HMO Revises Process to Obtain Valid Authorizations
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 on these forms before
responding to any disclosure requests, even if patients bring in their
own “authorization” form. The new authorization specifies what records
and/or portions of the files will be disclosed and the respective
authorization will be kept in the patient’s record, together with the
disclosed information.
| Clinic Sanctions Supervisor for Accessing Employee Medical Record Covered Entity: Outpatient Facility Issue: Impermissible Use and Disclosure A hospital employee's supervisor accessed, examined, and disclosed an employee's medical record. OCR's investigation confirmed that the use and disclosure of protected health information by the supervisor was not authorized by the employee and was not otherwise permitted by the Privacy Rule. 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. Among other corrective actions to resolve the specific issues in the case, a letter ...read more |
| Entity Rescinds Improper Charges for Medical Record Copies to Reflect Reasonable, Cost-Based Fees Covered Entity: Private Practice Issue: Access A patient alleged that a covered entity failed to provide him access to his medical records. After OCR notified the entity of the allegation, the entity released the complainant’s medical records but also billed him $100.00 for a “records review fee” as well as an administrative fee. 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. To ...read more |
| State Hospital Sanctions Employees for Disclosing Patient's PHI Covered Entity: Health Care Provider / General Hospital Issue: Impermissible Disclosure A nurse and an orderly at a state hospital discussed the HIV/AIDS status of a patient and the patient's spouse within earshot of other patients without making reasonable efforts to prevent the disclosure. Upon learning of the incident, the hospital placed both employees on leave; the orderly resigned his employment shortly thereafter. 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 ...read more |
| State Hospital Sanctions Employees for Disclosing Patient's PHI Covered Entity: Health Care Provider / General Hospital Issue: Impermissible Disclosure A nurse and an orderly at a state hospital discussed the HIV/AIDS status of a patient and the patient's spouse within earshot of other patients without making reasonable efforts to prevent the disclosure. Upon learning of the incident, the hospital placed both employees on leave; the orderly resigned his employment shortly thereafter. 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 ...read more |
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