Issue 4 - March 2003

HIPAA: A big deal even for small practices
By Lisa Lavia Byrd

As the April 14 deadline for HIPAA compliance nears, you might be wondering about the true necessity of complying with this Federal regulation. As we talk with doctors about HIPAA and its mandates, we frequently hear such comments as: “Why do I have to go through official training for this HIPAA thing? The government is only going after the big guys. I’m in a one-person office; they’ll never come after me.” But here’s something you might not know about just why you should take steps to become HIPAA-compliant.

Even if your office handles all files in a paper form and a third-party billing service handles your billing, you'll most likely need to comply with HIPAA because almost all billing service handle patient information electronically, especially if they're filing for Medicare of Medicaid benefits.

• If you’re non-compliant, you’ll probably be caught. Legal experts feel HIPAA will become a “popular” add-on when doctors are investigated for any type of complaint.
Consider this scenario: You terminate an employee. She, being aware of HIPAA requirements and your practice’s failure to comply, notifies authorities. Unless you can prove compliance, you could face punishment.• Non-compliance is costly. You could also go to jail. Failure to implement HIPAA can result in significant fines – as much as $25,000 a year. Criminal penalties can total $250,000 and you could be required to serve up to 10 years of jail time.

• You can lose preferred-provider status. If you work with managed-care organizations, you’ll need to prove HIPAA compliance.
Managed-care organizations will de-credential practices that are unable to prove compliance. So if you want to get paid, you’ll need to be HIPAA-compliant.

• Extensions are not an option. If your practice isn’t fully compliant with all HIPAA mandates, it’s critical to initiate compliance now. Extensions are not available for the April 14 privacy-regulation compliance deadline.

A number of quality programs, both Internet-based and offline, are available to walk you through the necessary steps. Look for a program that offers features such as:

• Fast, efficient training;

• Easy-to-use assessment tools;

• Patient privacy forms;

• Compliance manual materials;

• Certificates of com-pletion; and

• Regular updates to ensure the most current compliance information.

Lisa Lavia Byrd is marketing communications editor for NCMIC Group, Inc.