MORE MONEY, MORE PROBLEMS? OCR Budget Proposal Will Result in Greater Enforcement and More Fines

May 16, 2022

If you think the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) isn’t zeroed in on compliance, think again. OCR recently announced its request for a 55% increase in its overall funding, for a total of $60.2 million for the 2023 fiscal year. While this number may seem shocking, their plans for the money may make your jaw drop. 

Let’s take a look at why the increase is needed. 

Nearly 46,000 complaints were received in FY 2021, a dramatic increase from nearly 2,000 in 2003. Just this year, they’re expecting more than 28,000 related strictly to HIPAA. OCR states, “given the trend in complaints to OCR as well as the priorities articulated by the Administration, OCR anticipates a significant increase in the number of civil rights, information breaches, and cybersecurity complaints.” OCR opens an investigation for any breach that affects more than 500 people. In 2021, there were 714 of those instances, more than 30% growth over the last two years. Currently, OCR is limited to how many of these they can conduct a full investigation on. Imagine how powerful this could be if granted the resources to execute the necessary amount?!

In addition, OCR is looking to add more regional investigators to address the backlog of existing complaints. With a goal of clearing the backlog by FY 2026, $8 million will be allocated to address the existing complaint inventory. OCR supports adding new regional investigators to “resolve new civil rights and HIPAA cases, address the backlog of complaints, and initiate compliance reviews in the Administration’s priority areas.” With a staff of 77 in 2020, they plan to add an additional 37 investigators and supervisory investigators in FY 2023. The budget accounts for a total increase of 64%, equating to 91 new employees. More staff could mean more knocks on your door! 

Still think that you’re the one that got (or will get) away?! This next bit is for you. Increasing fines and the institution of injunctive relief are more immediate than 2023. 

Not sure what a HIPAA violation could cost you? Don’t go get a tattoo of these any time soon – OCR is requesting increases based on a federal court evaluation. In 2019, then-OCR Director Roger Severino published a “notice of enforcement discretion” complementing the HITECH Act basing violation amounts on the party’s awareness and fault. While you could imagine this leaves some room for interpretation, the tiered fine structure will remain in place.

Changing lanes, Injunctive relief essentially restrains a party from a certain action. OCR regulator, Adam Greene openly notes the HITECH Act “provides attorneys general with authority to seek injunctive relief.” Green continues to state, “If OCR were given authority to obtain injunctive relief, then it could require entities to take or discontinue actions –such as by requiring an entity to provide an individual with access to records or to discontinue a use or disclosure of protected health information – rather than only being able to penalize the entity after an act or omission occurs.”

If you still aren’t convinced that OCR means business, let’s wrap up with a summary of what their request for extra dollar signs means for you. An increase in budget simply equates to an increase in resources – more employees to not only attack the existing backlog but the ability to complete more in-depth and frequent investigations. Higher fines and more meaningful corrective action plans mean greater penalties and violation costs.

We hope you take your compliance seriously, OCR certainly is! Let us navigate these upcoming changes with you – from our simple software to our readily available education, we will be your companion in confidence that you are set up for any OCR changes that come our way. 

 

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