Read More, The Department of Health and Human Services Office for Civil Rights has agreed to a $650,000 settlement with University of Massachusetts Amherst (UMass). renewals of licenses or APRN authorizations, or both. The case was settled with OCR for $25,000. A patients rights under the Privacy Rule are not contingent on the patients agreement with a covered entity. OCR received a complaint from a patient who alleged he had been denied access to his medical records. Termination for Nurse HIPAA Violation Upheld by Court Among other corrective actions to resolve the specific issues in the case, OCR required the provider to develop and implement policies and procedures regarding appropriate administrative and physical safeguards related to the communication of PHI. Detailed below is a summary of all HIPAA violation cases that have resulted in settlements with the Department of Health and Human Services Office for Civil Rights (OCR), including cases that have been pursued by OCR after potential HIPAA violations were discovered during data breach investigations, and investigations of complaints submitted by patients and healthcare employees. Issue: Impermissible Uses and Disclosures. Issue: Notice. 0:04. Aim: This study aimed to evaluate nurses' ability to evaluate ethical violations to hypothetical case studies involving social media use. In response to OCRs investigation, the mental health center acknowledged that it had not provided the complainant and his daughter with a notice prior to her mental health evaluation. Read More, The Department of Health and Human Services Office for Civil Rights (OCR) imposed a $1.6 million civil monetary penalty (CMP) on Texas Health and Human Services Commission (TX HHSC) for multiple violations of HIPAA Rules discovered during the investigation of an exposed internal application containing ePHI. A study found that the average person spends about 52 minutes per day engaging in this type of conversation. Therefore, it . There may be a viable claim, in some cases, under state laws. Read more, Denver Retina Center, a Denver, CO-based provider of ophthalmological services, failed to provide a patient with timely access to the requested medical records. 3 Examples of HIPAA Violation Cases Example #1: When it comes to HIPAA, curiosity can kill the cat or your career. When dealing with these complex issues, you need legal representation that has a long track record of success in these types of cases. OCR received a complaint from a patient who had not been provided with a copy of his medical records. Read More, Anchorage Community Mental Health Services (ACMHS) runs five mental health facilities in Alaska and is a non-profit organization. Everything You Need to Know About a HIPAA Violation Read More, Office for Civil Rights has issued a statement confirming that an agreement has been reached with Adult & Pediatric Dermatology, P.C., of Concord, Massachusetts following the accidental disclosure of approximately 2,200 patients after a memory stick was stolen from the car of one of the centers employees. An OCR investigation indicated that the form the HMO relied on to make the disclosure was not a valid authorization under the Privacy Rule. The case was settled for $200,000. There are two key events to consider when looking at the timeline of penalties for HIPAA violations the passage of the HITECH Act in 2009 which reversed the burden of proof for HIPAA violations, and the HIPAA Omnibus Rule in 2013 which enacted the passage of the HITECH Act making business associates liable for HIPAA violations that were their fault. OCR intervened but received a second complaint a month later when the records had still not been provided. OCR conducted an investigation into an incident involving a stolen laptop that contained the ePHI of 20,431 patients. In 2012 it suffered a security breach that exposed the data of 2,700 individuals as a result of a malware infection. Gossip HIPAA Violations: When, Where, How and Why Etactics Five Memphis healthcare workers charged with conspiracy, HIPAA violations. Large Medicaid Plan Corrects Vulnerability that Resulted in Dsiclosure to Non-BA Vendors The Phoenix, Arizona-based non-profit health system, Banner Health, experienced a hacking incident that resulted in the impermissible disclosure of the PHI of 2.81 million individuals in 2016. What is a HIPAA violation? 26 HIPAA violation examples - Alleva The private practice maintained that the disclosure to the contract research organization was permissible as a review preparatory to research. > HIPAA Compliance and Enforcement Issue: Impermissible Uses and Disclosures. As a result of this review, the hospital revised the distribution of the OR schedule, limiting it to those who have a need to know., Private Practice Ceases Conditioning of Compliance with the Privacy Rule Read more, Dr. Robert Glaser, a New Hyde Park, NY-based cardiovascular disease and internal medicine doctor, failed to provide a patient with timely access to the requested medical records after repeated requests. The trial court noted that HIPAA does not create a private right of action, but instead requires that violations be pursued via administrative channels (ie: by filing a complaint with HHS). Read More, Paradise Family Dental was investigated in response to a complaint that a parent had not been provided with a copy of her minor childs medical records, despite submitting multiple requests to the practice. Read More, The Department of Health and Human Services Office for Civil Rights has announced it has reached a settlement with North Memorial Health Care of Minnesota over alleged HIPAA violations from a 2011 data breach. Toll Free Call Center: 1-800-368-1019 The complainant alleged that a mental health center (the "Center") refused to provide her with a copy of her medical record, including psychotherapy notes. All Case Examples | HHS.gov There may be a viable claim, in some cases, under state privacy laws. Read More, An investigation of five separate breaches at HIPAA-covered entities owned by Fresenius Medical Care North America revealed multiple HIPAA violations had contributed to the breaches. Common HIPAA Violations with Examples | Inspired eLearning The OCR investigation revealed a lack of business associate agreements, insufficient access rights, a risk analysis failure, a failure to respond to a security incident, a breach notification failure, media notification failure. Between October 23, 2009, and March 7, 2010 part of its database of policyholders was accessible to unauthorized individuals. They split the fines and charges into two categories: reasonable cause and willful neglect. While the amendment provisions of the Privacy Rule permit a covered entity to deny an individual's request for an amendment when the covered entity did not create that the portion of the record subject to the request for amendment, no similar provision limits individuals' rights to access their protected health information. The case was settled for $6,850,000. Pharmacy Chain Revises Process for Disclosures to Law Enforcement Initially, the pharmacy chain refused to acknowledge that the log books contained protected health information. OCR investigated and found multiple violations of the HIPAA Rules including a delayed response to a known security breach, risk analysis and risk management failures, and a lack of procedures to monitor information system activity logs. The case was settled for $25,000. Covered Entity: General Hospital Mental Health Center Provides Access after Denial Criminal HIPAA violations and penalties fall under three tiers: Tier 1: Deliberately obtaining and disclosing PHI without authorization up to one year in jail and a $50,000 fine Tier 2: Obtaining PHI under false pretenses up to five years in jail and a $100,000 fine Read More, Memorial Hermann Health System agreed to settle potential HIPAA Privacy Rule violations with the Department of Health and Human Services Office for Civil Rights for $2.4 million. The case was settled for $3 million. Read More, Athens Orthopedic Clinic PA in Georgia had its systems hacked in 2016. MIE also settled a multi-state action with state attorneys general and paid a penalty of $900,000. An organizations willingness to assist with an investigation is also taken into account. In 2016, 12 entities agreed to settle their compliance investigations and pay a financial penalty, with one case seeing civil monetary penalties imposed. Under the revised policies and procedures, the practice may use and disclose PHI for research purposes, including recruitment, only if a valid authorization is obtained from each individual or if the covered entity obtains documentation that an alteration to or a waiver of the authorization requirement has been approved by an IRB or a Privacy Board. Blogs - Skyhigh Security The containers had labels that included the PHI of patients. Can an RN lose his or her nursing license over a HIPAA violation? After OCR intervened, the records were provided, but it took 22 months from the initial date of the request. 3. Private Practice Revises Access Procedure to Provide Access Despite an Outstanding Balance OCR's investigation confirmed that the use and disclosure of protected health information by the supervisor was not authorized by the employee and was not otherwise permitted by the Privacy Rule. What Happens When Nurses Violate HIPAA | S J Harris Law Case Examples Organized by Issue | HHS.gov This case study involving one nursing education program's experience with a HIPAA violation illustrates how one nursing college dealt with a student's HIPAA . It took 8 months from the date of the first request for the records to be provided. Read more, Wake Health Medical Group, a Raleigh, NC-based provider of primary care and other health care services, failed to provide a patient with timely access to the requested medical records. Since HIPAA's enactment in 1996, we've witnessed almost 20 reported cases of unauthorized personnel looking up the medical records of celebrities. A nurse at a Texas children's hospital has been fired for violating Health Insurance Portability and Accountability Act (HIPAA) Rules by posting protected health information on a social media website. That's almost an hour devoted to talking about someone else. 0:57. However, the investigation revealed that the pharmacy chain and the law firm had not entered into a Business Associate Agreement, as required by the Privacy Rule to ensure that PHI is appropriately safeguarded. The hospital disciplined and retrained the employee who made the impermissible disclosure. Outpatient Surgical Facility Corrects Privacy Procedure in Research Recruitment Shaila Mae. Activities considered preparatory to research include: preparing a research protocol; developing a research hypothesis; and identifying prospective research participants. National Pharmacy Chain Extends Protections for PHI on Insurance Cards Another potential HIPAA violation that's easily overlooked is discussing information over the phone. Covered Entity: Health Plans Concentra has agreed to pay OCR $1,725,220 to resolve the case. A settlement of $500,000 was agreed upon to resolve the alleged HIPAA violations. Mental Health Center Provides Access and Revises Policies and Procedures However, the court also legitimized private cause for action in HIPAA lawsuits, which could set a precedent for HIPAA related legal action. And when data breaches like this occur, it's usually because of a HIPAA violation. The data breach exposed the Protected Health Information of 55,000 patients. Numbers at a Glance - Current | HHS.gov CHCS failed to perform a comprehensive risk analysis since September 23, 2013. Receive weekly HIPAA news directly via email, HIPAA News Issue: Safeguards, Minimum Necessary. Read More, The University of Washington Medicine has agreed to settle with the Department of Health and Human Services Office for Civil Rights and will pay a HIPAA fine of $750,000 for potential HIPAA violations stemming from a 90,000-record data breach suffered in 2013. Nancy Brent replies: Dear Paige: The Health Insurance Portability and Accountabilty Act requires that all covered entities (including nurses, whether they work in a hospital or other healthcare setting) protect against unauthorized disclosure of a patient's personally identifiable health information. Had software patches been installed on the computers the malware would not have been unable to infect the PCs. Issue: Impermissible Uses and Disclosures; Authorizations. Read More, OCR announced that it has reached a settlement for $125,000 with a Denver-based healthcare provider, Cornell Pharmacy, following the improper disposal of patient health records. Covered Entity: Pharmacies Large Provider Revises Patient Contact Process to Reflect Requests for Confidential Communications In many cases, records were only provided after OCR intervened. OCR investigated the incident and discovered risk analysis and risk management failures, insufficient information system activity logging and monitoring, missing business associate agreements, and employees had not been provided with HIPAA Privacy Rule training. Boston Medical Center agreed to settle the alleged HIPAA violations with OCR for $100,000. One addressed the issue of minimum necessary information in telephone message content. If a nurse breaches HIPAA, a patient cannot sue the nurse directly for a HIPAA breach. Read More, The solo dental practitioner in Butler, PA, failed to provide a patient with a copy of their medical record in a timely manner. OCR intervened and provided technical assistance, but it took 16 months for the records to be provided. The four categories range from unknowing violations to willful disregard of HIPAA rules. On Tuesday, the Department of Justice said Jeffrey Parker of Rincon . Yes. Kentucky HIPAA Violation Case Ruling Held by Appeals Court For one violation, fines can range from $100-$50,000 for each instance of wrongdoing. Covered Entity: Private Practice An OCR investigation indicated that the form the HMO relied on to make the disclosure was not a valid authorization under the Privacy Rule. A public hospital, in response to a subpoena (not accompanied by a court order), impermissibly disclosed the protected health information (PHI) of one of its patients. The cost of employer HIPAA violations in the supreme court ranges from $100 to $50,000 based on a variety of factors, including: Whether or not there was malicious intent (civil vs. criminal penalties) The degree of negligence If a doctor violates HIPAA, including inadvertent disclosure If a breach occurred The above penalties were implemented as demanded by the HITECH Act of 2009 and increase annually in line with inflation. HIPAA Journal provides the most comprehensive coverage of HIPAA news anywhere online, in addition to independent advice about HIPAA compliance and the best practices to adopt to avoid data breaches, HIPAA violations and regulatory fines. Read More, Skagit County, Washington is paying the price for failing to implement the appropriate controls and safeguards to protect the data it held. Office for Civil Rights Headquarters. The disclosed information included details of patients visits, treatment, and insurance. Read More, Brigham and Womens Hospital was fined for allowing an ABC film crew to record footage of patients as part of the Boston Med TV series, without first obtaining consent from patients. OCR intervened and closed the case but received a second complaint a month later when the records had still not been provided. > For Professionals The case was settled for $1,500,000. A mother requested a copy of her sons medical records, but the records had not been provided three months after submitting the request. The employee responsible for the disclosure received a written disciplinary warning, and both the employee and the physician apologized to the patient. HIPAA requires nurses and other health care professionals to report any violations they witness, even if they recognize it was accidental. Covered Entity: Outpatient Facility The medical center had also failed to enter into a BAA with a business associate. A settlement of $85,000 was agreed upon to resolve the violation. OCR investigated and discovered similar privacy violations had occurred responding to patient reviews. Entity Rescinds Improper Charges for Medical Record Copies to Reflect Reasonable, Cost-Based Fees Health Plan Corrects Computer Flaw that Caused Mailing of EOBs to Wrong Persons OCR intervened and closed the case but received a second complaint 6 months after the first stating the records had still not been provided. In the majority of cases, the agency resolves the complaints without the need for an investigation or finds no HIPAA violation exists. Moreover, the entity was required to train of all staff on the revised policy. North Memorial has agreed to pay $1,550,000 to OCR to settle the HIPAA violation charges. The investigation revealed a failure to conduct an accurate risk analysis, noncompliance with the security incident response and reporting requirements of the HIPAA Security Rule, the failure to conduct an evaluation following changes that affected the security of ePHI, a lack of audit controls, breach notification delays, and the impermissible disclosure of the PHI of 279,865 individuals. A private practice failed to honor an individual's request for a complete copy of her minor son's medical record. If an organization fails to take corrective action after having been issued a fine, the HHS Office of Civil Rights can impose subsequent fines. A nurse practitioner who has privileges at a multi-hospital health care system and who is part of the systems organized health care arrangement impermissibly accessed the medical records of her ex-husband. The Center did not, however, provide the complainant with the opportunity to have the denial reviewed, as required by the Privacy Rule. Nurses HIPAA Violation Examples The list of potential HIPAA violations by nurses is long so the most commonly experienced nurse HIPAA violations are listed below: OCR discovered a risk analysis failure, the lack of a security awareness training program, and a failure to implement HIPAA Security Rule policies and procedures. A settlement of $85,000 was agreed upon with OCR to resolve the HIPAA violation. 13 hospital workers fired for snooping in Britney Spears' medical OCRs investigation revealed that: the hospital distributed an Operating Room (OR) schedule to employees via email; the hospitals OR schedule contained information about the complainants upcoming surgery. HIPAA Journal states that if a nurse violates HIPAA, it is important that the incident is reported to the person responsible for HIPAA compliance in your facility or your supervisor. A was charged with violating the Health Insurance Portability and Accountability Act (HIPAA) and with "conspiracy to wrongfully disclose individual health information for personal gain with maliciously harmful intent in a personal dispute." Her husband was charged with witness tampering. A grocery store based pharmacy chain maintained pseudoephedrine log books containing protected health information in a manner so that individual protected health information was visible to the public at the pharmacy counter. Read more, The Diabetes, Endocrinology & Lipidology Center, Inc, a West Virginia-based healthcare provider specializing in treating endocrine disorders, failed to provide a parent with a copy of her minor childs protected health information within 30 days. To resolve the issues in this case, the hospital developed and implemented several new procedures. A nurse and an orderly at a state hospital discussed the HIV/AIDS status of a patient and the patient's spouse within earshot of other patients without making reasonable efforts to prevent the disclosure. November 16, 2022. Gossip is a casual conversation about other people which can be positive, neutral, or negative. An OCR investigation confirmed allegations that a dental practice flagged some of its medical records with a red sticker with the word "AIDS" on the outside cover, and that records were handled so that other patients and staff without need to know could read the sticker. In case you aren't sure what I mean regarding judgment and professional boundaries: Nurses need to avoid the appearance of impropriety. OCR investigated and identified longstanding, systemic noncompliance with the HIPAA Security Rule, including risk analysis and risk management failures, and the failure to provide security awareness training to employees. Read more, In 2015, Excellus Health Plan reported a breach of the ePHI of 9,358,891 individuals. A complaint alleged that an HMO impermissibly disclosed a members PHI, when it sent her entire medical record to a disability insurance company without her authorization. The device was not protected by a password and data on the device was not encrypted. Memorial Healthcare Systems has paid the penalty for non-compliance with HIPAA Rules, and in addition to the $5.5 million settlement, a robust corrective action plan must be adopted to address all areas of non-compliance. The acknowledgement form is now included in the intake package of forms. Read More, After the permanent closure of the company, paperwork containing former patients PHI was discarded by FileFax. To remedy this situation, the private practice revised its policies and procedures regarding the disclosure of PHI and trained all physicians and staff members on the new policies and procedures. The settlement stems from an impermissible disclosure in a press release issued by MHHS in September 2015. The nurse explained that the two individuals whose . Read More, An OCR investigation into an impermissible disclosure of 9,255 individuals PHI by Advanced Care Hospitalists, a business associate of a HIPAA-covered entity, revealed serious HIPAA compliance failures including a lack of a BAA, insufficient security measures to protect ePHI, and no documentation showing there had been any HIPAA compliance efforts prior to April 1, 2014. An organizations prior history with regard to HIPAA non-compliance can also be a contributory factor in the calculation of penalties for HIPAA violations and therefore a second or subsequent fine will likely be much larger than the first. The center also provided OCR with written assurance that all policy changes were brought to the attention of the staff involved in the daughters care and then disseminated to all staff affected by the policy change. Read More, Following the report of the theft of a laptop from the Springfield Missouri Physical Therapy Center, Concentra Health Services was subjected to an investigation by the OCR. Read more, San Diego-based Sharp Healthcare, dba Sharp Rees-Stealy Medical Centers, failed to provide a patients medical records to a patient-specified third party for more than 2 months. HIPAA News Releases | HHS.gov At minimum, the nurse who violated HIPAA will probably have to go on a training course to prevent further violations. Further, the covered entity's Privacy Officer and other representatives met with the patient and apologized, and followed the meeting with a written apology.