Home Health & Hospice Week

HHS proposes civil monetary penalties for all HIPAA infractions.

Get HIPAA-compliant or get smacked with civil money penalties, says the Department of Health and Human Services.

HHS issued a proposed Health Insurance Portability and Accountability Act enforcement rule in the April 18 Federal Register. Existing HIPAA enforcement relies heavily on voluntary compliance. If violations aren't resolved informally, HHS will issue CMPs.

Now HHS wants to streamline CMPs and enforcement to bring together and adopt CMP implementation rules for all HIPAA rule violations. The proposed rule addresses determining violations, calculating CMPs, procedures for court hearings and the statutory limitations in enforcing CMPs.

The proposed new subpart D, "Imposition of Civil Money Penalties," allows up to a $100 penalty per violation and up to $25,000 for identical violations within one calendar year. However, you can receive separate CMPs for violating the security and privacy rules in the same occurrence. You can also receive multiple penalties for multiple violations of the same requirement.

Hidden trap: The proposed rule provides that you could be held liable for CMPs imposed on an affiliated covered entity.

The proposed enforcement rule is at www.access.gpo.gov/su_docs/fedreg/a050418c.html under "Health and Human Services."  The Centers for Medicare & Medicaid Services official responsible for the national wheelchair coverage criteria process is in hot water over false record charges.

CMS chief medical officer Sean Tunis was placed on administrative leave with pay earlier this month after a state medical board accused him of lying about his credentials, according to press reports. The Maryland Board of Physicians on Feb. 23 formally charged him with falsifying documents relating to his continuing medical education requirements. Tunis works as a part-time emergency physician at a Baltimore hospital.

In his defense, Tunis says he merely attempted to reproduce lost records of CME credits and blames a disgruntled CMS employee for making false accusations against him. An administrative law judge will hear the case in July. Barry Straube, chief medical officer for CMS Region IX in San Francisco, is temporarily filling in for Tunis.
  The U.S. District Court for the Western District of Louisiana has shot down Aging Care Home Health Inc.'s request for an injunction against a Medicare payment suspension. After a whistleblower suit accusing the Monroe, LA agency of medical director kickbacks was unsealed earlier this year (see Eli's HCW, Vol. XIV, No. 6), intermediary Palmetto GBA suspended Medicare payments to the HHA, according to a ruling on the injunction filed March 31.

The Court denied a request for a temporary restraining order in February, and now has denied Aging Care's request for a preliminary injunction against the suspension. The Court doesn't have jurisdiction over the suspension because the agency hasn't exhausted its administrative remedies with Medicare, the ruling says.

While the intermediary can suspend payments [...]