physician Practices: Are Application Service Providers Right for You?
IT Challenges in Physician Practice Management
The Best Care Anywhere
HIPAA FACT Sheet
Is Your HIPAA Halfway There? Check to See If You Are
Advanced Technologies to Lower Health Care Costs and Improve Quality


 

Supported Web Sites

That One Glorious Season
Outdoor Steve
Granite State Senior Games
Professor Steve & Associates
The Loon's Nest - Guided Maine Wilderness Expeditions
Electronic Communications Association, Inc.
The Flower Parrot


 

CloserQ Sales Blog

Sales People Helping Sales People and Customers


CloserQ is a Sales Blog.  The name CloserQ stands for "closer questions" in a sales or career situation. CloserQ helps sales people, sales managers, and customers by sharing sales and career questions, and then listening to various reader responses to these questions. The blogger and readers will assist the sales person and customer with answers and options.

All professionals at one time or another are both customers and sales person.  Whether you are a customer dealing with a vendor, or a vendor dealing with a customer, the insights of CloserQ and its bloggers offer unique perspectives for dealing with customers and sales people.  

Click CloserQ to Learn and Share!

CloserQ Readers, Shaun Priest had the privilege of being interviewed by Chris Thompson on his weekly radio show, The Business Advantage, on WKXL 1450AM. Chris and Shaun discussed prospecting and business development in a challenging economy. Please click the link below to listen to the interview:

http://www.wkxl1450.com/mp3/Business%20Advantage/Business%20Advantage%20032409.mp3


 

Free Consultation

Call for your FREE 2-hour consultation

Phone 603-471-0605
or
E-mail: Professor Steve


 

Contact Us

Stephen L. Priest, FHIMSS
Professor Steve & Associates
50 Old Sawmill Road
Bedford, NH 03110
E-mail: Professor Steve
603-471-0605
603-218-7200 Fax