Expensive Oversight: The Importance of Timely Patient Record Access

October 24, 2024

There has been a flurry of HIPAA fines in the past few weeks, with over half a million dollars levied in the last month. 

Just one example is Gums Dental Care, LLC, a small dental practice in Maryland that was fined for a Right of Access violation.

Right of Access violations, which involve failing to provide medical records in a timely manner, are a common HIPAA mistake. Another violation for this was issued in August.

 

What Happened? 

A patient requested her medical records from Gums Dental on April 8, 2019. After not receiving them, she issued a complaint to the OCR in May 2019. The OCR contacted Gums Dental Care for technical assistance and believed the case was over. 

This was just the beginning. This case spanned years, with a second complaint filed in August 2019 and the OCR sending several data requests through letters and calls to Gums Dental. 

On October 1, 2020, the OCR sent Gums Dental a proposed resolution agreement and corrective action plan. At the end of the month, Dr. Gums wanted to present her case in front of a judge, believing the patient would commit Medicaid fraud with her records. She also said that the complainant didn’t pay a $25 administrative fee to release the medical records through mail.

First, patients should always have access to their medical records, regardless of their reasons. Second, the fee would be waived if the patient requested it digitally, not through mail.  

In December 2020, the OCR issued a Letter of Opportunity to Gums Dental. At the beginning of the next year, Dr. Gums once again justified her refusal to provide the records since she believed her patient would commit a crime with them. She also believed her website wasn’t secure enough to send them digitally. However, Gums Dental didn’t attempt to send the records at all. 

By the time the Notice of Proposed Determination was sent in March 2022, roughly three years after the first medical record request, Gums Dental faced a Civil Monetary Penalty fine as high as $7,676,692. However, the OCR ultimately levied a $70,000 fine, recognizing the smaller size of the dental practice. 

 

How to Protect Your Practice

Common HIPAA fines often involve Right of Access violations. At the federal level, practices are required to provide patients with their medical records within 30 days, and some states have an even shorter timeline. Navigating these unique regulations can be challenging, so having an intelligent solution is crucial.

Smart software can streamline compliance for your practice by generating policies and procedures tailored to your needs. These solutions also include access to a team of compliance experts who can help answer your questions and ensure that you are interacting with patients in a HIPAA-compliant manner. 

To learn more about software solutions, with a compliance expert here. 

 

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