It was well known fact that audits are a reality. The details of audit were announced by Office of Civil Rights (OCR), and some highlights are below:
Audits will begin as early as this month with a Pilot of 20 Audits between now and April 2012. Between May and December rest of the audits will take place. OCR has contracted an outside agency to audit about 120+ audits. That means, between May 2012 and December 2012, we can expect not less than 15 Audits a month. Any covered entity or business associate can be audited and post audit corrective action plan need to be imple,mented by the covered entitiy.
Though there are no civil money penalty for the findings during the audit, the enforcement cost and audit cost would be pretty steep once the audit begins. That is a cause of concern for group practices that may have more than 50 Physicians. it is not known if any small practices are going to be targetted, however, it seems to be a representative selection during the first year.
If you need more information, either contact OCR directly, or you may email me at bmc@healthitplus.com and I would be more than happy to assist you.
Following are the full details:
Source: Office of Civil Rights
When will the audits begin?
The pilot audit program is a three step process. The first step entailed developing the audit protocols. Next, a limited number of audits will be conducted in an initial wave to test these protocols. OCR expects the initial audits to begin in November 2011.The results of the initial audits will inform how the rest of the audits will be conducted. The last step will include conducting the full range of audits using revised protocol materials. All audits in this pilot will be completed by the end of December, 2012.
Who Will Be Audited?
Every covered entity and business associate is eligible for an audit. Selections in the initial round will be designed to provide a broad assessment of a complex and diverse health care industry. OCR is responsible for selection of the entities that will be audited. OCR will audit as wide a range of types and sizes of covered entities as possible; covered individual and organizational providers of health services, health plans of all sizes and functions, and health care clearinghouses may all be considered for an audit. We expect covered entities to provide the auditors their full cooperation and support and remind them of their cooperation obligations under the HIPAA Enforcement Rule.
Business Associates will be included in future audits.
How Will the Audit Program Work?
The privacy and security performance audit process will include generally familiar audit mechanisms. Entities selected for an audit will be informed by OCR of their selection and asked to provide documentation of their privacy and security compliance efforts. In this pilot phase, every audit will include a site visit and result in an audit report. During site visits, auditors will interview key personnel and observe processes and operations to help determine compliance. Following the site visit, auditors will develop and share with the entity a draft report; audit reports generally describe how the audit was conducted, what the findings were and what actions the covered entity is taking in response to those findings. Prior to finalizing the report, the covered entity will have the opportunity to discuss concerns and describe corrective actions implemented to address concerns identified. The final report submitted to OCR will incorporate the steps the entity has taken to resolve any compliance issues identified by the audit, as well as describe any best practices of the entity.
References to days are in business days.
What is the General Timeline for an Audit?
When a covered entity is selected for an audit, OCR will notify the covered entity in writing. The OCR notification letter will introduce the audit contractor, explain the audit process and expectations in more detail, and describe initial document and information requests. It will also specify how and when to return the requested information to the auditor. OCR expects covered entities and business associates who are the subject of the audit to provide requested information within 10 business days of the request for information.
OCR expects to notify selected covered entities between 30 and 90 days prior to the anticipated onsite visit. Onsite visits may take between 3 and 10 business days depending upon the complexity of the organization and the auditor’s need to access materials and staff. After fieldwork is completed, the auditor will provide the covered entity with a draft final report; a covered entity will have 10 business days to review and provide written comments back to the auditor. The auditor will complete a final audit report within 30 business days after the covered entity’s response and submit it to OCR.
What Happens After an Audit?
Audits are primarily a compliance improvement activity. OCR will review the final reports, including the findings and actions taken by the audited entity to address findings. The aggregated results of the audits will enable OCR to better understand compliance efforts with particular aspects of the HIPAA Rules. Generally, OCR will use the audit reports to determine what types of technical assistance should be developed, and what types of corrective action are most effective. Should an audit report indicate a serious compliance issue, OCR may initiate a compliance review to address the problem. OCR will not post a listing of audited entities or the findings of an individual audit which clearly identifies the audited entity.