Health Information Management

OIG recommends OCR strengthen oversight, implement permanent audit program

HIM-HIPAA Insider, November 9, 2015

Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

The Office for Civil Rights (OCR) enforcement and oversight policies are inadequate, according a report published by the Office of the Inspector General (OIG). The report criticizes OCR’s investigations as primarily reactive, meaning that noncompliance can only be addressed after it’s already caused harm. The lack of a permanent audit system contributes to OCR’s inability to proactively assess whether a covered entity (CE) is compliant, the report says.

In roughly half of the closed privacy cases, OCR found that the CE was noncompliant with at least one privacy standard, the OIG notes. Among the sample of cases the OIG looked at, the two most common types of noncompliance involved restricting the uses and disclosure of PHI and implementing safeguards. The most frequent offenders, according the report, were hospitals and individual providers.

The report goes on to criticize OCR’s lack of documentation of corrective actions. Without this documentation, OCR can’t be certain what, if any, actions CEs actually took to address noncompliance. Additionally, the OIG found that 29% of OCR staff “rarely or never” checked whether a CE under investigation had been previously investigated. While OCR staff are able to search for this information, the agency’s case-tracking system has serious limitations, according to the report. Variations in how OCR staff enter a CE’s name into the system mean that another staff member might have to search for all possible variations of the name in order to collect a complete history of prior investigations and corrective actions.

The OIG recommended that OCR:

  • Fully implement a permanent audit program
  • Maintain complete documentation of corrective action
  • Develop an efficient search system
  • Require OCR staff to check if CEs have been previously investigated
  • Expand outreach and education efforts to CEs
     

OCR has agreed with the OIG’s findings and recommendations. It has upgraded its case-tracking system and is developing policies to train staff to search for prior investigations, according to the report. OCR also restated their plan to begin Phase 2 audits in 2016.



Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular