Keith A Reynolds

Healthcare attorney Isabelle Bibet-Kalinyak, partner at McDonald Hopkins LLC, in Cleveland, Ohio, raised the alarm on cyber security for physician practices at the MGMA 2019 conference in New Orleans.

During her presentation on medical records and HIPAA, Bibet-Kalinyak said that 76 percent of types of medical records breaches are due to hacking and IT incidents.

The second most common type of breach is theft at 15 percent, loss at 10 percent, and unauthorized use at four percent.

Some of the most common forms these breaches take are due to ransomware and phishing of cloud computing service providers, Bibet-Kalinyak says. There has been an increase in these malicious cyber breaches rather than coincidental or accidental breaches.

Ransomware is when a bad actor gains access to your computer system and holds your files hostage until you pay a specific sum of money, usually through untraceable means such as gift cards or cryptocurrency. Phishing refers to the act of using fraudulent emails-which often mimic an email from a colleague or someone the victim knows-to attempt to gain access to a computer system by the victim simply giving their login and password away.

In the past, larger health systems have been the most popular targets of these kinds of scams, but Bibet-Kalinyak warns that the smaller practices aren’t safe.

“They’re targeting smaller practices,” she says. “The first attacks are against hospitals [and hackers] said, ‘we want $5 million or you can’t touch your chart. It’s a prisoner.’ Now they’re going after small practices and they say, ‘$10,000 [to] $50,000 and we’ll release your records.’

Bibet-Kalinyak says the FBI and authorities can’t keep pace with these hacks, leaving most hospitals or practices forced to pay the ransom-unless they have a good backup system.

Besides having data backed up securely, the best way to address the threat of ransomware is through cyber liability insurance.

“If you already have it, increase the amount,” she said drawing laughs from the crowd. “This is exponential.”

The HHS Office for Civil Rights suggests a robust security incident procedure to respond to these attacks, according to Bibet-Kalinyak’s presentation.

Eradicate the instances of ransomware and mitigate or remediate vulnerabilities that permitted the ransomware attack and propagation

Recover from attack by restoring data lost and returning to “business as usual” operations

Conduct post-incident activities including: breach notification under HIPAA and incorporating lessons learned to avoid future attacks

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Even small practices are not safe from the threat of hackers, healthcare attorney warns

MGMA 2019: Cyber security a rising threat to physician practices

The Medical Group Management Association (MGMA) kicked off their annual conference October 13 in New Orleans with a bit of local flavor as U.S. Sen. Bill Cassidy, MD, spoke during the conference’s kickoff.

Cassidy began his speech after MGMA Board Chair Todd D. Grages, MSBA, ACMPE, and CEO Halee Fischer-Wright, MD, greeted the crowd and spoke about the conference’s goal to “ignite excellence.”

The senator, a Republican and gastroenterologist, started his remarks by urging physicians and others in the healthcare industry to bring their expertise into the political realm.

“My premise is that, unless we in healthcare, physicians and those who are so familiar with healthcare systems such as you, bring our expertise to the public policy debate, we’re going to end up with public policy that does not work,” he says. “But if we do, we end up serving our patients and our profession in a different way, but in an incredibly powerful way.”

He said that the issues of high cost of healthcare stretches across both sides of the current extreme political divide, saying that both President Donald J. Trump and Democratic presidential candidate Bernie Sanders are both trying to attack the problem of providing quality, affordable, sustainable healthcare from different angles.

Cassidy said that he believes Medicare will go bankrupt in eight years.

“Clearly Medicare gives access to quality affordable healthcare, but if you go bankrupt it is ultimately not affordable,” he says.

Cassidy expressed his distaste for the Democrats’ calls for Medicare for All and pushed for market-based solutions, decrying the “silo-ization” of care.

He spent a majority of his presentation speaking about surprise medical bills and told an anecdote about how he was preparing to get a colonoscopy when he was presented with a document to sign saying he would be liable for any costs not covered by his insurance.

“What a time to ask me, right?” he says. “I’d taken the prep, my wife had left to get a cup of coffee. I could have walked home, she had my clothes. There goes my re-election, so of course I signed it.”

Cassidy says this highlighted how even “sophisticated” people can be surprised by these issues. He also compared and contrasted the Democratic bill in House of Representative seeking to end surprise healthcare bills with the proposal he supports.

The bill Cassidy signed onto is based on the New York law governing out of network billing. If the physician or hospital is paid by the insurer less than they think is fair the two parties negotiate and if the negotiations break down the claim then goes to arbitration with the loser paying the arbitration costs.

The House’s bill is based on California’s law, which Cassidy says gives the insurance company more power than the physician group in a similar situation by forcing the hospital or physician group to just accept the insurance company’s rate.

Cassidy says he believes the issue of surprise billing will be worked out by the end of the year.

Other topics Cassidy touched on in his remarks included:

Cassidy claimed that in conversations with Federal Reserve Chairman Jerome Powell about the national deficit, which has reportedly surpassed $1 trillion this year, the chairman put the blame at the feet of healthcare and said that if something is done about those costs the deficit “goes away. Everything else is easy.”

He says Trump is making a push to bring more transparency to healthcare prices saying, “The administration has proposed that hospitals and insurers publish their negotiated rates for things which they’ve commonly before.”

Trump is also looking at Medicare Advantage as a model for where the program should go saying that premiums have decreased 34 percent over the years because of the shift to Medicare Advantage over Fee for Service.

Stay tuned to Physicians Practice for more coverage from MGMA 2019.

The annual conference of the Medical Group Management Association kicked off October 13 with a speech by Louisiana Sen. Bill Cassidy

Author | Keith A Reynolds

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