HIPAA

Published on: June 8, 2012

HHS Releases Memo to Consumers Highlighting HIPAA Rights to Access Health Records

On May 31, 2012, Department of Health and Human Services (HHS) Director of the Office of Civil Rights Leon Rodriguez issued a memo to consumers regarding those consumers’ right to access their protected health information and medical records. In this memo, Rodriguez stressed that it is important for consumers and providers to remember that the Health Insurance Portability and Accountability Act (HIPAA) not only provides protection for personal health information, but also provides consumers with the right to view and obtain copies of health records.

Many providers, when dealing with HIPAA compliance, tend to focus on safeguarding protected health information, but fail to recognize the importance of patient rights including the right to access. Under HIPAA, patients have the right to view their health records from most providers, pharmacies, and health plans. Patients also have the right to obtain copies of those records in the form they choose, be it electronic or on paper, if the provider is able to do so.

Providers can charge patients a reasonable amount for the copies of health records the patient receives, and any cost for mailing the records. This amount is statutorily regulated in most states. It is important to note that a provider cannot charge a fee for searching for and retrieving records, and providers cannot withhold access to records because a patient has not paid for services received.
Continue reading

Published on: June 5, 2012

State AG HIPAA Training Materials Available Online

by Wachler & Associates, P.C.

The Office of Civil Rights (OCR) announced yesterday that its Health Insurance Portability and Accountability Act (HIPAA) Enforcement Training tools would be available to the general public today, June 5, 2012.

Since 2009, as part of the Health Information Technology for Clinical and Economic Health (HITECH) Act, State Attorneys General (SAGs) were given the authority to bring civil suit for HIPAA violations on behalf of the aggrieved patients. To assist SAGs, the OCR developed a wide range of HIPAA Privacy and Security Rules compliance, enforcement, and training tools.

Included in the materials are computer-based modules, and videos and slides from in-person training sessions covering the following topics:

General Introduction to the HIPAA Privacy and Security Rules
Analysis of the impact of the HITECH Act on the HIPAA Privacy and Security Rules
Investigative techniques for identifying and prosecuting potential violations
A review of HIPAA and State Law
OCR’s role in enforcing the HIPAA Privacy and Security Rules
SAG roles and responsibilities under HIPAA and the HITECH Act
Resources for SAG in pursuing alleged HIPAA violations
HIPAA Enforcement Support and Results

These materials may be a helpful training tool for health care providers and privacy officers. The materials highlight to whom, what, where, when, and how HIPAA Rules will be enforced and provide basic summaries of the HIPAA Privacy and Security Rule requirements.
Continue reading

Published on: May 29, 2012

Knowledge of Illegality Not Required For Criminal Charges Under HIPAA

by Wachler & Associates, P.C.

On May 10, 2012 the United States Court of Appeals for the Ninth District decided that criminal charges under the Health Insurance Portability and Accountability Act (HIPAA) do not require that an individual have knowledge that their actions are illegal. The case, United States of America v. Zhou, is the first such case to establish that the knowledge requirements of a criminal HIPAA violation apply only to the fact that the information accessed was protected health information, and not that obtaining the information was in violation of HIPAA.

Under the statute, HIPAA provides that a criminal penalty applies to a person who knowingly and in violation of the statute, uses, obtains, or discloses protected health information. Zhou argued that the statute requires knowledge that the information obtained was protected health information, as well as knowledge that obtaining it was illegal. The court rejected the argument and determined that the language of HIPAA is plain. The court found that the word “and” unambiguously indicates that there are two elements of a violation, and that knowingly applies only to obtaining the protected health information, and not to the fact that obtaining the protected health information was illegal.

The statute at issue in the decision is 42 U.S.C §1320d-6a, which reads as follows:

(a) Offense A person who knowingly and in violation of this part–

(1) uses or causes to be used a unique health identifier;

(2) obtains individually identifiable health information relating to an individual; or

(3) discloses individually identifiable health information to another person,
shall be punished as provided in subsection (b) of this section. For purposes of the previous sentence, a person (including an employee or other individual) shall be considered to have obtained or disclosed individually identifiable health information in violation of this part if the information is maintained by a covered entity (as defined in the HIPAA privacy regulation described in section 1320d-9 (b)(3) of this title) and the individual obtained or disclosed such information without authorization.

Penalties for violations of the statute can include fines of up to $250,000, imprisonment for up to 10 years, or both.
Continue reading

Published on: March 16, 2012

HHS Settles First Breach Notification Case

by Wachler & Associates, P.C.

The first enforcement action from a breach report required by the Health Information Technology for Economic and Clinical Health (HITECH) Act Breach Notification Rule has resulted in an agreement by Blue Cross Blue Shield of Tennessee (BCBST) to pay the Department of Health and Human Services (HHS) $1.5 million.

BCBST reported that unencrypted hard drives had been stolen from a leased storage facility in Tennessee. The hard drives contained personal health information of more than one million people, and included information such as social security numbers and dates of birth. An investigation discovered BCBST failed to ensure the facility had proper security measures in place as required by HIPAA rules. The settlement also requires BCBST to establish a corrective action plan to revise its security policies and conduct training.

The HITECH Breach Notification Rule requires HIPAA covered entities to promptly make notifications in the event of a breach that affects more than 500 individuals. The entity must notify each individual affected, the HHS Secretary, and the media. A breach of information affecting fewer than 500 individuals need only be reported to the HHS Secretary on an annual basis.

More information on the HITECH Breach Notification Rule can be found on the Department of Health and Human Services website.

HIPAA Privacy and Security Rules are enforced by the Health Human Services (HHS) Office for Civil Rights. HIPAA Security Rules establish requirements for how entities must secure and protect electronic health information, and ensure that it remains secure and protected.

More information on the HHS Office for Civil Rights can be found on their website.
Continue reading

Published on: August 16, 2010

CMS Reminds Providers of the Document Retention Requirements

by Wachler & Associates, P.C.

The Centers for Medicare and Medicaid Services recently published an MLN Matters Article regarding the length of time physicians are required to retain documentation. The article reiterated that the Health Insurance Portability and Accountability Act (HIPAA) of 1996 requires a covered entity to retain required documentation for six years from the date of its creation or the date when it was last in effect, whichever is later. Although some state laws may have shorter periods, HIPAA requirements preempt these laws. In addition, the HIPAA Privacy Rule requires covered entities to utilize appropriate administrative, technical and physical safeguards to protect the privacy of medical records and other protected health information (PHI) for the period in which the information is maintained by the covered entity, including disposal.

The MLN Matters Article also reminded providers that submit cost reports that they are required to retain the original or legally reproduced for at least 5 years after the closure of the cost report.

As is reiterated by this MLN Matters Article, the maintenance of accurate medical records for Medicare beneficiaries is very important. The medical records should be completed promptly, accessible, retained and providers should implement a system of author identification to ensure authenticity and security.