HMO Revises Process to Obtain Valid Authorizations
HMO Revises Process to Obtain Valid Authorizations
Covered Entity: Health Plans / HMOs
Issue: Impermissible Uses and Disclosures; Authorizations
A complaint alleged that an HMO impermissibly disclosed a member’s
PHI, when it sent her entire medical record to a disability insurance
company without her authorization. An OCR investigation indicated that
the form the HMO relied on to make the disclosure was not a valid
authorization under the Privacy Rule. Among other corrective actions to
resolve the specific issues in the case, the HMO created a new
HIPAA-compliant authorization form and implemented a new policy that
directs staff to obtain patient signatures on these forms before
responding to any disclosure requests, even if patients bring in their
own “authorization” form. The new authorization specifies what records
and/or portions of the files will be disclosed and the respective
authorization will be kept in the patient’s record, together with the
disclosed information.
| TYLER, Texas — U.S. Attorney John M. Bales announced today that a former employee of an East Texas hospital has pleaded guilty to criminal HIPAA charges in the Eastern District of Texas. Joshua Hippler, 30, formerly of Longview, Texas, was indicted on March 26, 2014, on charges of Wrongful Disclosure of Individually Identifiable Health Information. Hippler pleaded guilty on August 28, 2014 during a hearing before United States Magistrate Judge John D. Love. The indictment alleged that from December 1, 2012, through January 14, 2013, Hippler, who was then an employee of a covered entity under HIPAA, obtained protected ...read more |
| Enforcement Results as of September 30, 2022 Since the compliance date of the Privacy Rule in April 2003, OCR has received over 309,475 HIPAA complaints and has initiated over 1,053 compliance reviews. We have resolved ninety-seven percent of these cases (300,427). OCR has investigated and resolved over 29,779 cases by requiring changes in privacy practices and corrective actions by, or providing technical assistance to, HIPAA covered entities and their business associates. Corrective actions obtained by OCR from these entities have resulted in change that is systemic and that affects all the individuals they serve. OCR has successfully enforced the ...read more |
| When does the Privacy Rule allow covered entities to disclose protected health information to law enforcement officials? Answer: The Privacy Rule is balanced to protect an individual’s privacy while allowing important law enforcement functions to continue. The Rule permits covered entities to disclose protected health information (PHI) to law enforcement officials, without the individual’s written authorization, under specific circumstances summarized below. For a complete understanding of the conditions and requirements for these disclosures, please review the exact regulatory text at the citations provided. Disclosures for law enforcement purposes are permitted as follows: To comply with a court order or ...read more |
| If a CSP stores only encrypted ePHI and does not have a decryption key, is it a HIPAA business associate? Answer: Yes, because the CSP receives and maintains (e.g., to process and/or store) electronic protected health information (ePHI) for a covered entity or another business associate. Lacking an encryption key for the encrypted data it receives and maintains does not exempt a CSP from business associate status and associated obligations under the HIPAA Rules. An entity that maintains ePHI on behalf of a covered entity (or another business associate) is a business associate, even if the entity cannot actually ...read more |
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