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10. Auditing & Monitoring
Auditing and monitoring of your security compliance infrastructure
is key to the long-term success and effectiveness of your program.
Requirements will change over time (due to regulatory and business
changes) and your privacy & security program should change with
them. Implementing a process or procedure that doesn't work operationally
creates a false sense of security. Create a feedback loop that allows
you to quickly identify dysfunctional processes, so you can evaluate
how to get the same results another way.
Are there any penalties for not complying with the Rules?
Yes. There are both civil and criminal penalties for noncompliance.
Civil penalties may be assessed at $100 for each provision of the
Rules violated, with an annual cap of $25,000 per person, per violated
provision. Criminal penalties for knowing violations of the Rules
may include monetary fines as well as imprisonment. Fines range
from up to $50,000 and one year of imprisonment to up to $250,000
and up to 10 years of imprisonment. [42 USC §§ 1176, 1177.]
Who enforces HIPAA?
HHS has delegated responsibility for enforcing the Rule to the
Center for Medicare / Medicaid Services (CMS). CMS's enforcement
regulations have not yet been published. [65 Fed. Reg. 82472.]
Can a participant or beneficiary sue me for alleged violations
of the Rules?
The Administrative Simplification Rules themselves do not provide
a private right of action, meaning they do not authorize private
individuals to sue covered entities, such as covered group health
plans, for alleged for violations. [65 Fed. Reg. 82566, 82604.]
Nonetheless, employers might find themselves subject to private
lawsuits under other theories. For example, in certain circumstances,
the Administrative Simplification Rules require an employer to amend
its group health plan documents. To the extent that such a group
health plan is governed by ERISA, participants and beneficiaries
will have the right to sue for enforcement of the plan document,
including, perhaps, the amendments required by the Administrative
Simplification Rules.
In addition, as noted above, state laws providing more stringent
remedies are likely to apply. Those applicable state laws may provide
private rights of action, and if they do, participants and beneficiaries
may be able to invoke them. [65 Fed. Reg. 82582.]
Where can I find more information about HIPAA?
More information about HIPAA can be found at the following web
sites:
http://www.cms.hhs.gov/hipaa/hipaa2/default.asp
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