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.
| Private Practice Revises Process to Provide Access to Records Covered Entity: Private Practices Issue: Access A private practice failed to honor an individual's request for a complete copy of her minor son's medical record. OCR's investigation determined that the private practice had relied on state regulations that permit a covered entity to provide a summary of the record. OCR provided technical assistance to the covered entity, explaining that the Privacy Rule permits a covered entity to provide a summary of patient records rather than the full record only if the requesting individual agrees in advance to such a summary ...read more |
| Direct Liability of Business Associates In 2009, Congress enacted the Health Information Technology for Economic and Clinical Health (HITECH) Act,1 making business associates of covered entities directly liable for compliance with certain requirements of the HIPAA Rules. Consistent with the HITECH Act, the HHS Office for Civil Rights (OCR) issued a final rule in 2013 to modify the HIPAA Privacy, Security, Breach Notification, and Enforcement Rules.2 Among other things, the final rule identifies provisions of the HIPAA Rules that apply directly to business associates and for which business associates are directly liable.3 As set forth in the HITECH ...read more |
| State Hospital Sanctions Employees for Disclosing Patient's PHI Covered Entity: Health Care Provider / General Hospital Issue: Impermissible Disclosure 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. Upon learning of the incident, the hospital placed both employees on leave; the orderly resigned his employment shortly thereafter. Among other actions taken to satisfactorily resolve this matter, the hospital took further disciplinary action with the nurse, which included: documenting the employee record with a memo of ...read more |
| Issued by: Office for Civil Rights (OCR) What if a HIPAA covered entity (or business associate) uses a CSP to maintain ePHI without first executing a business associate agreement with that CSP? Answer: If a covered entity (or business associate) uses a CSP to maintain (e.g., to process or store) electronic protected health information (ePHI) without entering into a BAA with the CSP, the covered entity (or business associate) is in violation of the HIPAA Rules. 45 C.F.R §§164.308(b)(1) and §164.502(e). OCR has entered into a resolution agreement and corrective action plan with a covered entity that OCR determined ...read more |
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