Radiologist Revises Process for Workers Compensation Disclosures
Radiologist Revises Process for Workers Compensation Disclosures
Covered Entity: Health Care Provider
Issue: Impermissible Uses and Disclosures
A radiology practice that interpreted a hospital patient’s imaging
tests submitted a worker’s compensation claim to the patient’s employer.
The claim included the patient’s test results. However, the patient
was not covered by worker’s compensation and had not identified worker’s
compensation as responsible for payment. OCR’s investigation revealed
that the radiology practice had relied upon incorrect billing
information from the treating hospital in submitting the claim. Among
other corrective actions to resolve the specific issues in the case, the
practice apologized to the patient and sanctioned the employee
responsible for the incident; trained all billing and coding staff on
appropriate insurance claims submission; and revised its policies and
procedures to require a specific request from worker’s compensation
carriers before submitting test results to them.
| Can a covered entity use existing aspects of the HIPAA Privacy Rule to give individuals the right to decide whether sensitive information about them may be disclosed to or through a health information organization (HIO)? Yes. To the extent a covered entity is using a process either to obtain consent or act on an individual’s right to request restrictions under the Privacy Rule as a method for effectuating individual choice, policies can be developed for obtaining consent or honoring restrictions on a granular level, based on the type of information involved. For example, specific consent and restriction policies could ...read more |
| Health Plan Corrects Impermissible Disclosure of PHI through Training, Mitigation, and Sanctions Covered Entity: Health Plans Issue: Impermissible Uses and Disclosures An employee of a major health insurer impermissibly disclosed the protected health information of one of its members without following the insurer's authorization and verification procedures. 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. In addition, the employee who made the disclosure was counseled and given a written warning. ...read more |
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| § 164.314 Organizational requirements. (a) (1) Standard: Business associate contracts or other arrangements. The contract or other arrangement required by § 164.308(b)(3) must meet the requirements of paragraph (a)(2)(i), (a)(2)(ii), or (a)(2)(iii) of this section, as applicable. (2) Implementation specifications (Required) - (i) Business associate contracts. The contract must provide that the business associate will - (A) Comply with the applicable requirements of this subpart; (B) In accordance with § 164.308(b)(2), ensure that any subcontractors that create, receive, maintain, or transmit electronic protected health information on behalf of the business associate agree to comply with the applicable requirements of ...read more |
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