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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September 22, 2014 Deadline for Business Associate Agreements

September 22nd Deadline Fast Approaching
September 22nd Deadline Fast Approaching

The final HIPAA Omnibus Rule (Omnibus Rule), published in the Federal Register on January 25, 2013, substantially increased the privacy and security responsibilities of a “business associate” of a “covered entity”, as those terms are defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)(see discussion later in this post regarding the expansion of the “business associate” definition).  Among other changes, the Omnibus Rule requires a covered entity and business associate to revise their business associate agreement (BAA) to reflect the business associate’s new obligations.  All BAAs signed after January 24, 2013 should already include new language necessary to comply with the Omnibus Rule.  BAAs that were signed on or before January 24, 2013 were deemed compliant until September 22, 2014; however, if renewed or modified before that date then they must be brought into actual compliance at that time.  Covered entities and business associates must ensure that all BAAs are compliant with the Omnibus Rule before the September 22, 2014 deadline. Continue reading

HIPAA BAA Deadline is Monday, September 23, 2013


by Margaret Young Levi

Reminder: the clock is ticking for covered entities and business associates to come into compliance with new requirements under HITECH-HIPAA Omnibus Rule.  Monday, September 23, 2013 is the deadline for covered entities and business associates to put into place new Business Associate Agreements (“BAAs”).  As we blogged on March 4th, any new BAAs signed after January 24, 2013 should comply with added requirements under the Omnibus Rule.  These new agreements must be signed and in place by September 23, 2013.

Current BAAs (those signed on or before January 24, 2013) will be grandfathered and deemed HIPAA compliant through September 23, 2014, at which time the BAA will need to have been amended for compliance with the Omnibus Rule. 

As a first step, covered entities should verify that they have identified all of their business associates, particularly in light of the revised definition of “business associate” in the Omnibus Rule.  Covered entities should enter into compliant BAAs with any newly identified Business Associates or with existing business associates if the agreements are renewed after January 24th (excluding those BAAs that automatically renewed). 

Business associates will now be directly liable for their actions under HIPAA and should take steps to identify their downstream business associates, called “subcontractors” and enter into BAAs with those subcontractors. 

See our March 4, 2013 post for additional details.

Sample BAA Provisions

The final HIPAA-HITECH Omnibus Rule (Omnibus Rule), released in January, substantially increases the privacy responsibilities of a business associate that receives protected health information, such as contractors and subcontractors.  These new requirements will need to be reflected in business associate agreements (BAAs) between the covered entity and the business associate as well as in agreements between a business associate and its subcontractor.

For example, BAAs must now contain provisions requiring business associates to notify the covered entity of any data breaches.  Moreover,  the Omnibus Rule expanded the definition of “business associates” to include subcontractors, which means business associates must now enter into BAAs with their subcontractors who access PHI. 

The Department of Health & Human Services (HHS), Office for Civil Rights (OCR) has posted sample BAA provisions on its website to help covered entities and business associates more easily comply with the additional BAA requirements found in the Omnibus Rule.  While these sample provisions are written for use in a contract between a covered entity and its business associate, the language may be tailored for purposes of a contract between a business associate and its subcontractor.

These sample provisions do not constitute a sample contract but are only a starting point.  It is not enough to print and sign these provisions.  As OCR warns, “These provisions address only concepts and requirements set forth in the HIPAA Privacy, Security, Breach Notification, and Enforcement Rules, and alone may not be sufficient to result in a binding contract under State law. They do not include many formalities and substantive provisions that may be required or typically included in a valid contract.  Reliance on this sample may not be sufficient for compliance with State law, and does not replace consultation with a lawyer or negotiations between the parties to the contract.”  Moreover, there are common concepts in BAAs that are notably missing from the sample provisions, such as indemnification, notification, and mitigation, which should be considered for inclusion with any BAA. 


If your current BAA was signed on or before January 24, 2013, then it will be deemed HIPAA compliant through September 23, 2014 (at which time the BAA will need to have been amended for compliance with the Omnibus Rule).  Any new BAAs signed after January 24, 2013 should comply with the new requirements under Omnibus Rule, and be in place by September 23, 2013.