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.
The HIPAA Privacy Rule: Ensuring Patient Privacy
April 18, 2024 Healthcare records can be pretty personal. That’s why it only makes sense that this Protected Health Information (PHI) needs to be secure, giving patients peace of mind. That’s where The HIPAA Privacy Rule comes in. While you already know that a patient’s health information shouldn’t be shared like the latest gossip, you might wonder what this broad rule actually entails. Let’s uncover it together! What is the Privacy Rule? The HIPAA Privacy Rule establishes the standards to protect the privacy of PHI, limiting how information can be shared, and setting patients’ rights regarding their PHI. HIPAA, and all of its rules, need to be followed by Covered Entities and Business Associates (BAs). Now, let’s break that down. Keep it Brief Here’s a simple anecdote: When you’re ordering a pizza, you only give them your address and phone number, not your entire life story. Well, that’s similar to this section of the Privacy Rule, but instead of a perfect, extra cheesy pizza, it’s medical information. Within the Privacy Rule, there is the Minimum Necessary standard. As in the name, this means to only provide the minimum necessary PHI for an intended purpose. Sharing PHI needs to be for the benefit of the patient. This rule ensures healthcare providers only share the essential bits of your health information to get the job done. However, there are a few times when the Minimum Necessary standard does not apply: By providing limited PHI, you establish trust and confidence with your patient, knowing that their information is secure, and when it’s shared, it’s for an important reason. Right to Medical Records As a part of the Privacy Rule, patients have the right to their medical records. This is known as the Right of Access. HIPAA gives patients the key to their medical records. This requires practices to give medical records to patients in a timely fashion, give patients the option to request to fix errors in the medical records, and copies of their records for free, or at a reasonable cost. While HIPAA considers this ‘timely fashion’ to be within 30 days, some states are even sooner! The Right of Access rule has been at the root of the past two OCR fines, highlighting the monetary penalty that can come with not providing patients (or authorized caretakers) medical records quickly. How Abyde Can Help Hopefully, we didn’t lose you after that HIPAA rundown! That’s where Abyde can help. Abyde streamlines the compliance process, turning complicated legislation into intuitive software that keeps you in check when it comes to compliance. We even make the process easy. Our plethora of resources will keep you educated and on top of everything compliance. To learn more about what your practice or business needs schedule an educational consultation today. Schedule here for Covered Entities and here for Business Associates.
Two Years on Probation, $140,000 Lighter: The Price of Healthcare’s Insider Threat
January 12, 2024 Two Years on Probation, $140,000 Lighter: The Price of Healthcare’s Insider Threat A former healthcare executive in Kentucky has been sentenced to probation and ordered to pay restitution after admitting to disclosing patients’ protected health information (PHI) in violation of HIPAA. This case highlights the ongoing threat of insider data breaches in the healthcare industry and the importance of strong data security measures. The Case: Mark Kevin Robison, a former vice president at Commonwealth Health Corporation (now Med Center Health), pleaded guilty to knowingly disclosing PHI of patients under false pretenses to an unauthorized third party between 2014 and 2015. While details of the unauthorized disclosure remain unclear, the incident underscores the potential harm caused by insider data breaches within healthcare organizations. Avoiding Jail, Facing Consequences: Despite facing a potential five-year prison sentence and a $100,000 fine, Robison’s plea deal secured him two years of probation and a $140,000 restitution to the hospital. Half of the restitution has already been paid, and Robison is expected to cover the remaining amount by the end of January. Lessons Learned: The Robison case serves as a stark reminder of the importance of data security in healthcare. Healthcare organizations must: Insider Threats Remain a Challenge: While HIPAA violations by external hackers often grab headlines, insider threats like the Robison case pose a significant and often underestimated risk. Healthcare organizations must prioritize data security measures that take into account both external and internal threats. Looking Ahead: This case should serve as a wake-up call for healthcare organizations to redouble their efforts to protect patient data. By prioritizing data security and creating a culture of compliance, healthcare providers can help ensure that patients’ personal information remains safe and secure. To learn more on how to ensure your practice is compliant, email info@abyde.com and schedule an educational consultation.
HIPAA Fine Announced: Medical Center Ignores Authorization Requirements for Media Release
November 20, 2023 In recent news, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) settled a HIPAA investigation with Saint Joseph’s Medical Center over the unauthorized disclosure of COVID-19 patients’ protected health information (ePHI) to a national media outlet. This incident underscores a critical lesson in patient privacy, prompting Abyde to emphasize the significance of obtaining patient authorization before releasing any ePHI or images. See, What Had Happened Was Saint Joseph’s Medical Center, a non-profit academic medical center in New York, faced potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. The center improperly disclosed sensitive patient information to a national media outlet without obtaining the necessary written authorization from the patients, leading to a settlement with the OCR. The Importance of Patient Authorization The OCR makes it clear that patients have the right to control the disclosure of their health information. This settlement highlights the need for healthcare providers to prioritize patient authorization before releasing any ePHI or images, particularly to the media. Abyde’s Take When undergoing medical treatment in medical facilities, patients should feel assured that their healthcare providers will not disclose their personal health information to the media without obtaining proper authorization. Abyde cannot stress enough the responsibility of healthcare providers in safeguarding patient privacy. Key Takeaways: Our Final Word The settlement with Saint Joseph’s Medical Center serves as a valuable lesson for healthcare providers everywhere. Abyde remains committed to supporting practices in navigating the complexities of HIPAA compliance, with a specific emphasis on the importance of obtaining patient authorization before disclosing any ePHI or images. To see why Abyde is considered the pre-eminent HIPAA compliance solution, click here to schedule a demo.
New Jersey Doctor Fined $30k for Breaching HIPAA in Responses to Negative Google Reviews
June 5, 2023 The U.S. Department of Health and Human Services (HHS) launched an investigation into Manasa Health Center LLC’s (Mansa) compliance with the The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule and notified them about it on November 18, 2020. Manasa is a psychiatric practice based in Kendall Park, New Jersey. As a covered entity under HIPAA, Manasa is required to comply with these rules. The investigation uncovered certain conduct, referred to as “Covered Conduct,” which includes the illegal disclosure of four patients’ protected health information (PHI) in response to negative reviews on Google. Additionally, Manasa was found to have failed to implement policies and procedures regarding PHI that comply with the standards and requirements of the Privacy and Breach Notification Rules. Manasa has agreed to pay HHS a resolution amount of $30,000. The payment will be made on the effective date of the agreement, following written instructions provided by HHS. Manasa has also committed to complying with a Corrective Action Plan (CAP) that serves as a roadmap for Manasa to rectify its non-HIPAA-compliant practices. The CAP put in place includes implementation of compliance policies and procedures, employee trainings, breach notifications, reports. Abyde’s HIPAA Compliance Software Solution can help healthcare providers effortlessly assess risks, implement necessary policies and procedures, and receive continuous support to maintain compliance with HIPAA regulations. If you have staff that has a bad case of keyboard-itis, make sure they are trained on what NOT to type out on the internet! By utilizing Abyde, healthcare providers can rest assured that they are meeting the requirements of the Privacy, Security, and Breach Notification Rules. This proactive approach to compliance helps them avoid the potential consequences of non-compliance, such as costly settlements like the one experienced by Manasa Health Center.
HIPAA Violations Unveiled: Examining Critical Breaches of Patient Privacy
May 30, 2023 We always talk about how important it is to set protocols to avoid HIPAA violations, but what exactly are you avoiding? The sobering examples of HIPAA violations are essential to be aware of so that you understand the gravity of safeguarding patient privacy and maintaining the trust placed in healthcare providers. Incidents serve as stark reminders of the profound consequences that can arise when personal health information falls into the wrong hands. These violation examples underscore the utmost importance of HIPAA compliance and the ethical imperative to protect patients’ privacy. Digital Data Disaster A healthcare organization falls victim to a malicious cyberattack, compromising its entire database of patient records. Personal information, medical histories, and even Social Security numbers are exposed, leaving thousands of individuals vulnerable to identity theft and potential harm. This incident serves as a critical reminder that cybersecurity measures must be robustly implemented to protect patient data from the ever-evolving threats lurking in the digital realm. Gossip Gone Wrong A trusted healthcare provider carelessly discusses a patient’s confidential medical condition with their friends during a casual gathering. This “meaningless” gossip spreads to an acquaintance of the patient, eventually getting back to said patient. The careless discussion that violated the patient’s right to privacy ends up in the papers. The patient is beyond embarrassed and the healthcare provider is in for a whirlwind of hurt including reputational carnage. This ever-so-cautionary tale accentuates the importance of professionalism and the duty to keep patient information strictly confidential. Insider Trading In a breach that shakes the foundation of trust, a trusted employee intentionally accesses patient records without a valid reason. Driven by curiosity or malintent, they betray the ethical responsibilities bestowed upon them. This particular violation underscores the significance of stringent access controls, regular auditing, and thorough background checks to maintain the integrity of patient information. Misdirected Medical Records A healthcare provider accidentally sends a patient’s medical records to the wrong individual. This innocent mistake exposes sensitive information to an unintended recipient, potentially compromising the patient’s privacy and causing emotional distress. This incident serves as a reminder of the importance of proper verification processes, double-checking recipient details, and implementing secure methods for transmitting confidential information. Disappearing Device A healthcare professional’s misplaced or stolen mobile device, containing unencrypted patient data, becomes a ticking time bomb. The consequences of the lost, unprotected device could be severe – ranging from identity theft to blackmail or even unauthorized disclosure of personal health information if caught in the wrong hands. This emphasizes the need for strong device security measures, including encryption, remote wiping capabilities, and constant vigilance when handling portable devices. In conclusion, HIPAA violations demand our utmost attention and respect for patient privacy. The examples here demonstrate the real-world implications of breaches in healthcare data security. As individuals and organizations, we must prioritize robust safeguards, ongoing training, and strict adherence to HIPAA guidelines to ensure the protection of sensitive patient information. Let Abyde unite our efforts to safeguard healthcare information and “Abyde” by HIPAA laws.
Fool me once, shame on you… Fool me twice, here’s a Corrective Action Plan
December 16, 2022 On Wednesday, the HHS Office for Civil Rights announced a settlement with a California dental practice over impermissible disclosure of patient-protected health information (PHI). The practice faces potential violations of the HIPAA Privacy Rule by inappropriate use of social media to respond to patient reviews and disclosing protected health information. OCR Director, Melanie Fontes Rainer, stated, “This latest enforcement action demonstrates the importance of following the law even when you are using social media. Providers cannot disclose protected health information of their patients when responding to negative online reviews.” The practice faces a lofty fine of $23,000 and a Corrective Action Plan that will be monitored by the OCR for the next two years. Within the CAP, the practice is responsible for updating and maintaining all policies and procedures to comply with the Federal standards that govern the privacy and security of individually identifiable health information. Additionally, all members of the staff must receive training within 30 days of the updated policies and procedures to comply with the Privacy Rule within 30 calendar days of the implementation of the policies and procedures. This is the second offense for the same office in the last 5 years. In November 2017, the OCR received a complaint regarding impermissibly disclosed PHI in online review responses. The protected health information included patient names, treatment, and insurance information. Through the investigation, the OCR found other violations including failure to provide an adequate Notice of Privacy Practices and implement Privacy policies and procedures. As a word of advice from your HIPAA and compliance experts, review all PHI and Privacy Rule policies and procedures with any members of your staff that handle online reviews and social media responses. And while you’re at it, for those of you who may use a third party to handle reputation management, check those Business Associate Agreements, and remind them of our best practices.
OCR Settles Three Cases with Dental Practices for Patient Right of Access under HIPAA
September 21, 2022 Boom! Pow! Bang! Three dental practices were sacked yesterday, resulting in nasty bruises and a loss of yards on the play. After heading into the locker room and studying some film, they recognized there were some lessons to be learned in the OCR’s HIPAA Right of Access playbook. The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced the completion of three investigations in its Health Insurance Portability and Accountability Act (HIPAA) Right of Access Initiative. The OCR’s HIPAA Right of Access Initiative started in 2019 to ensure patients receive their records in a timely and costly manner. With three actions in one day and a total of 20 just this year, we are seeing a 42% increase year over year in the enforcement of the Privacy Rule. The OCR’s effort has now raised the total to 41 Right of Access actions across the span of 3 years, setting a strong example for practices across the country on the importance of maintaining compliance. OCR Director, Melanie Fontes Rainer, states, “Patients have a fundamental right under HIPAA to receive their requested medical records, in most cases, within 30 days. I hope that these actions send the message of compliance so that patients do not have to file a complaint with OCR to have their medical records requests fulfilled.” Here is an instant replay of when three dental practices crossed the line of scrimmage: The first dental practice had a delay of game penalty after failing to provide timely access to their former patient’s records. The former patient didn’t receive a complete copy of their records until October 2020, five months after they filed a complaint back in May 2020. This resulted in a $30,000 settlement and the implementation of a Corrective Action Plan. The second dental practice got a 15-yard penalty for not providing a patient with a copy of her records in a timely or costly manner. The practice refused to provide the records because the patient wouldn’t pay the $170 copying fee. That’s not a fair catch! After the OCR got involved, the dental practice had to cough up $80,000 in settlement and adopt a Corrective Action Plan. Maybe they should’ve read the HIPAA Rule book! The starting running back fumbled the ball when this practice failed to provide a mother and her son with copies of their PHI until after the play clock hit zero. After multiple requests and eight months of waiting, she finally got the medical records in her hands. The dental practice had to fork over $25,000 and implement a Corrective Action Plan. After watching the game footage, there is a clear solution here! Make sure your practice provides patients with timely and costly access to their medical records. Six dental practices have been sacked so far in 2022, which means we have already witnessed a 600% increase solely in the dental space compared to the 2021 season. That is not a statistic you can ignore! You could be next, so we encourage you to make sure you have the right compliance measures in place to avoid these large fines. Is your game plan ready?
Dentistry HIPAA Fines
March 29, 2022 Dental practices are no longer flying under the radar! The Office for Civil Rights (OCR) just concluded its twenty-seventh enforcement action since the HIPAA Right of Access Initiative began in 2019. Totaling over $170,000 across four penalties, the announcement of the verdicts includes two cases as part of the HIPAA Privacy Rule. The additional actions related to the disclosure of patients’ protected health information (PHI). Here is a brief breakdown of the three dental cases just released by HHS: The first dental action includes a $30,000 settlement against the initially cited $104,000 for failure to comply with the Right of Access provision stating covered entities must permit individuals to inspect and obtain a copy of their PHI. Nearly two-and-a-half years from the time of citation, the practice has completed a package of action plans, creating a costly and lengthy resolution process. Something as simple as Google review responses can get you fined! One provider learned the hard way the dos and don’ts of reputation management. A patient filed a complaint with the OCR after the provider included the patient’s full name and PHI in their review response. This cost the practice a whopping $50,000! Not the usual politician slip up, but a recent provider running for office learned not to mix business and pleasure. As part of his political campaign, the provider shared names and addresses of over 5,000 patients with both his campaign manager and third-party marketing partner to distribute letters and emails. Resulting in a final citation of $62,500, this surely put a roadblock on his campaign trail! As we see the OCR cracking down on their HIPAA Right of Access Initiative across dental practices, we encourage you to ensure you have the right HIPAA compliance measures in place. With an hour of your time, we will get you everything you need. How much is an hour of your time worth – we bet it’s not $170,000!
Privacy Rule Proposed Modifications | Public Comments Released
July 8, 2021 Remember those Privacy Rule modifications that the Department of Health and Human Services (HHS) proposed late last year? Well, after adding a 45-day extension on the public comment period back in March, the responses submitted have finally been made available – giving us some additional insight on what we can expect to see when the updates are officially finalized. For anyone looking for a light-read while they drink their morning coffee – diving into the official HHS document might not be for you. The proposal included a lengthy list of changes centered around increasing permissible disclosures of protected health information (PHI) and enhancing care coordination and case management. As the healthcare industry has evolved, so have the necessary requirements for protecting data privacy and security – and these modifications address several issues that have become the source of widespread non-compliance over recent years. One of the major areas of focus should come as no surprise considering the initiative that was declared in 2019 to enhance enforcement for patient right of access violations – and the 19 different settlements that have resulted from it so far. So in looking at how the Privacy Rule changes plan to improve this issue, some of the major proposed provisions include: In addition to addressing patients’ right of access, the proposed modifications also clarify certain definitions and phrasing that oftentimes leads to confusion and misunderstanding by providers and patients. Some of these updates include: While the examples provided are only a snapshot of the full list of proposed modifications, each update follows suit with the evolving environment in the healthcare industry and covers relevant concerns felt by both providers and patients. So much so, that the comment period extension was made due to such a “high degree of public interest” and amounted to a total of 1,391 comments submitted in response to the HHS’s proposal. So what can we expect? These proposed modifications take into consideration the public comments received on the OCR’s 2018 RFI that requested public input on how HIPAA rules could improve to better “support care coordination and case management and promote value-based care while preserving the privacy and security of PHI.” Each provision is a direct reflection of the key themes identified in the public opinion received back in 2018 and addresses issues like administrative burdens and the need for improving upon patient rights. So although we don’t have a time machine to jump ahead and see what exactly the final rule will entail, we can pretty confidently say that these concerns addressed in the HHS document will continue to be a focus in regulatory amendments and government enforcement. And the high volume of public interest clearly depicts the impact and value that enacting these changes will have on patients and providers. When will you need to comply As far as knowing the what and when of the final ruling – we don’t quite have a definitive answer. But it’s important for all covered entities to be aware and prepared for the expectations of complying with the modified Privacy Rule provisions when they are made official. According to the HHS, “The effective date of a final rule would be 60 days after publication.” Additionally, entities will still have 180 days from that effective date to update or implement policies and procedures to achieve compliance with these new standards. So when it comes to the timeframe for when the government will actually start enforcing the new compliance standards, you have 240 days of breathing room once the final rule is published. BUT based on the HHS’s acknowledgment that the impact of adhering to these new guidelines will involve “covered entities actions to re-train their employees on, and adopt policies and procedures to implement, the legal requirements of this proposed rule” we highly recommend taking an ‘early bird gets the worm’ approach for compliance. Having a complete HIPAA program in place along with a full understanding of the potential changes that could be coming your way is the best way to ensure that your patients’ data is best protected and your practice is best prepared for avoiding a HIPAA violation and fine.