Cybersecurity & Fleet Interest Groups
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orThe Department of Homeland Security (DHS) Intelligence Enterprise Homeland Threat Assessment reflects the insights from across the Department, the Intelligence Community, and other critical homeland security stakeholders. It focuses on the most direct, pressing threats to our Homeland during the next year and is organized into four sections. We organized this assessment around the Department’s missions that most closely align or apply to these threats—public safety, border and immigration, critical infrastructure, and economic security. As such, many of the threat actors and their efforts cut across mission areas and interact in complex and, at times, reinforcing ways.
Going forward, the annual Homeland Threat Assessment will serve as the primary regular mechanism for articulating and describing the prevailing terrorism threat level, which has previously been done through our issuance of National Terrorism Advisory System (NTAS) bulletins. In the future, the issuance of NTAS bulletins will be reserved for situations where we need to alert the public about a specific or imminent terrorist threat or about a change in the terrorism threat level.
On March 9, 2024, the Centers for Medicare and Medicaid Services (CMS) announced the creation of the Change Healthcare/Optum Payment Disruption (CHOPD) Program. Under the CHOPD Program, CMS will make accelerated payments to Part A providers and advance payments to Part B suppliers that have experienced claims disruptions as a result of the Change Healthcare cyberattack.
Under the CHOPD Program, qualifying providers and suppliers will be eligible to apply for and receive Medicare advances of up to 30 days of their average Medicare payments. Applications for payment advances must be made to the provider’s or supplier’s Medicare Administrative Contractor (MAC). The 30-day payment advance will be based on the average Medicare payments to the provider or supplier between August 1, 2023 and October 31, 2023. Specifically, CMS will compute the total amounts paid to the provider during this period, and then divide by 3 to arrive at the 30-day average amount.
Advance payments received through the CHOPD Program are considered a loan. Therefore, these amounts must be repaid through offsets against future Medicare payments. Recoupments will commence on the date the advance payments are received by the provider or supplier. These recoupments will be equal to 100% of future payments, and will continue until the earlier to occur of: (1) the full repayment of the advance payment or (2) 90 days. In the event a balance remains after 90 days, the MAC will generate a demand notice for the outstanding balance, which must be repaid within 30 days. If the provider does not repay the outstanding balance within that period, interest will start to accrue on the outstanding balance.
Providers and suppliers with multiple National Provider Identifiers (NPIs) may be eligible for multiple advance payments.
To qualify for advance payments, a provider or supplier must meet the following requirements:
To the extent a provider or supplier is approved for an advance payment, they must then execute a Terms and Conditions document acknowledging the following:
From the Centers for Medicare & Medicaid Services on March 9
The Centers for Medicare & Medicaid Services (CMS) is continuing to monitor and assess the impact that the cyberattack on UnitedHealth Group’s subsidiary Change Healthcare has had on all provider and supplier types. Today, CMS is announcing that, in addition to considering applications for accelerated payments for Medicare Part A providers, we will also be considering applications for advance payments for Part B suppliers.
Over the last few days, we have continued to meet with health plans, providers and suppliers to hear about their most pressing concerns. As announced previously, we have directed our Medicare Administrative Contractors (MACs) to expedite actions needed for providers and suppliers to change the clearinghouse they use and to accept paper claims if providers need to use that method. We will continue to respond to provider and supplier inquiries regarding MAC processes.
CMS also recognizes that many Medicaid providers are deeply affected by the impact of the cyberattack. We are continuing to work closely with States and are urging Medicaid managed care plans to make prospective payments to impacted providers, as well.
All MACs will provide public information on how to submit a request for a Medicare accelerated or advance payment on their websites as early as today, Saturday, March 9.
CMS looks forward to continuing to support the provider community during this difficult situation. All affected providers should reach out to health plans and other payers for assistance with the disruption. CMS has encouraged Medicare Advantage (MA) organizations to offer advance funding to providers affected by this cyberattack. The rules governing CMS’s payments to MA organizations and Part D sponsors remain unchanged. Please note that nothing in this statement speaks to the arrangements between MA organizations or Part D sponsors and their contracted providers or facilities.
For more information view the Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/change-healthcare/optum-payment-disruption-chopd-accelerated-payments-part-providers-and-advance
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On Wednesday, December 6, 2023, the Department of Health and Human Services (HHS) Office of Intergovernmental Affairs (IEA) will host a webinar on healthcare sector cybersecurity from 4:30 p.m. to 5:00 p.m. EST. HHS IEA stated speakers will discuss “the Department’s roadmap for cybersecurity in health care and answer questions on how HHS can help protect patient safety, secure our hospitals, and improve cyber resiliency in health care.”
HHS IEA indicated the event will feature the following speakers:
Registration for the event can be found at: Webinar Registration.
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orFor ambulance services, HIPAA compliance is a particularly sensitive issue. Because of the sensitive nature of the health data that EMS and EMT professionals deal with on a daily basis, HIPAA Privacy and Security standards must be carefully adhered to.
This issue becomes even more sensitive when you consider that most of the data collected during pre-hospital care will likely be collected, tracked, and documented on a mobile device. Laptops, smartphones, and tablets are indispensable tools for ambulance care. Most of these devices will have access to electronic health records (EHR) platforms, which will in turn be connected to the rest of a hospital’s EHR data.
While mobile devices can provide convenience in life-or-death situations, they are also particularly vulnerable to the risk of a data breach. A data breach of unsecured health information can lead to serious HIPAA violations and put patient privacy at risk.
The kind of health information that these devices have access to is called protected health information, or PHI. PHI is any demographic information that can be used to identify a patient. Common examples of PHI include names, dates of birth, medical information, insurance ID numbers, addresses, full facial photos, and telephone numbers, to name a few.
The HIPAA Rules set specific standards for maintaining the privacy, security, and integrity of PHI. Though the regulation can seem complex, the standards are in place to safeguard PHI. As per HIPAA, ambulance services necessarily fall under the category of Covered Entities, meaning that they are responsible for maintaining compliance with both the HIPAA Privacy Rule and the HIPAA Security Rule.
These two rules set limits for how and when PHI must be stored and accessed. Below, we list a few of the major components of the HIPAA Rules that all ambulance services can implement in order to keep PHI safe and secure on the go.
These are just a few of the ways that ambulance services can protect PHI and comply with HIPAA mobile device standards.
In addition to the actions listed above, a total compliance program that addresses the full extent of the law must be in place in order to prevent HIPAA violations and data breaches.
Addressing HIPAA compliance can help ambulance services confidently treat their patients without worrying about the risk of data breaches or government fines.
By Cindy Elbert
President, Cindy Elbert Insurance Services, Inc
If you’re doing business online, you need cyber-insurance. This fact was never made truer than on May 12, 2017 when 50,000 businesses in at least 74 countries were hit by a ransomware attack code named “WannaCry”. Hackers demanded companies to pay a $300 ransom fee or their files would be published on the Internet. The data thieves targeted mostly hospitals and other medical facilities because their data not only included names, home addresses, addiction histories, financial information and religious affiliations but also disclosed patients’ mental health and medical diagnoses, HIV statuses and sexual assault and domestic violence reports. A gold mine of personal information for those with dark purposes.
Two days earlier, a data breach at the Bronx Lebanon Hospital Center in New York compromised the medical records of at least 7,000 people. According to NBC News, “Leaks from the Rsync servers, which transfer and synchronize files across systems, are common. How many more nude photos of patients or ultrasound images will be exposed because of misconfigured Rsync backups?”
On May 4, 2017, a group calling themselves TheDarkOverload uploaded almost 180,000 stolen patient/medical records from three companies onto the Internet because they refused to pay a ransom. The databases stolen were in the .csv format and contained health information about cardiac diagnoses and psychiatric conditions such as depression, along with date of birth and social security numbers.
Most ransomware attacks are led by organized criminal groups utilizing a network of computers infected with malware that then poisons other computers once a spam message is opened. An example of a spam malware would be emails falsely marked as being from a co-worker or friend asking a recipient to open an attached file. Or, an email might come from a trusted institution, like a bank or merchant, asking you to perform a specific task. In other instances, hackers will use scare tactics such as claiming that a victim’s computer has been used for illegal activities to bully victims. When the malware is executed, it encrypts files and demands a ransom to unlock them.
Imagine the nightmare scenario of medical teams out on the field relying on electronic devices such as tablets, laptops, smartphones and PDAs to access patient care records suddenly discovering that their data has been locked, captured by malicious malware., held for ransom with lives in the balance.
Companies need the protection cyber liability insurance offers now more than ever.
Ransomware attacks and cyber theft will not be defeated any time soon. So now is the time to ask: How do you store sensitive information? How do you control access to sensitive information? Do you utilize a firewall and protection software? Do you allow employees and others remote access to your data bases? Do you have a written security policy? And, most importantly, do you have cyber liability insurance? Is it safe? If your company stores customer information, especially billing and medical data, then there is no question about it: You must protect yourself from the growing legion of cyber predators. You need cyber liability insurance.
Cindy Elbert is President of Cindy Elbert Insurance Services, Inc. She is a licensed Property & Casualty Insurance broker/agent, and a proud member of the American Ambulance Association, California Ambulance Association, Arizona Ambulance Association, and The Independent Agents Association.
Cindy has been assisting ambulance providers with their insurance needs since 1982. She understands your questions and concerns and with her relationships with insurance underwriters she can provide you with coverage and service you deserve.
www.ambulanceinsurance.com
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