At the start of each new year, it is always good to look back at federal settlements under the Health Insurance Portability and Accountability Act (HIPAA). That is how you know matters most to the Feds in terms of privacy enforcement.
From 2017, here is a short list of key messages:
- It’s your job to understand HIPAA requirements.
- Execute Business Associate Agreements with vendors and independent contractors with potential access to private health information.
- Don’t rest easy because you have security policies; you also need to manage security processes for daily vigilance.
- If you do experience a breach, report to the Feds in a timely manner.
- Be sure to monitor activity on your databases.
Now let’s take these one by one, with examples illustrating each point.
Understanding HIPAA requirements:
In a case involving CardioNet, a provider of remote mobile monitoring of heart patients, the Feds said that a lack of understanding of HIPAA creates risk. CardioNet paid the cost of such ignorance in a $2.5 million settlement, stemming from a laptop stolen from an employee’s vehicle, and containing private health information. Read the Press Release.
- Business Associate Agreements:
In April, the Feds put out a news alert with the headline, No Business Associate Agreement? $31K Mistake.
It’s was as if to say “Gotcha” -- albeit in a small settlement by HIPAA standards. The case involved a children’s digestive health center. As the Feds were investigating one of the center’s Business Associates, they discovered the absence of a Business Associate agreement, which was the health center’s responsibility to execute. Read the Resolution Agreement and Corrective Action Plan - PDF.
- Security management:
In a case involving unauthorized access to health information, Memorial Healthcare System (MHS) paid the Feds $5.5 million to settle potential violations. Private health information had been impermissibly accessed and disclosed through login credentials of a former employee of an affiliated physician’s office. For a year’s time, the unauthorized access took place on a daily basis -- and without detection due to a failure to monitor of database activity. Read the Resolution Agreement.
- Timely breach response:
A case involving Children’s Medical Center of Dallas (Children’s) stemmed from impermissible disclosure of unsecured, electronic health information and non-compliance with HIPAA standards over many years, according to the Feds. The Feds issued a notice to Children’s, which included instructions for how Children’s could file a request for a hearing. Children’s did not request a hearing. Children’s paid a civil penalty of $3.2 million, and the Feds called out the issue of timely response. Read the Press Release.
- Monitor databases:
This is essential to HIPAA compliance. In a case resulting in a $2.3 million settlement, the Federal Bureau of Investigation (FBI) notified 21st Century Oncology, Inc. (21CO)
on two separate occasions that patient information was illegally obtained by an unauthorized third party. Evidence included 21CO patient files purchased by an FBI informant. Among other things, the Feds determined that 21CO failed to implement procedures to regularly review records of information system activity, such as audit logs, access reports, and security incident tracking reports. Read the News Release.
The vast majority of HIPAA cases are resolved through corrective action plans that the Feds monitor. While that means no fine, you'll still have the Feds hovering over you for a while.