Hospital Revises Email Distribution as a Result of a Disclosure to Persons Without a "Need to Know"
Hospital Revises Email Distribution as a Result of a Disclosure to Persons Without a "Need to Know"
Covered Entity: General Hospital
Issue: Impermissible Use and Disclosure
A complainant, who was both a patient and an employee of the
hospital, alleged that her protected health information (PHI) was
impermissibly disclosed to her supervisor. OCR’s investigation revealed
that: the hospital distributed an Operating Room (OR) schedule to
employees via email; the hospital’s OR schedule contained information
about the complainant’s upcoming surgery. While the Privacy Rule may
permit the disclosure of an OR schedule containing PHI, in this case, a
hospital employee shared the OR scheduled with the complainant’s
supervisor, who was not part of the employee's treatment team, and did
not need the information for payment, health care operations, or other
permissible purposes. The hospital disciplined and retrained the
employee who made the impermissible disclosure. Additionally, in order
to prevent similar incidents, the hospital undertook a complete review
of the distribution of the OR schedule. As a result of this review, the
hospital revised the distribution of the OR schedule, limiting it to
those who have “a need to know.”
| Issued by: Office for Civil Rights (OCR) Do the HIPAA Rules allow a covered entity or business associate to use a CSP that stores ePHI on servers outside of the United States? Answer: Yes, provided the covered entity (or business associate) enters into a business associate agreement (BAA) with the CSP and otherwise complies with the applicable requirements of the HIPAA Rules. However, while the HIPAA Rules do not include requirements specific to protection of electronic protected health information (ePHI) processed or stored by a CSP or any other business associate outside of the United States, OCR notes that ...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 |
| 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 ...read more |
| Public Hospital Corrects Impermissible Disclosure of PHI in Response to a Subpoena Covered Entity: General Hospital Issue: Impermissible Uses and Disclosures 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. Contrary to the Privacy Rule protections for information sought for administrative or judicial proceedings, the hospital failed to determine that reasonable efforts had been made to insure that the individual whose PHI was being sought received notice of the request and/or failed to receive satisfactory assurance that the party seeking the information ...read more |
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