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What recourse do I have when my doctor violates my HIPAA rights by sending my personal health information to the wrong address? I was notified by the people at the address, not by my doctor's office.

What happened to you is extremely common. Mislabeled documents may be the single most common form of HIPAA violation. And under the rules, it is considered a breach. Here are the actions you could take:NOTIFY - Notify the doctors office. By law, every physician practice has a person designated to be the HIPAA Privacy Officer. This person’s contact information is supposed to be published so you may find it on the doctors website or on a board in the lobby. It also should be on the Notice of Privacy Practices which the practice should provide to you upon request. If not, call the office and ask to speak to the administrator or the privacy officer (in smaller practices they are usually the same person). Tell them what happened. If they are a conscientious practice they will follow-up with both you and the recipient, determine that the PHI was destroyed or otherwise secured and keep you informed about the actions that were taken. They should work to remedy the situation.COMPLAIN - If you still aren’t satisfied, you can file a complaint with the Office of Civil Rights at the Department of Health and Human Services which you can do right here. The likely action on the part of OCR is that you will never hear from them again. This type of breach is extremely common. The practice is required by law to report these events annually and they will probably add it to the half dozen or so other incidences that happened that year and report it at the end of the year. The only breaches that get much attention from the OCR are ones that involve over 500 records which have more rigorous reporting requirements and have to be reported within 60 days.SUE - If you were truly harmed by the disclosure, and the practice fails to remedy the damage or the potential harm caused by the breach, you could hire an attorney and sue. It is very unlikely that you were harmed to a degree that the risk of suing is worth the costs. Let’s say for example the disclosure included an embarrassing diagnosis, such as a diagnosis for an anal fissure. You might have experienced some mild embarrassment that a stranger could have potentially noticed you had an anal fissure. The harm done is minimal. On the other hand, imagine a scenario where the report was inadvertently sent to your husband’s mother, whom you are currently separated from and in the process of divorcing and the document that was disclosed was a pregnancy report indicating you are pregnant by a man who is not your husband. Such a disclosure is potentially extremely costly and damaging and suing the practice may be warranted.My general advice is to work with the practice to remedy the situation. Much beyond that is generally not worth the effort.

What's the best way to ensure HIPAA compliance on a small practice website?

The first question to ask is if your website even needs to be HIPAA compliant. Ask yourself these questions to determine if it does indeed require compliance:1 - Will you be collecting Protected Health information (PHI) on the site?2 - Will you be transmitting PHI from the site to third parties?3 - Will any PHI be stored on the site?4 - Will you be messaging through the site that will contain PHI?If you answered YES to any of these, then HIPAA will need to be adhered to.If you are collecting information on your site, then the website will need to use SSL encryption so that when the data is entered by patients, it will be sent to your site in an encrypted form. Once the data arrives to your site, it will need to be stored in an encrypted database.Often small practices link to patient portals at their EMR vendor. This would be an exception since this is just a link from your site to the vendor. They would need to be using SSL to encrypt the data.Make sure you have a Business Associate Agreement with your EMR vendor.If you are transmitting PHI, you must also use SSL to protect the data. If you are using email to transmit PHI, you will need to use a service that provides end to end encryption of the data. Using self hosted email, Gmail, etc is NOT HIPAA compliant. Email must be encrypted from the sender to the receiver.If you are storing data on your site, the database must be encrypted. this is why so many sites are breached and the data stolen. Their databases aren’t using encryption or are using weak encryption.One final point. Post your Notice of Privacy Practices (NPP) on your website.This should get you started on making sure you have a HIPAA compliant website.

What advise can you give me to build a website for professional counselor to receive booking for appointment, counseling to be done through private video call.clients pay for 45mins session. Can this be possible? Can counseling be done online?

My advice to you is to first learn everything you can about HIPAA compliance. If you neglect this area of your site, you risk getting fined and/or jailed if you leak confidential patient information.Also you’ll want to learn about business associate agreements, because everyone who contributes to your site in the development and maintenance of it will have to sign one. WordPress will not issue one, so you can’t use them as your platform. Even the plug-in developers will have to be compliant or you can’t use the plugins. You could use WordPress as a bridge to the HIPAA compliant software, but I don’t recommend it.HIPAA PrivacyConversations (phone, text, video, etc.)Billing informationPatient identifying information (including general conversation attempting to hide who the patient is when process of elimination may identify the person, especially in a small town)Charts, tables, images and other mediaPrescription informationTreatmentsHIPAA SecurityPerforming periodic risk analyses to determine physical and digital vulnerabilitiesReducing risks to acceptable levelsRegularly reviewing system activities, digital logs and audit trailsAuthorizing and supervising the employees who have access to PHIProtecting PHI from unauthorized parent companies, subcontractors and partner organizationsSending regular updates to staff members about security issues and training employees to recognize malware, malicious software and other virtual and real-world threatsImplementing a system of access controlsProviding encryption and decryption toolsFacilitating safeguards like automatic logoffsEstablishing mandatory policies for using work stations and mobile devicesHIPAA Enforcement (non-compliance penalties and investigations)Getting authorization forms for disclosing information to third-party sourcesProviding customers with a Notice of Privacy PracticesDrawing up Business Associate Agreements for partners to acknowledge their responsibilities under HIPAAHIPAA Breach Notification - (Unauthorized access to physical areas, inadvertent disclosures, stolen or misplaced documents and digital hacks.)Determine if PHI is compromised.Assess the type and amount of data involved.Find out who used the PHI illegally or to whom information was disclosed.Chronicle steps taken to mitigate the breach.Ascertain if the breach was closed or information returned before being used or if the breach occurred inadvertently under a covered associate’s or entity’s authority.Send notices of incidents that are determined to be breaches to each patient's last known address by first class mail or email if electronic notifications are authorized.The notice must be written in easy-to-understand language and include a summary of how the situation occurred, the date of exposure and other relevant details.SOURCES FOR ABOVE INFORMATIONHIPAA RULES(Health Insurance Portability and Accountability Act)The rules: PrivacyFor Clouds: Cloud ComputingExplanation: HIPAA Compliant Website Checklist2. BUSINESS ASSOCIATION AGREEMENTThe rules: Business AssociatesExplanation: What is a HIPAA Business Associate Agreement (BAA)There should be an “UNBROKEN CHAIN” of BAA agreements in place all the way up the chain. A BAA agreement protects your client, not you or us but it is actually REQUIRED according to HIPAA Regulations and without the BAA in place your client is not in compliance and may be violating both federal and state privacy laws. Source: Web DesignersOQ: What advise can you give me to build a website for professional counselor to receive booking for appointment, counseling to be done through private video call.clients pay for 45 session. Can this be possible? Can counseling be done online?

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