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Recent HIPAA Breach Settlements - Lessons Learned

Client Alert
June 19, 2023

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.

HIPAAHIPAA ComplianceHealth Law
Client Alert

Ohio Department of Health Releases Updated Charge Limits for Medical Records

March 7, 2022Under Ohio law, a healthcare provider or medical records company that receives a request for a copy of a patient's medical record may charge an amount in accordance with the limits set forth in Ohio Revised Code Section 3701.741. The allowable amounts are increased or decreased annually by the average percentage of increase or decrease in the consumer price index for all urban consumers, prepared by the United States Department of Labor, Bureau of Labor Statistics, for the immediately preceding calendar year over the calendar year immediately preceding that year, as reported by the Bureau. The Director of the Ohio Department of Health makes this determination and adjusts the amounts accordingly. The list is then published, here.Client Alert

No Surprises Act Compliance (Published by NAMAS, 2/25/22)

March 7, 2022The Department of Health and Human Services published three parts to the No Surprises Act towards the end of 2021, which took effect January 1, 2022. The Act is intended to protect consumers from “balance billing,” which occurs when a patient receives a bill with a higher price than they may have anticipated because they did not have knowledge that the provider or facility was out-of-network. The purpose of this article is to note certain requirements that compliance employees will need to be aware of at their facilities, including notice and consent, good faith estimates, and public disclosures.Client Alert

No Surprises Act and You (Published in the SCMS Winter 2022 Newsletter)

March 3, 2022Legislation has been adopted by the United States Congress and the Ohio Legislature known as the “No Surprises Act” which attempts to regulate billing by professionals and facilities to patients who are not in networks with those facilities or providers at those facilities. The federal bill was triggered by some sensational news stories of patients being billed for tens of thousands of dollars for emergency care when the hospital was out of the network under the patient’s insurance plans.Client Alert

Are You Impacted by the Project Labor Agreement Executive Order?

February 28, 2022Project Labor Agreements (PLAs) are a quasi-collective bargaining agreement between employers and unions. They establish the terms and conditions of employment, including dispute resolution. They are put into place on specific projects and apply to the contractor, whether it is union or non-union. Employees hired on the project will be treated as union.Client Alert

No Surprises Act Update: Federal Judge Strikes Portions of the No Surprises Act

February 25, 2022In a win for providers, a Texas federal court granted the Texas Medical Association’s (TMA) motion for summary judgment and struck down portions of a federal rule that establishes a reimbursement rate arbitration process between payors and providers under the No Surprises Act (NSA).
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