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PHI under false pretenses, that person or entity may be subject
to $100,000 in fines and/or five years in prison. In addition, if
the individual obtains or discloses PHI with an intent to sell,
transfer, or use it for commercial advantage, commercial gain,
or malicious harm, that individual or entity may be fined up to
$250,000 and/or be imprisoned for up to 10 years.
It is important to note that there is no private right of action
under HIPAA. Therefore, an individual may file a complaint
with HHS with respect to a covered entity’s compliance with
the Privacy Rule, but he or she may not file an action against the
covered entity for violating the Privacy Rule.
Conclusion
As stated above, in order to comply with the Privacy Rule, a
person or entity must, at a minimum, determine:
n if the Privacy Rule applies,
n what information is protected, and
n what uses and disclosures of PHI are permitted.
In addition, covered entities must have procedures in place to
allow individuals to exercise their rights with respect to their
PHI. Finally, and perhaps most importantly, covered entities
must implement the administrative requirements required
under the Privacy Rule. These administrative requirements create
a HIPAA privacy compliance program infrastructure that is
necessary to ensure compliance with the Privacy Rule’s requirements.
Because Privacy Rule enforcement is a complaint-driven
process, it is important to have this infrastructure in place, not
only to comply with the law, but also to:
n Reduce the potential for incidents to occur that may give rise
to complaints; and
n Be able to show OCR or DoJ that PHI is properly safeguarded
by the covered entity. Such proof may be essential to avoid
civil or criminal penalties should a Privacy Rule violation
occur. n
1. Public Law 104-191.
2 67 Fed. Reg. 53182 (Aug. 14, 2002) codified at 45 C.F.R. Parts 160 and 164.
To Register visit www.hcca-info.org
Whistleblower Claims in Healthcare
October 8
Part 1: A Compliance Perspective
Available on CD
Part 2: The Enforcement Perspective
Carmen Wolf, Principal, BlickenWolf LLC
Patrick Coffey, Partner, Locke Lord Bissell & Liddell
Linda Wawzenski, Assistant United States Attorney, Deputy Chief,
Civil Division, United States Attorney’s Office
2008 MACS and RACS: What It
Means For The Lab — October 14, 2008
In this presentation you will learn about Medicare
Administrative Contractors (“MAC’s”) and the MACs process
both Part A and B claims allowing for increased program
integrity. The full fee-for-service workload is scheduled to be
transitioned to the MACs by October 2009.
2009 OIG Work Plan for Hospitals &
Physicians — October 23 & 24
Be prepared for the year ahead by taking advantage of
the HCCA’s presentation of the 2009 OIG Work Plan for
Hospitals. Outstanding speakers combine with engaging
interaction for a serious, in-depth look at the OIG’s key
compliance concerns for fiscal year 2009. If you’re looking for
OIG Work Plan coverage that is substantial and to‐the‐point
don’t miss this conference
An Insider’s Guide to
Workplace Investigations
October 30, 2008
Meric Craig Bloch,
Vice President–Corporate
Compliance, Adecco S.A.
Past Audio/Web conferences
are available on CD at
www.hcca-info.org/ pastweb
Health Care Compliance Association • 888-580-8373 • www.hcca-info.org
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October 2008