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.
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| Pharmacy Chain Revises Process for Disclosures to Law Enforcement Covered Entity: Pharmacies Issue: Impermissible Uses and Disclosures 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. Among other corrective actions to resolve the specific issues in the case, OCR required this chain to revise its national policy regarding law enforcement's access to patient protected health information to comply with the Privacy Rule requirements, including that disclosures of protected health information to law enforcement only be made in response to written requests from ...read more |
| Large Health System Restricts Provider's Use of Patient Records Covered Entity: Multi-Hospital Healthcare Provider Issue: Impermissible Use A nurse practitioner who has privileges at a multi-hospital health care system and who is part of the system’s organized health care arrangement impermissibly accessed the medical records of her ex-husband. In order to resolve this matter to OCR’s satisfaction and to prevent a recurrence, the covered entity: terminated the nurse practitioner’s access to its electronic records system; reported the nurse practitioner’s conduct to the appropriate licensing authority; and, provided the nurse practitioner with remedial Privacy Rule training. ...read more |
| Health Plan Corrects Computer Flaw that Caused Mailing of EOBs to Wrong Persons Covered Entity: Health Plans Issue: Safeguards A national health maintenance organization sent explanation of benefits (EOB) by mail to a complainant's unauthorized family member. OCR's investigation determined that a flaw in the health plan's computer system put the protected health information of approximately 2,000 families at risk of disclosure in violation of the Rule. Among the corrective actions required to resolve this case, OCR required the insurer to correct the flaw in its computer system, review all transactions for a six month period and correct all ...read more |
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