Violations are subject to enforcement that can include fines up to $50,000 per day and more, and years-long corrective action plans that can cost many times the financial settlement with HHS. Enforcement is no longer in the slap-on-the-wrist days; violations do bring significant penalties today.


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Course Description

Communications in healthcare is an increasingly complex issue. The use of texting and plain e-mail, and Patients’ access of their health information are two of the most current issues in HIPAA compliance and enforcement. Providing appropriate access is one of the cornerstones of HIPAA and has been identified as an area of serious non-compliance that has been targeted in the most recent round of HIPAA Audits. Proper evaluation and management of risks is also on the hot list for audits and enforcement, and that includes considering communications appropriately both with patients, and for business purposes that may or may not contain Protected Health Information. In addition, extensive new guidance from HHS about individual access of information makes clear many areas of the access rules that must be reviewed for compliance in every health care organization.

With the advent of these new technologies and increased desires to use e-mail and texting, and with increases in audits and enforcement actions following breaches, now is the time to ensure your organization is in compliance with the regulations and meeting the e-mail and texting communication needs and desires of its providers, staff, and patients. You need the proper privacy protections for health information, including documented policies and procedures on which your staff has been trained, as well as documentation of any actions taken pursuant to those policies and procedures.

The stakes are high – any improper exposure of PHI against the rules may result in an official breach that must be reported to the individual and to the US Department of Health and Human Services, at great cost and with the potential to bring fines and other enforcement actions if a violation of rules is involved. Likewise, complaints by a patient if they are not afforded the access they desire can bring about HHS inquiries and enforcement actions, so it is essential to find the right balance of access and control.

In addition to HIPAA, there are impacts of the Telecommunications Protection Act (TCPA) that limit the use of cell phones for payment and healthcare purposes unless consent is obtained, and there have been recent actions by the Joint Commission for the Accreditation of Healthcare Organizations (JCAHO) to approve and then withdraw approval of using secure texting for physician orders.

The session will discuss the requirements, the risks, and the issues of the increasing use of e-mail and texting for patient and provider communications and provide a road map for how to use them safely and effectively, to increase the quality of health care and patient satisfaction. In addition, the session will discuss how to be prepared for the eventuality that there is a breach, so that compliance can be assured.

Description of the topic

As HIPAA requirements for allowing patients electronic access to their health information are now in effect, and as patients increasingly come to depend on electronic communications, there are new demands for communication via e-mail and texting. Patients don’t want to bother with secure Web-site-based solutions, they just want to use the tools they already use for communication, and they have a right to communicate how they wish. How can HIPAA requirements for privacy and security be reconciled with patient requests for information provided by e-mail and text messages? This session will discuss the differences between professional communications and patient communications, and how they must be treated to best serve patients, most efficiently enable communications, and remain within the bounds of HIPAA compliance.

This session will focus on the rights of individuals under HIPAA to communicate in the manner they desire, and how to decide what is an acceptable process for communications with individuals. The session will explain how to discuss communications options with individuals so that you can best meet their needs and desires, while preserving their rights under the rules. The new 2016 guidance on individual access of information will be discussed in detail.

E-mail has long been a staple of people’s lives, but as we move into the new digital age, texting is often the preferred, or sometimes the only way of communicating with patients. Doctors are finding that texting is far more flexible, convenient, and effective than paging, and patients want to be able to use short message texting for handling of appointments, updates, and the like, where even e-mail or the telephone would seem inconvenient. Communicating with patients’ cell phones via texting or voice call for purposes of payment and even for providing healthcare information requires consent, and using texting for official purposes still remains outside the bounds of physician orders. These issues must be considered when evaluating the use of texting and e-mail for all kinds of communications.

In order to integrate the use of e-mail and texting into patient communications, it is essential to perform the proper steps in an information security compliance process to evaluate and address the risks of using the technology. This session will describe the information security compliance process, how it works, and how it can help you decide how to integrate e-mail and texting into your organization in a compliant way. The process, including the use of information security risk analysis, will be explained, and the policies needed to support the process will be described. There has long been a HIPAA requirement for covered entities to do their best to meet the requests of their patients for particular modes of communication, and using e-mail or texting is no exception.

Areas Covered in the Session

• Find out the ways that patients want to use their e-mail and texting to communicate with providers, and the
ways providers want to use e-mail and texting to enable better patient care.
• Learn what are the risks of using e-mail and texting, what can go wrong, and what can result when it does.
• Find out about HIPAA requirements for access and patient preferences, as well as the requirements to
protect PHI.
• Learn how to use an information security management process to evaluate risks and make decisions about how
best to protect PHI and meet patient needs and desires.
• Find out about limitations on the use of messages and calls to cell phones under TCPA.
• Discover how JCAHO decided to allow and then withdraw allowing the use of texting for physician orders.
• Find out what policies and procedures you should have in place for dealing with e-mail and texting, as well
as any new technology.
• Learn about the training and education that must take place to ensure your staff uses e-mail and texting
properly and does not risk exposure of PHI.
• Find out the steps that must be followed in the event of a breach of PHI.
• Learn about how the HIPAA audit and enforcement activities are now being increased and what you need to do
to survive a HIPAA audit.
Learning Objectives
At the conclusion of the session, participants will be able to:
1. Understand the rules surrounding provider and patient communications and access of information under HIPAA.
2. Know how to explain the risks of insecure communications to patients and among staff.
3. Manage and audit the use of insecure communications made at the request of patients.
4. Know when secure communications are required and what must be done to secure communications and devices.

Who Should Attend

• Compliance Director
• Privacy Officer
• Security Officer
• Information Systems Manager
• HIPAA Officer
• Chief Information Officer
• Health Information Manager
• Healthcare Counsel/lawyer
• Office Manager
• Contracts Manager


Joe Rivet, J.D., CCS-P, CPC, CEMC, CPMA, CICA, CCEP, CHRC, CHPC, CHC has extensive experience in compliance and privacy matters serving much of his career in compliance and regulatory audit roles. His experience brings a well-rounded depth of knowledge covering healthcare operations, compliance, privacy, coding, and regulations impacting various functions along with associated risks. Rivet is the Director of Payment Integrity with Health Alliance Plan. His scope of responsibility includes fraud, waste, and abuse.

Rivet has strong experience in physician and emergency department professional and facility coding which is a leading compliance risk for most organizations. He has expertise in evaluation and management auditing. He has taught intensive coding courses to physicians and coders nationwide. His experiences bring an in-depth understanding of Medicare regulations related to physician documentation and billing. He has worked on a variety of matters involving government investigations, compliance matters, and third party payer audits.
Rivet has published numerous articles and two books on E/M Auditing. He has extensive coding experience and also holds a law degree.

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