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Home Health & Hospice Week

Industry Notes:

HIPAA Privacy Complaints Pour In By The Hundreds

Published on Sun Oct 12, 2003

Are your privacy practices enough to satisfy  your patients?

Just because HIPAA privacy enforcement is largely complaint-driven doesn't mean you're out of the woods.

Your patients are showing they're willing to speak up when they feel their privacy rights are being violated. During the first five months of Health Insurance Portability and Accountability Act privacy rule enforcement, the HHS Office for Civil Rights has received more than 1,800 complaints, according to OCR Director Richard Camp-anelli. That averages out to more than 15 complaints per business day.

Speaking at a hearing before the Senate Special Committee on Aging Sept. 23, Campanelli said OCR already has resolved and closed about 30 percent of those complaints.

The closed matters either didn't raise a real privacy issue, didn't involve an actual violation of HIPAA or were resolved "expeditiously and informally - through voluntary compliance - usually after providing some technical assistance," he said.

  • Home care providers can download a copy of the new PC Pricer software from the Centers for Medicare & Medicaid Services Web site. The software "is a personal computer compatible version of the software used in Medicare systems to calculate payments under the home health prospective payment system," CMS notes.

    The new software, which reflects the payment rate update that took effect Oct. 1, is available at http://cms.hhs.gov/providers/pricer/.

  • CMS may have granted providers a reprieve on the HIPAA electronic and code set rule that takes effect Oct. 16, but they should still get compliant as soon as possible (see Eli's HCW, Vol. XII, No. 34, p. 269). Providers can get free HIPAA help from CMS, which has its series of HIPAA roundtable conference calls archived on its HIPAA Web site. The most recent call took place Oct. 8. To access the roundtable transcripts, go to www.cms.hhs.gov/hipaa/hipaa2/events/default.asp#roundtable.

  • One HIPAA item providers don't have to worry about for now is the physician's employer identification number (EIN) or social security number (SSN). Home care providers can use a "dummy" nine-digit number for the item on the HIPAA-compliant 837 format.

    Requiring a doc's EIN or SSN "places a burden on providers," CMS says in a new HIPAA frequently asked question. "We are aware that some providers are reluctant, or even refuse, to furnish that information when requested to do so for this purpose."

    While Medicare won't edit for the accuracy of the EIN or SSN, providers should consider using a dummy number as only a temporary contingency plan, a CMS official said in the Oct. 7 Open Door Forum for home health. Providers should work toward obtaining those numbers.

    Eventually, CMS will assign physicians with National Provider Identifier numbers, which will replace the EIN/SSN HIPAA requirement, it says.

  • Lawmakers appear to be making little headway on the compromise bill for the Medicare prescription drug benefit and other Medicare provisions. Conferees are mired in disagreements about the structure of the drug benefit, and other provisions such as restoration of a rural add-on for home health agencies are held up as a result, according to press reports.

    Congressional insiders say chances are slim that legislators will hit the Oct. 17 deadline for the bill that they have set for themselves.

  • Home care providers won't be able to access the fiscal intermediary shared system (FISS) starting at 4 p.m. on Fri., Oct. 17, intermediary Palmetto GBA says. The system will be back up for use the following Monday.

  • A Kentucky home pharmacy and DME owner may face up to 40 years in jail after pleading guilty to bilking the Indiana Medicaid program out of more than $1.8 million. Peggy A. Bisig, owner of Home Pharm-Assist Inc., could also face a $1.2 million fine, AP reports.

    Bisig pled guilty to mail and health care fraud charges and illegal kickbacks Sept. 4, and faces sentencing Nov. 14. Prosecutors allege Bisig overcharged the state's Medicaid program for various medical products from 1997 to 2000, and paid nurses at the New Albany, IN-based Cancer Care Center to refer patients for home infusion, AP says.

    Bisig already has had to forfeit luxury items purchased with the Medicaid proceeds - jewelry, mink coats, a grand piano and her six-bath, 3,454-square foot home, swimming pool and cabana in Louisville, according to AP.

  • The Department of Health and Human Services will fund five new demonstration grants aimed at improving recruitment and retention of personal care providers for people with disabilities. Three of the six projects that will receive nearly $6 million will test whether providing direct care workers with health insurance keeps them on the job, HHS says.

    The other grants will go for developing educational materials, worker training, mentorship programs and other activities.

    "These personal assistance workers are the backbone of the nation's community-based long-term care system, and should have the same access to health insurance and other work incentives as millions of working Americans," CMS Administrator Tom Scully says in a release.

  • In another grant announcement, HHS says it will provide $33 million in funding to help states develop long-term care programs that will keep beneficiaries with disabilities or long-term illnesses in their homes. "These grants will help people with disabilities exercise meaningful choices
    about how and where to live their lives," HHS Secretary Tommy Thompson says in a release.

    The 75 grants announced "are intended to provide states and other eligible entities with funding to make lasting improvements to their home and community-based services programs," HHS says. HHS has awarded about $125 million in grants in the previous two years to help states improve their community-based services, it says.

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