The Office for Civil Rights (OCR) of the United States Department of Health and Human Services (HHS) enforces federal civil rights laws, conscience and religious freedom laws, the Health Insurance. The Patient Safety Act and Rule and the Health Insurance Portability and Accountability Act (HIPAA) Rule all defend your fundamental human rights to equal treatment, dignity, religious freedom, and your health information privacy. The Office of Civil Rights (OCR) safeguards your rights by:
- Civil rights legislation, conscience and religious freedom laws, health information privacy regulations, and patient safety confidentiality laws are all taught to health and social care personnel.
- Educating communities about civil rights, religious freedom, and health information privacy.
- Investigating human rights, conscience, and religious freedom, health information privacy, and patient safety confidentially complaints in order to detect discrimination or legal violations and take corrective action.
To discuss the types of circumstances in which OCR cannot initiate enforcement action, see What OCR Considers During Intake and Review of a Complaint. If OCR accepts a complaint about the investigation, the person who filed it and the covered entity identified in it will be notified. The client and the entity are then required to provide extra information about the problem. OCR might demand precise details from each to obtain a clearer understanding of the facts. The statute requires covered entities to participate in complaint investigations. If it explains an action that could violate HIPAA’s criminal provision, OCR may file a complaint with the Department of Justice for investigation (42 USC 1320d-6).
When Can the OCR Audit You
An OCR audit is usually initiated by one of two things: either a patient or an internal whistleblower has filed a complaint against the clinic, or the practice has reported a breach to OCR HIPAA audits can happen for a variety of reasons, and here are three of the most common ones:
- The OCR makes a random pick for an audit.
- An individual files a complaint with the OCR against your company
- As a result of a data breach that was self-reported to the OCR.
The data, or record, collected by OCR is examined in each inspection. It may determine that the covered company complied with the Privacy or Security Rule’s requirements in other cases. If the evidence shows that the covered entity was not in compliance, OCR will work with the covered business to resolve the issue by obtaining:
- Compliance on a voluntary basis
- Corrective action
- Resolution agreement.
Problem Managing in HIPAA Audits
The Office for Civil Rights (OCR) of the Department of Health and Human Services performs periodic audits to ensure that covered companies and their business affiliates follow HIPAA standards. In 2001, OCR launched a pilot audit program to assess covered companies’ performance using a set of guidelines known as an audit program protocol. In 2016, the protocol was changed.
One of the few deciding considerations for firms considering a HIPAA audit appears to be cost. It’s undoubtedly a topic about which we are frequently questioned. When it comes to the cost of a HIPAA audit, it can be divided into two groups.
- Direct Cost
The fees of hiring an auditing firm to conduct the audit and submit a report are the first step. Surprisingly, most individuals use the auditor’s charge to compute the total cost of an audit, which is entirely inaccurate. There are various sorts of HIPAA audits. These expenses are based on a small-to-medium-sized business.
| HIPAA Audits | The Direct Cost |
| Of HIPAA Gap Assessment | $20,000-$30,000 |
| Full HIPAA Audit | $20,000-$50,000 |
| Validated Hitrust Assessment (similar to full HIPAA audit) | $60,000-$120,000 |
- Indirect Cost
Indirect costs are more difficult to calculate. The most important consideration is time. The indirect expenses of each category of audits listed above rise as you progress down the list. We estimated the total time spent for all employees in each of our audits (we didn’t split it out by employee, so it’s not ideal).
| HIPAA Audits | Indirect Cost |
| Of HIPAA Gap Assessment | 40 Hours |
| Full HIPAA Audit | 100 Hours |
| Validated Hitrust Assessment (similar to full HIPAA audit) | 400 Hours |
The cost of one hour of work was conservatively calculated to be $100. This is due to a reduction in the cost of salary and benefits and the opportunity cost of not doing something else with this time (writing code, customer support, sales, marketing, etc.). Based on those figures, the overall cost of the various audits is as follows:
| HIPAA Audits | Total Cost |
| Of HIPAA Gap Assessment | $24,000-$34,000 |
| Full HIPAA Audit | $30,000-$60,000 |
| Validated Hitrust Assessment (similar to full HIPAA audit) | $100,000-$160,000 |
So, Internal/external audits are challenging to manage because they are costly and time-consuming, and organizations are unsure if they comply.
We need an assessment checklist to solve the auditing challenges. HIPAA audit checklist will assist you in fulfilling the standards for your audits. It acts as a point of reference before, during, and after the audit process, and it can give the following benefits if it is built for a specific audit and used successfully:
- Ensures that the audit is carried out systematically; encourages audit planning.
- Ensures that the audit approach is consistent.
- Actively participates in your company’s auditing procedure.
- Provides a place to save notes gathered throughout the audit.
The Potential Solution
The potential solution to the problems managing the HIPAA audits is a new way: HIPAA Audit Simulator. Audit Simulator is a platform that evaluates the risks and readiness of the audit. To stay compliant, HIPAA Audit Simulator eliminates the need for manual and time-consuming operations. Using the OCR methodology, the audit supports customers in simplifying processes and simulating audits. This continuous compliance technology allows you to keep track of your HIPAA compliance at all times. The software provides a specific time and cost-saving optimization with over 60+ built-in templates and dynamic project management expertise. This is only a few clicks away from federal publications about the OCR protocol and offers automated PHI queries that are simple to integrate with legacy on-premises and cloud systems.
How Can HIPAA Audit Simulator Help?
HIPAA Audit Simulator also identifies and closes the gaps by providing the Risk Calculator that calculates an Audit Risk Score and Security Risk Assessment (SRA).
Dynamic reporting and agile methodology organizes the audit tasks, determine the priority, status, deadline, and reviewer, and makes changes as needed to provide the most current reports. Our team of experts is available to those seeking advice.