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Recent HIPAA Breach Settlements - Lessons Learned

Client Alert

As a healthcare provider, you are likely familiar with the Health Insurance Portability and Accountability Act (HIPAA). But, do you know how serious the consequences could be for a breach of HIPAA? According to the U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR), the consequences for providers may include settlements of $30,000 to $240,000. OCR recently released two settlements for improper breaches of protected health information (PHI) that are good examples of the major monetary penalties that can result from common HIPAA mistakes.

Disclosing PHI in Responses to Negative Reviews

In April 2020, a health care provider in New Jersey impermissibly disclosed the PHI (including information on diagnoses and treatment) of its patients in response to negative online reviews. OCR investigated following a complaint from the patient and found that the provider impermissibly disclosed patient PHI and failed to implement policies and procedures with respect to protected information. On June 5, 2023, the provider agreed to pay $30,000 to OCR to settle the complaint. Additionally, the provider agreed to implement a corrective action plan to resolve potential violations. The plan included a few of the following steps:

  • Train all members on the organization’s policies and procedures to comply with HIPAA Privacy;
  • Issue breach notices to all whose PHI was disclosed on any internet platform without valid authorization; and
  • Submit a breach report to HHS on individuals whose PHI was disclosed on any internet platform without valid authorization.

In response to the complaints, OCR Director Melanie Fontes Rainer stated, “OCR continues to receive complaints about health care providers disclosing their patients’ protected health information on social media or on the internet in response to negative reviews.” They added, “[s]imply put, this is not allowed.”

Snooping by Security Guards

On June 15, 2023, a Washington hospital paid $240,000 to settle its HIPAA breach affecting 419 individuals. Following a breach notification report filed by the hospital, OCR investigated and found that 23 of the hospital’s security guards impermissibly accessed the medical records of hundreds of patients without a job-related purpose. The guards accessed information including names, dates of birth, medical record numbers, addresses, certain notes related to the treatment, and insurance information.

In addition to a $240,000 settlement, the hospital was required to implement a plan to update its policies and procedures to safeguard PHI and prevent its workforce members from snooping in the future. Further, the hospital was to be monitored for two years by the OCR to ensure its compliance with the HIPAA Security Rule. The hospital agreed to take the following steps, among others, to bring it into HIPAA compliance:

  • Conduct a risk analysis to determine risks and vulnerabilities to electronic PHI;
  • Develop and implement a risk management plan to address and mitigate identified security risks and vulnerabilities identified in the risk analysis; and
  • Enhance its existing HIPAA and Security Training Program to provide workforce training on updated HIPAA policies and procedures.

“Data breaches caused by current and former workforce members impermissibly accessing patient records are a recurring issue across the healthcare industry. Healthcare organizations must ensure that workforce members can only access the patient information needed to do their jobs,” Fontes Rainer stated. “HIPAA covered entities must have robust policies and procedures in place to ensure patient health information is protected from identity theft and fraud.”

HIPAA breaches are to be taken very seriously. It is imperative for health care providers to have current HIPAA compliance plans, trainings, and breach protocols. For questions, or to update your HIPAA compliance plan, please reach out to attorney Ashley Watson at abwatson@bmdllc.com or any members of the BMD Healthcare Team.


Property Owner Protection from Tax Valuation Challenges

New legislation provides significant new protections for commercial property owners against challenges to valuation primarily by local school boards and prohibiting side agreements to avoid tax valuation changes. The Ohio Legislature has approved House Bill 126 which will go into effect July 2022 but will effectively apply to the 2023 tax valuation year.

No Surprises Act Update: The IDR Portal is Open

The No Surprises Act (“NSA”) became effective January 1, 2022, and has been the subject of lawsuits and criticisms since its inception. The goals of the No Surprises Act are to shield patients from surprise medical bills, provide to uninsured and self-pay patients good faith estimates of charges, and create a process to resolve payment disputes over surprise bills, which arise most typically in emergency care settings. We have written about Part I and Part II of the NSA previously. This update concerns the Independent Dispute Resolution (“IDR”) procedure created by Part II but applicable to claims covered by Part I. The Centers for Medicare & Medicaid Services (“CMS”) finally opened the Portal for providers to submit disputes to the IDR process following some updated guidance regarding the arbitration process itself.

Updated FAQs for the No Surprises Act - Good Faith Estimates

The No Surprises Act (“NSA”) became effective January 1, 2022. Meant to protect consumers from surprise medical bills, the new law is good for consumers, but vexatious for health care providers and facilities. One particular source of frustration is the operationalization of the Good Faith Estimate (“GFE”) requirement, governed by Part II of the regulations that implement the NSA. The GFE requirements apply broadly to all healthcare providers and facilities that practice within the scope of their state-issued license.

IMPORTANT PRF UPDATE! HRSA Allows Providers the Opportunity to Correct Missed Period 1 Reporting

Late Wednesday, April 6, HRSA announced that it was going to allow providers with extenuating circumstances that prevented them from preventing a completed Period 1 Report to submit a Request to Report Late Due to Extenuating Circumstances.

Advanced Practice Providers and Telemedicine Start-Up Surge

Throughout the COVID-19 pandemic, we heard a lot about “surges” that happened all over the country regarding the virus. One of the other interesting “surges” we have followed is the “surge” in new healthcare business start-ups, particularly businesses owned by advanced practice providers, such as nurse practitioners, physician assistants, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists (“Advanced Practice Providers” or “APPs”). One of the hottest areas in the healthcare start-up surge has been the creation of practices that are telemedicine focused.