Audio-Video Conferencing Risks and Tips for Healthcare Providers

by Margaret Young Levi and Kathie McDonald-McClure

Federal and state governments have relaxed restrictions on telehealth to encourage and empower medical providers to serve patients at home during the novel coronavirus (COVID-19) national public health emergency (PHE). Both medical providers and patients have embraced this new way of connecting due to its convenience and, as a result, the expanded use of telehealth is likely here to stay.  The use of audio and video conferencing for patient care, while convenient, risks an unauthorized disclosure of sensitive information if it is used without due regard for whether the connections are secure. 

Following expansion by the U.S. Department of Human Health Services’ Office for Civil Rights (OCR) and the Centers for Medicare and Medicaid Services (CMS) of federal telehealth services and relaxation of certain requirements during the COVID-19 PHE, Kentucky Medicaid followed suit.  See our previous post about Kentucky Medicaid’s expansion of coverage for telehealth. 

OCR Relaxes HIPAA enforcement for telehealth during COVID-19 PHE.  OCR, the agency responsible for enforcement of HIPAA, issued guidance on its enforcement discretion with regard to certain telehealth practices under HIPAA.  This guidance makes it clear that OCR will not enforce penalties for the use of technology that is not HIPAA compliant, when used in the good faith provision of telehealth services.

Under this Notice, covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 PHE. 

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FBI Issues New COVID-19 Cyber Alert for Healthcare Providers on April 21, 2020

On April 21, 2020, the American Hospital Association alerted its members that the Federal Bureau of Investigations (FBI) had issued an FBI Flash to update healthcare providers on additional cyber activity* that continues to exploit fears related to the COVID-19 pandemic. The FBI stated that it had been notified of targeted email phishing attempts against US-based medical providers. The phishing attempts use subject lines and content related to COVID-19 and distribute malicious attachments. Individuals or companies receiving email with unsolicited attachments that may be a phishing attempt should NOT open the email or email attachment if the individual or the company does not have the capability to examine the attachment in a controlled and safe manner.

FBI Alert provides technical details. The FBI Flash provides technical details about the phishing campaign to assist individuals and company IT personnel in identifying the malicious emails. The technical details include a list of email senders, email subject lines, attachment file names and hashes related to the phishing attempts.

The FBI Requests Assistance to Respond to the Threat. To assist in the FBI’s response to the COVID-19 phishing campaign, the targeted individual, or his or her company, is being asked to:

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Kentucky Medicaid Further Expands Telehealth Coverage

By Lindsay K. Scott

Following expansion by the Department of Human Health Services’ Office for Civil Rights (“OCR”) and the Centers for Medicare and Medicaid Services (“CMS”) of federal telehealth services and relaxation of certain requirements, Kentucky Medicaid is following suit.

On March 17, 2020, the Centers for Medicare and Medicaid Services published guidance expanding the use of telehealth and relaxing restrictions on its use. The Office for Civil Rights, the agency responsible for enforcement of HIPAA, followed up with guidance making it clear that it will not enforce penalties for the use of technology that is not HIPAA compliant, when used in the good faith provision of telehealth services:

Under this Notice, covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency.  Providers are encouraged to notify patients that these third-party applications potentially introduce privacy risks, and providers should enable all available encryption and privacy modes when using such applications.

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HHS Office for Civil Rights Issues Telehealth HIPAA Guidance during COVID-19 Emergency

On March 17, 2020, the Office for Civil Rights (“OCR”), the agency within the Department of the United States Health & Human Services (“HHS”) responsible for enforcement of HIPAA, issued the following guidance: “Notification of Enforcement Discretion for telehealth remote communications during the COVID-19 nationwide public health emergency.” Pursuant to Telehealth regulatory waivers issued by the HHS Centers for Medicare & Medicaid Services (“CMS”) effective during the COVID-19 Public Health Emergency (“PHE”), providers can use telehealth at any location including in a patient’s home. As more fully explained in its Telehealth Fact Sheet March 17, 2020, HHS stated:

“The provider must use an interactive audio and video telecommunications system that permits real-time communication between the distant site and the patient at home. …  It is imperative during this public health emergency that patients avoid travel, when possible, to physicians’ offices, clinics, hospitals, or other health care facilities where they could risk their own or others’ exposure to further illness.” Continue reading

OCR’s 2019 Right of Access Initiative Bears First Fruit

Hospital Agrees to Pay $85,000 for Failure to Provide Patient Timely Access to Records

by Margaret Young Levi and Kathie McDonald-McClure

On September 9, 2019, the Office for Civil Rights (OCR) announced its first settlement under its “Right of Access Initiative.” Without admitting any wrongdoing, a hospital has agreed to pay $85,000 to the United States Department of Health & Human Services (HHS) as a result of a 10-month delay in providing access to protected health information (PHI). Importantly, the Health Insurance Portability and Accountability Act (HIPAA) requires covered entities to “act on” requests for access within 30 days of a request. The hospital also entered into a Corrective Action Plan (CAP) that required the hospital to implement, and train staff on, policies and procedures to ensure individuals have timely access to their requested PHI.

What led to the settlement? The patient raised the issue of untimely access in a complaint to the OCR on August 14, 2018. The patient alleged that on October 18, 2017, she requested her unborn child’s fetal heart monitor records from Bayfront Health – St. Petersburg (Hospital), a Florida hospital.  At the time of her OCR complaint, nine months had passed without receiving any records.  The reason given to the patient by the Hospital for not producing the records was that it could not find them. Continue reading