FileFax agreed to settle the alleged HIPAA violations for $100,000. Operating as Agape Health Services, the company experienced a breach of the ePHI of 1,263 patients. The case was settled for $1,500,000. 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). Among other corrective action taken to resolve this issue, the Center provided the complainant with a copy of her records. Read more, Renown Health, a not-for-profit healthcare network in Northern Nevada, failed to provide a patients attorney with a copy of her medical and billing records within 30 days. Documentation was uncovered that clearly showed that mobile devices were believed to represent a critical security risk, yet action was not taken to address this issue in time to prevent the data breach. Issue: Impermissible Uses and Disclosures. It took 5 months from the initial request for the complete set of medical records to be provided. Read More, Medical Informatics Engineering, an Indiana-based provider of electronic medical record software and services, experienced amajor data breachin 2015 at its NoMoreClipboard subsidiary. The details come from . The incident for which the fine has been issued dates back to 2009 when a data security complaint was filed by a patient of one of its doctors. Issue: Impermissible Uses and Disclosures; Business Associates. The minimum fines are $100 per violation for tier 1, $1,000 per violation for tier 2, $10,000 per violation for tier 3, and $50,000 per violation for tier 4. OCR imposed a civil monetary penalty of $100,000. 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. 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. Advocate Health Care Network will pay a record $5.55 million to settle multiple potential violations of the Health Insurance Portability and Accountability Act. Case Examples by Issue. Health Plan Corrects Computer Flaw that Caused Mailing of EOBs to Wrong Persons OCR intervened and closed the case but received a second complaint a year later alleging the records had still not been provided. Issue: Impermissible Use and Disclosure. HIPAA violation penalties are tiered based on the level of negligence determined by the Department of Health and Human Services or the state attorney general. The device was not password-protected, and the personal information of over 20,000 patients wasn't encrypted. If not, the form is invalid and any information released to a third party would be in violation of HIPAA regulations. Read more, In 2015, Excellus Health Plan reported a breach of the ePHI of 9,358,891 individuals. A Nurse's Guide to the Use of Social Media discusses the case of a hospice nurse whose cancer patient had posted about her depression. HMORevises Process to Obtain Valid Authorizations HIPAA violations don't just occur when a nurse posts something of their own accord. CHMC settled the HIPAA Right of Access case with OCR and paid an $80,000 penalty. Dr. Glazer did not cooperate with OCR during the investigation, resulting in OCR imposing a civil monetary penalty of $100,000 for the HIPAA Right of Access violation. This was OCRs first settlement under the 2019 HIPAA Right of Access enforcement initiative. 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. OCR attempted to resolve the matter via informal means between November 6, 2015, to August 30, 2016, before issuing a Notice of Proposed Determination on September 30, 2016. 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. St. Joseph Health has agreed to pay OCR $2,140,500. The Center provided OCR with a valid authorization, signed by the complainant, permitting the release of information to the auto insurance company. Read More, The HHS has announced that Lahey Hospital and Medical Center has agreed to settle a case with the Office for Civil Rights over alleged HIPAA violations following a data breach that occurred in October 2011. The case was settled for $3,500. Receive weekly HIPAA news directly via email, HIPAA News The case was settled and a financial penalty of $28,000 was paid. An organizations willingness to assist with an investigation is also taken into account. 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. However, as violations of HIPAA are so severe, then CEs will choose to terminate the . A hospital employee's supervisor accessed, examined, and disclosed an employee's medical record. U.S. Department of Health & Human Services 200 Independence Avenue, S.W. OCR intervened but received a second complaint a month later when the records had still not been provided. The case was settled for $38,000. Gossip is a casual conversation about other people which can be positive, neutral, or negative. The nurse in question sent out six text messages to warn the patient's girlfriend about his STD. It took multiple requests and almost 5 months for all of the requested medical records to be provided. OCR provided technical assistance and closed the case, but the records were still not provided. In some severe cases, yes, nurses can lose their jobs if they violate HIPAA. The data breach investigation revealed a substandard security management process and a catalog of HIPAA Security Rule violations. Among other corrective actions to resolve the specific issues in the case, OCR required the health insurer to train its staff on the applicable policies and procedures and to mitigate the harm to the individual. 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). OCR determined there had been a risk analysis failure, access control failure, information system activity monitoring failure, and an impermissible disclosure of 6,617 patients ePHI. Failure to report a violation could have serious consequences. The Privacy Rule requires covered entities to provide individuals with access to their medical records; however, the Privacy Rule exempts psychotherapy notes from this requirement. 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. Even though it is not done maliciously. A national health maintenance organization sent explanation of benefits (EOB) by mail to a complainant's unauthorized family member. In addition, the covered entity forwarded the complainant a complete copy of the medical record. > For Professionals The case was settled for $200,000. The case was settled with OCR for $25,000. Read More, An investigation into Anthem Incs massive 78.8 million-record data breach of 2015 revealed multiple HIPAA violations. UMMC has also agreed to adopt a corrective action plan (CAP) to bring privacy and security standards up to the level required by HIPAA. 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. 8. OCR settled the case for $55,000. Nurse Faced with Jail Time for Violating HIPAA Laws Without appropriate HIPAA training, this case of a HIPAA violation demonstrates how critical it is to train workers before there is an issue. The HIPAA Right of Access violation was settled with OCR for $65,000. The hospital asserted that the disclosures were made to avert a serious threat to health or safety; however, OCRs investigation indicated that the disclosures did not meet the Privacy Rules standard for such actions. The case was settled for $850,000. There are four tiers of HIPAA violation penalties for nurses, ranging from unknowing violations to willful neglect of HIPAA Rules. Pharmacy Chain Revises Process for Disclosures to Law Enforcement Read more, OCR investigated a breach reported by the Department of Veteran Affairs involving a business associate, Authentidate Holding Corporation. The settlement stems from an impermissible disclosure in a press release issued by MHHS in September 2015. Covered Entity: Pharmacies 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. Read More, New England Dermatology and Laser Center in Massachusetts disposed of empty specimen containers in regular dumpsters between February 4, 2011, and March 31, 2021. The maximum penalty for a single breach is $1.5 million per year. Covered Entity: Health Care Provider A Georgia man has been sentenced to federal prison in an unusual case in which he portrayed himself as a whistleblower while falsely reporting to authorities that a hospital worker committed criminal HIPAA violations. MIE also settled a multi-state action with state attorneys general and paid a penalty of $900,000. 3 Examples of HIPAA Violation Cases Example #1: When it comes to HIPAA, curiosity can kill the cat or your career. Without a properly executed agreement, a covered entity may not disclose PHI to its law firm. The disclosure was not consistent with documents approved by the Institutional Review Board (IRB). An OCR investigation also indicated that the confidential communications requirements were not followed, as the employee left the message at the patients home telephone number, despite the patients instructions to contact her through her work number. Read More, A $2.5 million settlement has been agreed upon with CardioNet to resolve potential HIPAA violations. In 2016, 12 entities agreed to settle their compliance investigations and pay a financial penalty, with one case seeing civil monetary penalties imposed. The table above will be updated when the new penalty amounts for 2023 are finalized by the HHS. To resolve the issues in this case, the hospital developed and implemented several new procedures. In many cases, records were only provided after OCR intervened. As HIPAA violations are so severe, and may result in huge fines for Covered Entities, if . Issue: Safeguards; Impermissible Uses and Disclosures; Disclosures to Avert a Serious Threat to Health or Safety. 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. The HIPAA Right of Access violation was settled with OCR for $30,000. The 2020 increase is largely due to OCRs HIPAA Right of Access enforcement initiative, which was launched in late 2019. Talking about a patient in a public area where others can hear you is a HIPAA violation. CHCS will also pay a financial penalty of $650,000. OCR settled the case for $5,000. Issue: Safeguards, Minimum Necessary. OCR investigated and uncovered multiple potential violations of the HIPAA Rules: A risk analysis failure, risk management failure, lack of information system activity reviews, and insufficient technical policies to prevent unauthorized ePHI access. Nurses who deliberately obtain or disclose individually identifiable protected health information can face a fine of up to $50,000 and a maximum of 12 months in jail. To resolve this matter, OCR also required the practice to revise the office's fax cover page to underscore a confidential communication for the intended recipient. Nurse Pleads Guilty to HIPAA Violation A licensed practical nurse who pled guilty to wrongfully disclosing a patient's health information for personal gain faces a maximum penalty of 10 years imprisonment, a $250,000 fine or both. OCR determined the failure to terminate access rights when employment had ended was in violation of the HIPAA Security Rule. The server had been purchased and a file-sharing application was installed, yet no changes were made to the application. A chain pharmacy disclosed protected health information to municipal law enforcement officials in a manner that did not conform to the provisions of the Privacy Rule. Presence Health took three months to issue breach notifications when the Breach Notification Rule requires notifications to be sent within 60 days of the discovery of a breach. OCR also identified issues with the notice of privacy practices and a HIPAA privacy officer had not been appointed. In some states, the amount of punitive damages awarded could far outweigh the maximum $1.5 million fine (per violation) that can be imposed by OCR. If an offense is committed under false pretenses, the criminal penalties increase to a maximum . Issue: Access, A patient alleged that a covered entity failed to provide him access to his medical records. There are four tiers of HIPAA violation penalties for nurses, ranging from unknowing violations to willful neglect of HIPAA Rules. Read More, A patient of Elite Dental Associates submitted a complaint to OCR stating her PHI had been disclosed by Elite Dental Associates in response to a review on Yelp. Regulatory Changes Issue: Safeguards. All rights reserved. The medical center had also failed to enter into a BAA with a business associate. St. Lukes-Roosevelt Hospital Center Inc. has paid OCR $387,200 to resolve potential HIPAA violations discovered during an OCR investigation of a complaint about an impermissible disclosure of PHI. Private Practice Revises Process to Provide Access to Records Covered Entity: General Hospital Among other corrective action taken, the Center provided the complainant with a copy of her medical record and revised its policies and procedures to ensure that it provides timely access to all individuals. The HIPAA Right of Access violation was settled with OCR for $10,000. Read More, OCR received a complaint from a patient of Dr. Rajendra Bhayani, a Regal Park, NY-based private practitioner specializing in otolaryngology, alleging he had not provided a patient with a copy of her medical records. PHI had been intentionally provided to the media on three separate occasions. Covered Entity: Mental Health Center The case was settled for $6,850,000. Some of these were HIPAA violations from employees posting a patient's protected health information (PHI) the social web. The man sued the clinic, even though it had already dismissed the nurse from her job. 2021 HIPAA Right of Access Enforcement Actions Other 2021 HIPAA Violation Penalties Covered Entity: General Hospital Entity Rescinds Improper Charges for Medical Record Copies to Reflect Reasonable, Cost-Based Fees A pharmacy employee placed a customer's insurance card in another customer's prescription bag. Covered Entity: Private Practice Read More, A patient submitted a complaint to OCR about an impermissible disclosure of PHI in a mailing. OCR investigated and discovered similar privacy violations had occurred responding to patient reviews. 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. Covered Entity: Pharmacies OCR settled the case for $30,000. Public Hospital Corrects Impermissible Disclosure of PHI in Response to a Subpoena The case was settled for $25,000. The case was settled for $62,500. A settlement of $85,000 was agreed upon to resolve the violation. The case was settled for $1,250,000. New York and Presbyterian Hospital (NYP) and Columbia University (CU) will jointly pay a penalty of $4,800,000. 4 . A number of patients were filmed, but consent had not been obtained. 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. The directory contained files that included the protected health information (PHI) of 307,839 individuals. A covered entitys obligation to comply with all requirements of the Privacy Rule cannot be conditioned on the patients silence. In order to resolve this matter to OCRs satisfaction and to prevent a recurrence, the covered entity: terminated the nurse practitioners access to its electronic records system; reported the nurse practitioners conduct to the appropriate licensing authority; and, provided the nurse practitioner with remedial Privacy Rule training. OCR received a complaint from a patient who had not been provided with a copy of his medical records. The complainant alleged that a mental health center (the "Center") improperly provided her records to her auto insurance company and refused to provide her with a copy of her medical records. A violation of HIPAA attributable to ignorance can attract a fine of $100 - $50,000. Read More, Wise Psychiatry is a small provider of psychiatric services in Colorado. A violation due to willful neglect which is not corrected within thirty days will attract the maximum fine of $50,000. HIPAA violations are not uncommon. The revised policies are applicable to all individual stores in the pharmacy chain. OCR discovered risk analysis failures, risk management failures, a failure toconduct technical and non-technical evaluations following environmental or operational changes, and the disclosure of ePHI to a contractor without first entering into a business associate agreement. OCR investigated Peachstate and uncovered multiple potential violations of the HIPAA Security Rule. Question: Dear Nancy, Can an RN lose his or her nursing license over a HIPAA violation? This discrepancy is expected to be addressed through further rulemaking to make the new penalty structure permanent.
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