nurse hipaa violation cases

Data were accessed by unknown third parties after ePHI data was unwittingly transferred to a server accessible to the public. Nurse Pleads Guilty to HIPAA Violation A licensed practical nurse who pled guilty to wrongfully disclosing a patient's health information for personal gain faces a maximum penalty of 10 years imprisonment, a $250,000 fine or both. Read More, Paradise Family Dental was investigated in response to a complaint that a parent had not been provided with a copy of her minor childs medical records, despite submitting multiple requests to the practice. Read More, OCR investigated a complaint from a mother who requested a copy of her sons medical records from St. Josephs Hospital and Medical Center but had not been provided with a complete set of the records. 0:57. A nurse practitioner who has privileges at a multi-hospital health care system and who is part of the systems organized health care arrangement impermissibly accessed the medical records of her ex-husband. Read More, Beth Israel Lahey Health Behavioral Services (BILHBS) is the largest provider of mental health and substance use disorder services in eastern Massachusetts. An OCR investigation indicated that the form the HMO relied on to make the disclosure was not a valid authorization under the Privacy Rule. The impermissible disclosures of PHI resulted in a $10,000 settlement. OCR received a complaint from a patient who alleged he had been denied access to his medical records. Among other steps to resolve the specific issue in this case, OCR required the private practice to revise its access policy and procedures to affirm that, consistent with the Privacy Rule standards, patients have access to their record regardless of whether another entity created information contained within it. A was charged with violating the Health Insurance Portability and Accountability Act (HIPAA) and with "conspiracy to wrongfully disclose individual health information for personal gain with maliciously harmful intent in a personal dispute." Her husband was charged with witness tampering. OCR determined this violated the HIPAA Right of Access provision of the HIPAA Privacy Rule. If a nurse breaches HIPAA, a patient cannot sue the nurse directly for a HIPAA breach. Violations related to HIPAA laws have serious consequences, including job loss and other penalties. Nurses may violate HIPAA if they use non-approved channels to transmit patient information. In 2012 it suffered a security breach that exposed the data of 2,700 individuals as a result of a malware infection. Read More, OCR investigated three breaches involving the loss of a laptop computer and two unencrypted thumb drives containing patients PHI. A Georgia man has been sentenced to federal prison in an unusual case in which he portrayed himself as a whistleblower while falsely reporting to authorities that a hospital worker committed criminal HIPAA violations. The data breach investigation revealed a substandard security management process and a catalog of HIPAA Security Rule violations. OCR provided technical assistance to the covered entity regarding the requirement that covered entities seeking to disclose PHI for research recruitment purposes must obtain either a valid patient authorization or an Institutional Review Board (IRB) or privacy-board-approved alteration to or waiver of authorization. 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 made reasonable efforts to secure a qualified protective order. "HIPAA applies to schools.". Read More, Elite Primary Care is a provider of primary health services in Georgia. Also, computer screens displaying patient information were easily visible to patients. OCR determined there had been risk analysis failures, insufficient reviews of system activity, a failure to respond adequately to a detected breach, and insufficient technical controls to prevent unauthorized ePHI access. OCR settled the case for $5,000. Read More, Presence Health, one of the largest healthcare networks serving residents of Illinois, has agreed to pay OCR $475,000 to settle potential HIPAA Breach Notification Rule violations. Boston Medical Center agreed to settle the alleged HIPAA violations with OCR for $100,000. A violation due to willful neglect which is not corrected within thirty days will attract the maximum fine of $50,000. CHMC settled the HIPAA Right of Access case with OCR and paid an $80,000 penalty. These cases include civil monetary penalties, where it has been established that HIPAA Rules have been violated, and settlements, where HIPAA violations have been alleged to have occurred but the covered entity or business associate has decided not to contest the case and has instead chosen to pay a financial penalty to resolve the potential HIPAA violations with no admission of liability. Read More, Cancer Care Group, an Indiana-based radiation oncology private physician practice, has agreed to settle with the Department of Health and Human Services Office for Civil Rights for $750,000, for potential HIPAA violations relating to a 2012 data breach. In August 2012, Cancer Care Group discovered a laptop computer and unencrypted backup drive had been stolen from the vehicle of an employee. Issue: Safeguards. The trial court noted that HIPAA does not create a private right of action, but instead requires that violations be pursued via administrative channels (ie: by filing a complaint with HHS). The case was contested, but an administrative law judge ruled in favor of OCR. MAPFRE has agreed to a $2,200,000 settlement with OCR. One addressed the issue of minimum necessary information in telephone message content. In fact, even a competent healthcare facility will experience minor HIPAA violation cases at some point. But it's vital. Read More, Anchorage Community Mental Health Services (ACMHS) runs five mental health facilities in Alaska and is a non-profit organization. The case was settled for $850,000. OCR has increased its enforcement activities in recent years. The table above will be updated when the new penalty amounts for 2023 are finalized by the HHS. Read More, OCR has announced a $5.5 million settlement had been reached with Florida-based Memorial Healthcare Systems to resolve potential Privacy Rule and Security Rule violations. The case was settled for $3 million. Read More, The Department of Health and Human Services Office for Civil Rights has sent another warning to HIPAA-covered entities about the need to obtain signed, HIPAA-compliant business associate agreements with all vendors prior to disclosing any protected health information. CHCS will also pay a financial penalty of $650,000. Contacting individuals to participate in a research study is a use or disclosure of protected health information (PHI) for recruitment, as it is part of the research and is not an activity preparatory to research. OCR investigated and found multiple violations of the HIPAA Rules including a delayed response to a known security breach, risk analysis and risk management failures, and a lack of procedures to monitor information system activity logs. OCR Imposes a $2.15 Million Civil Money Penalty against Jackson Health System for HIPAA Violations - October 23, 2019 Dental Practice Pays $10,000 to Settle Social Media Disclosures of Patients' Protected Health Information - October 2, 2019 OCR Settles First Case in HIPAA Right of Access Initiative - September 9, 2019 The HIPAA Right of Access violation was settled with OCR for $30,000. Read More, Athens Orthopedic Clinic PA in Georgia had its systems hacked in 2016. Additionally, OCR required the covered entity to revise its Notice of Privacy Practices. The case was settled for $1,500,000. Read More, The city of New Haven in Connecticut was investigated over an incident where a former employee accessed its systems after termination and copied a file containing the ePHI of 498 individuals. > HIPAA Compliance and Enforcement The case was settled for $15,000. Detailed below is a summary of all HIPAA violation cases that have resulted in settlements with the Department of Health and Human Services Office for Civil Rights (OCR), including cases that have been pursued by OCR after potential HIPAA violations were discovered during data breach investigations, and investigations of complaints submitted by patients and healthcare employees. 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 the incident; one year probation; referral for peer review; and further training on HIPAA Privacy. An employee at a mid-size clinic was involved in a suit when an auto collision victim sued her spouse. A mental health center did not provide a notice of privacy practices (notice) to a father or his minor daughter, a patient at the center. Breach News If not, the form is invalid and any information released to a third party would be in violation of HIPAA regulations. Read More, Wise Psychiatry is a small provider of psychiatric services in Colorado. OCR received a complaint from a patient who alleged AIMS refused to give her a copy of her medical records. Among other corrective actions to remedy this situation, OCR required that the hospital revise its subpoena processing procedures. A private practice denied an individual access to his records on the basis that a portion of the individual's record was created by a physician not associated with the practice. Unprotected storage of private health information can be an issue. Taking this into account, the figures OCR is working with are detailed in the table below and will apply indefinitely, until the next increase to account for inflation. The cost-of-living adjustment multiplier for 2023 is 1.07745, but this has not officially been applied by the HHS. A grocery store based pharmacy chain maintained pseudoephedrine log books containing protected health information in a manner so that individual protected health information was visible to the public at the pharmacy counter. To avoid these, a proactive approach should include a regular risk assessment and corrective action plan. In more servers cases, or where multiple violations have occurred, the nurse may lose their job. The case was settled for $25,000. All rights reserved. Read More, After the permanent closure of the company, paperwork containing former patients PHI was discarded by FileFax. State Attorney Generals can also impose financial penalties on HIPAA-covered entities and business associates for violations of the HIPAA Rules. HIPAA Journal's goal is to assist HIPAA-covered entities achieve and maintain compliance with state and federal regulations governing the use, storage and disclosure of PHI and PII. The Department of Health and Human Services' Office for Civil Rights (OCR) has revealed a $65,000 HIPAA violation settlement has been agreed with West Georgia Ambulance, Inc., to address multiple breaches of Health Insurance Portability and Accountability Act Rules. There are four tiers of HIPAA violation penalties for nurses, ranging from unknowing violations to willful neglect of HIPAA Rules. To resolve this matter, OCR also required the practice to revise the office's fax cover page to underscore a confidential communication for the intended recipient. This discrepancy is expected to be addressed through further rulemaking to make the new penalty structure permanent. Read More, The Department of Health and Human Services Office for Civil Rights (OCR) has taken action against a Denver, CO-based federally-qualified health center (FQHC) for security management process failures that contributed to the organization experiencing a data breach in 2011. Covered Entity: Health Plans / HMOs A Nurse's Guide to the Use of Social Media discusses the case of a hospice nurse whose cancer patient had posted about her depression. The HIPAA Right of Access violation was settled with OR for $75,000. Read more, In 2015, Excellus Health Plan reported a breach of the ePHI of 9,358,891 individuals. OCR issued a written analysis and a demand for compliance. 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. The Notice of Enforcement Discretion only applied a cap to each violation tier. The following three years saw similar numbers of financial penalties; however, there was another major increase in HIPAA fines in 2020 when 19 HIPAA violation cases were settled with OCR. For example, texting or calling a coworker to ask about a shared patient's case would be a HIPAA violation. Under the revised policies and procedures, the practice may use and disclose PHI for research purposes, including recruitment, only if a valid authorization is obtained from each individual or if the covered entity obtains documentation that an alteration to or a waiver of the authorization requirement has been approved by an IRB or a Privacy Board. HIPAA calls for civil fines up to $25,000 per violation to be paid by the employer, and criminal fines up to $250,000 to be paid by the employer and/or the individual. An organizations willingness to assist with an investigation is also taken into account. The case was settled for $15,000. MIE also settled a multi-state action with state attorneys general and paid a penalty of $900,000. OCR investigated and found multiple potential HIPAA violations such as the failure to conduct a thorough risk analysis, risk management failures, and insufficient mechanisms to identify suspicious network activity. OCR intervened but received a second complaint a month later when the records had still not been provided. in Chicago, Illinois, was investigated in response to a complaint from a patient who had only been provided with a partial copy of her requested medical records. Pharmacy Chain Institutes New Safeguards for PHI in Pseudoephedrine Log Books In 2015, Premera discovered there had been a breach of the ePHI of 10,466,692 individuals. . The HIPAA Right of Access violation was settled with OCR for $5,000. The PHI of 58,106 patients was improperly disposed of during that timeframe. OCR intervened and closed the case but received a second complaint a month later when the records had still not been provided. The nonprofit teaching hospital has also agreed to adopt the OCRs corrective action plan to address HIPAA-compliance issues discovered by OCR investigators. CardioNet is a Pennsylvania-based provider of remote mobile monitoring and rapid response services to patients at risk for cardiac arrhythmias. The case was settled for $1,040,000. The nurse sent six text messages, warning the man's girlfriend about the disease. A study found that the average person spends about 52 minutes per day engaging in this type of conversation. 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. In some severe cases, yes, nurses can lose their jobs if they violate HIPAA. Covered Entity: Private Practice Although the Center gave the complainant the opportunity to review her medical record, this did not negate the Centers obligation to provide the complainant with a copy of her records. In April, nurses on the night shift at Denver Health Medical Center were caught making inappropriate comments about a male patient's genitalia, according to a report from the Colorado Department. Department of Justice is the authority that handles all the breach fines and charges for violating HIPAA regulations. Issue: Impermissible Uses and Disclosures. Issue: Impermissible Uses and Disclosures. OCR provided technical assistance but received another complaint from the same patient that the records had still not been provided. Resolution Agreements. Issue: Impermissible Uses and Disclosures. A complaint alleged that an HMO impermissibly disclosed a members PHI, when it sent her entire medical record to a disability insurance company without her authorization. A covered entitys obligation to comply with all requirements of the Privacy Rule cannot be conditioned on the patients silence. Nurses HIPAA Violation Examples The list of potential HIPAA violations by nurses is long so the most commonly experienced nurse HIPAA violations are listed below: PHI had been intentionally provided to the media on three separate occasions. OCR intervened and closed the case but received a second complaint a year later alleging the records had still not been provided. Read More, Memorial Hermann Health System agreed to settle potential HIPAA Privacy Rule violations with the Department of Health and Human Services Office for Civil Rights for $2.4 million. Read More, Skagit County, Washington is paying the price for failing to implement the appropriate controls and safeguards to protect the data it held. OCR intervened and provided technical assistance on the HIPAA Right of Access but received a second complaint when the practice continued to deny him access. Read More, OCR received a complaint from a patient of NY Spine, a private New York medical practice, who alleged she had not been provided with a copy of the diagnostic films that she specifically requested. The case was settled for $25,000. Criminal HIPAA violations and penalties fall under three tiers: Tier 1: Deliberately obtaining and disclosing PHI without authorization up to one year in jail and a $50,000 fine Tier 2: Obtaining PHI under false pretenses up to five years in jail and a $100,000 fine Covered Entity: Health Care Provider > For Professionals The Privacy Rule permits the imposition of a reasonable cost-based fee that includes only the cost of copying and postage and preparing an explanation or summary if agreed to by the individual. Read More, WellPoint is one of the largest providers of Affiliated Health Plans, with almost 36 million policyholders across the United States. St. Joseph Health has agreed to pay OCR $2,140,500. The investigation confirmed there had been a HIPAA Right of Access failure. HIPAA Violations: Nurse Looked At Her Mother's, Sister's Charts, Termination Upheld. The minimum fines are $100 per violation for tier 1, $1,000 per violation for tier 2, $10,000 per violation for tier 3, and $50,000 per violation for tier 4. To resolve the issues in this case, the hospital developed and implemented several new procedures. Mental Health Center Provides Access and Revises Policies and Procedures Read More, Great Expressions Dental Center of Georgia, P.C. However, the patient was not covered by workers compensation and had not identified workers compensation as responsible for payment. 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 on these forms before responding to any disclosure requests, even if patients bring in their own authorization form. Read More, Danbury Psychiatric Consultants in Massachusetts received a request for medical records on March 24, 2020, but access to the records was refused due to an outstanding bill. Therefore you should assess employees security awareness as part of a risk analysis to see if more training is required. Back to Top Enforcement Highlights and Numbers at a Glance Current Enforcement Highlights Enforcement Highlights Archived by Month Among other corrective actions to resolve the specific issues in the case, OCR required the hospital to develop and implement a policy regarding disclosures related to serious threats to health and safety, and to train all members of the hospital staff on the new policy. Covered Entity: Private Practices November 16, 2022. Read More, Memorial Hermann Health System in Texas received five requests from a patient for complete records to be provided between June 2019 and January 2020. OCR settled the case for $55,000. The nurse received the board notice for a hearing and the allegations against her, which involved breaching her duty to protect the patients' confidentiality and privacy rights in violation of the state's nurse practice act and administrative rules. To sign up for updates or to access your subscriber preferences, please enter your contact information below. This case study involving one nursing education program's experience with a HIPAA violation illustrates how one nursing college dealt with a student's HIPAA . A settlement of $85,000 was agreed upon with OCR to resolve the HIPAA violation. OCR received a complaint from a patient who had not been provided with her medical records after a 2-month wait. Read More, Mountlake Terrace, WA-based Premera Blue Cross is the largest health plan in the Pacific Northwest. The HIPAA Right of Access violation was settled with OCR for $70,000. Therefore, it . An employee's medical record is protected by the Privacy Rule, even though employment records held by a covered entity in its role as employer are not. The patient had requested a copy of her childs fetal heart monitor records, but 9 months after the request had been submitted the records still had not been provided. Clinic Sanctions Supervisor for Accessing Employee Medical Record The firewall was inactive for a period of 10 months leaving the data exposed and potentially accessible to unauthorized third parties for an unacceptable period of time. Read More, Southwest Surgical Associates in Texas took 13 months to provide a patient with all of the requested records between February 11, 2020, and March 5, 2021. Mental Health Center Corrects Process for Providing Notice of Privacy Practices Large Provider Revises Patient Contact Process to Reflect Requests for Confidential Communications Read More, An investigation into Anthem Incs massive 78.8 million-record data breach of 2015 revealed multiple HIPAA violations. Read More, OCR imposed a $2.154 million civil monetary penalty against the Miami, FL-based nonprofit academic medical system, Jackson Health System (JHS), for a slew of violations of HIPAA Privacy Rule, Security Rule, and Breach Notification Rule. The case was settled for $100,000. Read More, Puerto Rico Blue Cross Blue Shield licensee Triple S Management Corporation has agreed to pay a HIPAA violation fine of $3.5 million to the Department of Health and Human Services Office for Civil Rights. Read More, Washington, NC-based Metropolitan Community Health Services is a Federally Qualified Health Center. The new authorization specifies what records and/or portions of the files will be disclosed and the respective authorization will be kept in the patients record, together with the disclosed information. The disclosed information included details of patients visits, treatment, and insurance. ACMHS has agreed to settle the case with OCR for $150,000. Issue: Impermissible Disclosure. When dealing with these complex issues, you need legal representation that has a long track record of success in these types of cases. In addition to corrective action taken under the Privacy Rule, the state attorney general's office entered into a monetary settlement agreement with the patient. Read More, A $2.5 million settlement has been agreed upon with CardioNet to resolve potential HIPAA violations. Issue: Access, Authorization. The revised policy was implemented in the chains' stores nationwide. Read More, OCR fined Pagosa Springs Medical Center $111,400 for the failure to terminate a former employees access to a web-based scheduling calendar, which resulted in an impermissible disclosure of 557 patients ePHI. The case was ultimately unsuccessful; the court ruled in favor of the nurse. There may be a viable claim, in some cases, under state laws. The paperwork was taken by a member of the public who sold the material to a recycling facility. Covered Entity: Private Practice It took 225 days from the initial request for the records to be provided. The local newspaper then featured on its front page the individuals x-ray and an article that included the date of the accident, the location of the accident, the patients gender, a description of patients medical condition, and numerous quotes from the hospital about such unusual sporting accidents. The last update to the HIPAA violation penalty amounts applies to cases assessed on or after March 17, 2022, as detailed in the table below: *Table last updated in March 2022.

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