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"Fewer than half of all respondents say that their organization has established security baselines for external partners, customers, suppliers, and vendors (43%) or requires third parties to comply with internal privacy policies (37%)."

- PWC Global State of Information Security Study



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Healthcare Providers

The HIPAA Privacy and Security Rules have been in force for many years. In the past few years, however, the health care industry has had to cope with extensions to HIPAA, as well as new EDI and diagnostic code standards.  Failure to meet some of the deadlines for compliance, particularly for ICD-10, can have real business impacts in terms of lost revenue, and inability to bill for Medicare work.

Healthcare providers require automated approaches that can streamline risk and compliance programs. With BenchMark's optimized workflows, pre-built assessment questionnaires, reports, and bundled professional services, Avior is providing solutions that ensure quick deployment, and rapid realization of value.

Avior’s extensive experience with healthcare providers has enabled us to create solutions that automate program management for ICD-10.  Our approach allows you to extend the work on managing ICD-10 to areas like Vendor Risk Management and CMS Security.  Avior’s solutions for healthcare providers enable organizations to more effectively manage compliance to a complex set of new regulations:

Health Insurance Portability and Accountability Act (HIPAA) CMS requires a new EDI standard for all insurance and Medicare transactions as of January 1, 2012 and new, expanded diagnostics codes by October 1, 2014. Providers must ensure that every affiliate who submits claims (and other transactions) comply and are compatible.  Failure to comply will result in significant lost revenue.

Health Information Technology for Economic and Clinical Health Act (HITECH Act) extends the Privacy and Security Provisions of HIPAA to business associates of covered entities. This includes the extension of newly updated civil and criminal penalties to business associates. Healthcare providers must now monitor their vendors and other business associates for compliance. HITECH provisions include data breach notification requirements for healthcare data breaches.

Centers for Medicare and Medicaid Services (CMS) Security Audits require regulated entities to conduct formal assessments of the security of HIPAA regulated data including affiliates, vendors and other business associates.

Corporate Integrity Agreements are imposed by the Health and Human Services (HHS) as negotiated compliance obligations with health care providers, life science companies and other entities as part of the settlement of Federal health care program investigations arising under a variety of civil statutes. A provider or entity consents to these obligations as part of the civil settlement and in exchange for HHS’s agreement not to seek an exclusion of that health care provider or entity from participation in Medicare, Medicaid and other Federal health care programs.

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