The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) has resolved 11 investigations in its Health Insurance Portability and Accountability Act (HIPAA) Right of Access Initiative, bringing the total number of these enforcement actions to 38 since the initiative began.
OCR created this initiative to support individuals' right to timely access their health records at a reasonable cost under the HIPAA Privacy Rule.
HIPAA gives people the right to see and get copies of their health information from their healthcare providers and health plans. After receiving a request, an entity that is regulated by HIPAA has, absent an extension, 30 days to provide an individual or their representative with their records in a timely manner, yet some provider organizations — large and small — are failing to meet these requirements.
“It should not take a federal investigation before a HIPAA-covered entity provides patients, or their personal representatives, with access to their medical records,” said OCR Director Lisa J. Pino, in a statement. “Healthcare organizations should take note that there are now 38 enforcement actions in our Right of Access Initiative and understand that OCR is serious about upholding the law and peoples’ fundamental right to timely access to their medical records.”
OCR has taken the following enforcement actions and ensured that complainants received copies of their records:
• ACPM Podiatry, with offices in Peoria and Canton, Illinois, failed to provide a former patient with his requested medical records. In response to an initial complaint, OCR provided ACPM with written technical assistance regarding the Privacy Rule’s right of access standard and closed the matter. OCR received a second complaint from the same individual, alleging that ACPM still had not provided the medical records, after numerous requests. ACPM did not respond to multiple data requests from OCR, nor to OCR’s Letter of Opportunity and Notice of Proposed Determination. OCR issued a Notice of Final Determination and imposed a civil money penalty of $100,000.
• Associated Retina Specialists, of New York, failed to provide a patient with a copy of her medical records until three days after OCR initiated its investigation, and nearly five months after the complainant’s first written request. Associated Retina has agreed to take corrective actions and paid $22,500 to settle a potential violation of the HIPAA Privacy Rule right of access standard.
• Lawrence Bell, Jr., D.D.S., a dental practice located in Baltimore, MD, failed to provide timely access to a patient’s medical record. The dental practice has agreed to take corrective actions and has paid $5,000 to settle a potential violation of the HIPAA Privacy Rule's right of access standard.
• Coastal Ear, Nose, and Throat (ENT), located in Ormond Beach, Florida, failed to provide timely access to medical records after multiple requests for such records from a patient. Coastal ENT has agreed to take corrective actions and has paid $20,000 to settle a potential violation of the HIPAA Privacy Rule's right of access standard
• Danbury Psychiatric Consultants (DPC), located in Massachusetts, failed to respond in a timely fashion to a complainant’s access request. DPC also withheld the complainant’s access on the basis that the complainant had an outstanding balance and required a signed request or authorization request. DPC has agreed to take corrective actions and has paid $3,500 to settle a potential violation of the HIPAA Privacy Rule's right of access standard.
• Erie County Medical Center Corporation, a public benefit corporation that operates a hospital, Erie County Medical Center (ECMC), located in Buffalo, New York, failed to provide an individual with a complete copy of his medical records in a timely fashion. ECMC has agreed to take corrective actions and has paid $50,000 to settle a potential violation of the HIPAA Privacy Rule’s right of access standard.
• Fallbrook Family Health Center, located in Nebraska, failed to provide timely access to medical records. Fallbrook Family Health Center has agreed to take corrective actions and has paid $30,000 to settle a potential violation of the HIPAA Privacy Rule’s right of access standard.
• Hillcrest Nursing and Rehabilitation, located in Massachusetts, failed to provide an individual’s personal representative with timely access to her son’s medical records. Hillcrest has agreed to take corrective actions and has paid $55,000 to settle a violation of the HIPAA Privacy Rule’s right of access standard.
• MelroseWakefield Healthcare (MWH), a provider in Massachusetts, did not provide a personal representative with timely access to medical records on the mistaken basis that the durable power of attorney in this instance did not allow for the provision of such medical records. MWH has agreed to take corrective actions and has paid $55,000 to settle a violation of the HIPAA Privacy Rule’s right of access standard.
• Memorial Hermann Health System, a not-for-profit health system in Southeast Texas, consisting of 17 hospitals, including Memorial Hermann Katy Hospital, failed to respond in a timely way to a complainant’s access request. Memorial Hermann has agreed to corrective actions and has paid $240,000 to settle a potential violation of the HIPAA Privacy Rule's right of access standard.
• Southwest Surgical Associates (SWSA) is a group practice with nine locations in the Greater Houston, TX area, failed to provide an individual timely access to their health information. SWSA has agreed to corrective actions and has paid $65,000 to settle a potential violation of the HIPAA Privacy Rule’s right of access standard.
In addition to these Right of Access resolutions, OCR also announced that Oklahoma State University – Center for Health Sciences (OSU-CHS) has paid $875,000 to OCR and agreed to implement a corrective action plan to settle potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, and Breach Notification Rules.
On January 5, 2018, OSU-CHS filed a breach report stating that an unauthorized third party gained access to a web server that contained electronic protected health information (ePHI). The hacker installed malware that resulted in the disclosure of the ePHI of 279,865 individuals, including their names, Medicaid numbers, healthcare provider names, dates of service, dates of birth, addresses, and treatment information. OSU-CHS initially reported that the breach occurred on November 7, 2017, but later reported that the ePHI was first impermissibly disclosed on March 9, 2016.
OCR’s investigation found potential violations of the HIPAA Rules including impermissible uses and disclosures of PHI; failure to conduct an accurate and thorough risk analysis; failure to perform an evaluation, failures to implement audit controls, security incident response and reporting, and failure to provide timely breach notification to affected individuals and HHS.
In addition to the monetary settlement, OSU-CHS will undertake a robust corrective action plan that includes two years of monitoring.
