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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.


Pondering Over Patient Billing: CARES Act and Provider Relief Fund Lead to More Questions

On April 11, 2020, HHS, along with the Department of Labor and Department of the Treasury, issued jointly prepared FAQs regarding the FFCRA, the CARES Act, and other health coverage issues. The FFCRA was enacted on March 18, 2020 and requires group health plans and health insurance issuers to provide benefits for certain items and services related to diagnostic testing for COVID-19. Additionally, plans and issuers must provide coverage without imposing any cost-sharing requirements (deductibles, copayments, and coinsurance), prior authorization, or other medical management requirements.

Important Update and FAQs: HHS Tweaks Guidance on The CARES Act Provider Relief Fund Terms and Conditions

On April 10, 2020, many providers awoke to find electronic payment deposits from Department of Health and Human Services (HHS) in their bank accounts. This was the first round of $30 billion of payments from the HHS Provider Relief Fund as a result of the CARES Act, which was signed into law on March 27, 2020. All healthcare providers that received Medicare fee-for-service payments in 2019 should have received a payment.

Returning to Work: Forecasting the New Normal in Business

We cannot predict when businesses will reopen across the county. As we publish this Alert, dynamic business leaders are cooperating in comprehensive efforts to create safe work environments so that they can all re-engage the workforce. However, we can predict the new normal in business. Some important studies were published yesterday, and the new normal in business will be facemasks for all employees, and probably all business visitors.

Updated Guidance on Ohio Department of Medicaid Telehealth Rules During the Covid-19 Public Health Emergency

In its initial response to the COVID-19 public health emergency, the Ohio Department of Medicaid (“ODM”) issued emergency rule 5160-1-21, which dramatically expanded reimbursable telehealth services, telehealth providers, allowable technology, location of both providers and patients, and covered billing provider types. See BMD’s initial COVID-19 and Telehealth Resource Guide here. This emergency rule provides wide flexibility for patients to receive necessary healthcare services while Ohio’s Stay-At-Home Order remains in place. Regulations are continually changing in response to the public health crisis, and on April 13, 2020, ODM issued new guidance further expanding telehealth services reimbursable under Ohio’s Medicaid program.

Essential Businesses during COVID-19: Identification and Operation FAQs

During the COVID-19 pandemic, the ability to classify your business as “essential” could be the key to its survival. Almost every state in the United States has imposed a “stay-at-home” or “shelter-in-place” order that restricts the types of businesses that can remain open. In fact, as of the writing of this alert, there are only seven states that have not imposed state-wide restrictions on which businesses can stay open during the Coronavirus pandemic and even those states have individual cities and counties that have imposed stricter orders. However, these orders are not always clear, and interpretation is often left to the individual business. This alert will answer some of the most common questions about essential businesses.