OCR Settles Three Cases with Dental Practices for Patient Right of Access under HIPAA
Enforcement Actions Ensure Patients Receive Timely Access to their Records, at a Reasonable Cost
Today, the U.S. Department of Health and Human Services (HHS) Office
for Civil Rights (OCR) announced the resolution of three investigations
concerning potential violations of the Health Insurance Portability and
Accountability Act (HIPAA) Privacy Rule's patient right of access
provision. These cases are part of a collective effort, bringing the
total 41 cases, to drive compliance on right of access under the law.
“These three right of access actions send an important message to
dental practices of all sizes that are covered by the HIPAA Rules to
ensure they are following the law,” said OCR Director Melanie Fontes
Rainer. “Patients have a fundamental right under HIPAA to receive their
requested medical records, in most cases, within 30 days. I hope that
these actions send the message of compliance so that patients do not
have to file a complaint with OCR to have their medical records requests
fulfilled.”
OCR has taken the following enforcement actions that underscore the
importance and necessity of compliance with the HIPAA Rules, including
the foundational right of access provision:
- Family Dental Care, P.C.
(“FDC”), is a dental practice located in Chicago, Illinois. OCR
received a complaint on August 8, 2020, alleging that FDC failed to
provide a former patient with timely access to her complete medical
records. The former patient requested her entire medical records in May
2020, but received only portions. The former patient filed a complaint
with OCR, and during OCR’s investigation, FDC provided her with the
remainder of her records in October 2020. Thus, FDC did not provide a
complete copy of the records until more than five months after the
request was made. OCR's investigation determined that FDC’s failure to
provide timely access to the requested medical records was a potential
violation of the HIPAA right of access provision. FDC agreed to pay
$30,000 and implement a corrective action plan.
- Great Expressions Dental Center of Georgia, P.C.
(“GEDC-GA”), is a dental and orthodontics provider with multiple
locations throughout the state of Georgia. In November 2020, OCR
received a complaint alleging that GEDC-GA would not provide an
individual with copies of her medical records because she would not pay
GEDC-GA’s $170 copying fee. The individual first requested her records
in November 2019, but did not receive them until February 2021, over a
year later. OCR's investigation determined that GEDC-GA’s failure to
provide timely access to the requested medical records, and its practice
of assessing copying fees that were not reasonable and cost-based, were
potential violations of the HIPAA right of access provision. GEDC-GA
agreed to pay $80,000 and implement a corrective action plan.
- B. Steven L. Hardy, D.D.S., LTD,
doing business as Paradise Family Dental (“Paradise”) is a dental
practice in Las Vegas, Nevada. On October 26, 2020, OCR received a
complaint alleging that Paradise had failed to provide a mother with
copies of her and her minor child’s protected health information. The
mother submitted multiple record requests between April 11, 2020, and
December 4, 2020, but Paradise did not send the records until December
31, 2020, more than eight months after her initial request. OCR's
investigation determined that Paradise’s failure to provide timely
access to the requested medical records was a potential violation of the
HIPAA right of access provision. Paradise agreed to pay $25,000 and
implement a corrective action plan.
| May a covered entity use or disclose protected health information for litigation? Answer: A covered entity may use or disclose protected health information as permitted or required by the Privacy Rule, see 45 CFR 164.502(a) (PDF); and, subject to certain conditions the Rule typically permits uses and disclosures for litigation, whether for judicial or administrative proceedings, under particular provisions for judicial and administrative proceedings set forth at 45 CFR 164.512(e) (GPO), or as part of the covered entity’s health care operations, 45 CFR 164.506(a) (PDF). Depending on the context, a covered entity’s use or disclosure of protected health information in ...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 |
| Private Practice Ceases Conditioning of Compliance with the Privacy Rule Covered Entity: Private Practice Issue: Conditioning Compliance with the Privacy Rule A physician practice requested that patients sign an agreement entitled “Consent and Mutual Agreement to Maintain Privacy.” The agreement prohibited the patient from directly or indirectly publishing or airing commentary about the physician, his expertise, and/or treatment in exchange for the physician’s compliance with the Privacy Rule. A patient’s rights under the Privacy Rule are not contingent on the patient’s agreement with a covered entity. A covered entity’s obligation to comply with all requirements of the Privacy Rule ...read more |
| 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 ...read more |
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