Tag Archives: dentist

$100,000 HIPAA Fine – Way Too Little, and Way Too Late

After more than five – FIVE – years of the HIPAA rules, and bazillions of small private practices of doctors, dentists, chiropractors, optometrists, shrinks, etc., NOT being compliant with the rules, and bazillions more patients who have no clue what their HIPAA healthcare privacy rights are, HHS finally got off their heinie and fined a hospital system in Washington State because it kept leaving those pesky laptops lying around, getting stolen, and not doing anything about it.  More than 386,000 patients’ healthcare information was lost on those laptops.  (Note to self — isn’t almost every loss of patient information lately been due to the loss of a laptop?  Must investigate why hospitals let members of their workforce walk out the door with laptops full of patient data. . .)

But wait – what’s that you say?!  It’s not a fine??  Why, by gosh and by golly, you’re right.  HHS has declined to call this a “fine” – they’re calling it a Resolution Amount.  Oh.  Yeah, that makes it all better.

Here’s how HHS describes it: “In the agreement, Providence agrees to pay $100,000 and implement a detailed Corrective Action Plan to ensure that it will appropriately safeguard identifiable electronic patient information against theft or loss. The Resolution Agreement relates to Providence’s loss of electronic backup media and laptop computers containing individually identifiable health information in 2005 and 2006. . .

“On several occasions between September 2005 and March 2006, backup tapes, optical disks, and laptops, all containing unencrypted electronic protected health information, were removed from the Providence premises and were left unattended. The media and laptops were subsequently lost or stolen, compromising the protected health information of over 386,000 patients. HHS received over 30 complaints about the stolen tapes and disks, submitted after Providence, pursuant to state notification laws, alerted patients to the theft. Providence also reported the stolen media to HHS. OCR and CMS together focused their investigations on Providence’s failure to implement policies and procedures to safeguard this information.

“As a result, Providence agrees to pay a $100,000 resolution amount to HHS and implement a robust Corrective Action Plan that requires: revising its policies and procedures regarding physical and technical safeguards (e.g., encryption) governing off-site transport and storage of electronic media containing patient information, subject to HHS approval; training workforce members on the safeguards; conducting audits and site visits of facilities; and submitting compliance reports to HHS for a period of three years.”

After pulling up the handy calculator that Microsoft ® XP ® so nicely provides, I’ve calculated that each patient’s healthcare info was worth, let’s see, 100,000 divided by 386,000 =  about .259; which is 25.9¢.  Is that right?  Let’s check: (.259)(386000) = 99,974.  Okay, close enough. 

What this means is, if you were one of those folks whose healthcare information was stolen because Seattle-based Providence Health & Services couldn’t get its act together over a more than two-year period and ENCRYPT the data contained on the laptops, tapes, etc., or even PREVENT them from being stolen in the first place (GPS locator, anyone?  Sheesh, even my cell phone has one.), your healthcare info was worth a measly 25.9¢. 

All I can say is: wow.

Whether you’re a Democrat or a Republican or a Libertarian, or a Green, or an Independent, etc., a radical change in leadership at the level of the Cabinet position of Secretary of Health & Human Services (HHS) is called for.  You and your family’s health information has got to be worth more than a little over a quarter.  Really.

So, think carefully and VOTE.

I blog regularly about the HIPAA Privacy & Security Rules.  If you’ve got a question about the privacy of your healthcare records, email me at hipaadiva@yahoo.com.  I would be happy to help you if I can.

 

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It Could Happen to You — A Call to Arms

On August 1, I wrote about how Big Brother may not be just the government, but, surprisingly, also your friendly pharmacist.  The Business Week article that I was referring to (http://www.businessweek.com/magazine/content/08_31/b4094000643943.htm) talked about how someone can be turned down for health insurance because the pharmacies they’ve used in the past have sent their pharmacy information to Pharmacy Benefit Managers (PBMs), who in turn sell the information to third parties, who sell the information to health insurance companies, who then deny health coverage. 

Sweet, huh?  For the health insurance companies, anyway.  But not for you.  Or your family.

And the road from the pharmacy to the PBM to the third party is all done without your authorization.  Which seems kind of funny to me, because pharmacies are HIPAA “covered entities”, and they need to have your authorization to share your protected health information, except in very specific circumstances.

Now, the HIPAA Privacy Rules allow an entity called a “Business Associate” to do business with a covered entity such as a pharmacy.  In such cases, the pharmacy, as the covered entity, must execute what’s called a “Business Associate Agreement” with the business associate, and part of the agreement allows the covered entity to share identifiable protected health information so that the business associate can do all kinds of things, under contract, to the covered entity — in this case, the pharmacy.

Okay.  So far we have a covered entity, the pharmacy.  And we have a business associate of the pharmacy, the PBM, pharmacy benefit manager.  Why would the pharmacy contract with a PBM? 

Because PBMs do all kinds of useful things that they can probably do a lot less expensively than the pharmacy.  Wikipedia says this about PBMs: PBMs are “. . . third party administrator(s) of prescription drug programs. They are primarily responsible for processing and paying prescription drug claims. They also are responsible for developing and maintaining the formulary, contracting with pharmacies, and negotiating discounts and rebates with drug manufacturers.  Due to their larger purchasing pool for prescription drugs, PBMs can negotiate rebates and discounts on behalf of their clients.”

I think we can agree that PBMs provide very useful services to pharmacies, right?  Good.

The problem comes along when the PBM sells your identified protected health information to yet a third party, for a profit.

I have a problem with that, a huge problem. 

The HIPAA Privacy Rules don’t allow your identifiable protected health information to be sold without your authorization. 

When was the last time your pharmacy asked your permission to sell your protected health information, or the protected health information of your children?  Gosh, I don’t remember ever being asked by a pharmacy to do such a thing with my protected health information. . . 

So I’m asking for your support: I’d like you to send an email to Health & Human Services and ask them the following questions:

1.  Is a pharmacy a HIPAA covered entity?

2.  Is a Pharmacy Benefit Manager a business associate of a pharmacy?

3.  Can a business associate of a HIPAA-covered entity sell identifiable protected health information to a third party — for a profit — without the patient’s authorization?

Folks, the FTC has looked into this and not seen a problem with the practice of PBMs selling your identifiable protected health information.  But they are not responsible for the HIPAA Privacy Rules, Health & Human Services is.

So, please — send an email to OCRPrivacy@hhs.gov and ask them the above questions.  The more people who ask, the more they’ll pay attention and look at this very serious problem.

If you think this couldn’t really be an important issue, then I’d like to introduce you to Mr. Walter Shelton and his wife, Paula, who were denied health insurance because pharmacies they’d used in the past — WalMart and Randall’s (part of Safeway) — sent their identifiable protected health information to a PBM, who, without their authorization, sold it to a company called Med Point.  Med Point put together a pharmacy profile on them and sold it, along with the Shelton’s names, for $15 to Humana.  And then Humana rejected their insurance application because of the use of a couple of very minor medications that many of us may need to use at one time or other.

Have Humana?  How about Aetna?  Blue Cross/Blue Shield?  UnitedHealth Group?  Some other health insurance?  Do you ever get your prescriptions filled at WalMart?  Safeway?  Randalls?  Then yes, it COULD happen to you, when they sell information about you to Med Point or their competitor, IntelliScript, for just $15.

Please everyone, a quick email to OCRPrivacy@hhs.gov — remember, it’s Health & Human Services (HHS) that administers the federal medical privacy laws and rules — and ask them:

1.  Is a pharmacy a HIPAA covered entity?

2.  Is a Pharmacy Benefit Manager a business associate of a pharmacy?

3.  Can a business associate of a HIPAA-covered entity sell identifiable protected health information to a third party — for a profit — without the patient’s authorization?

Mr. Shelton has already sent his email to HHS, will you send one, too?  Just takes a minute.

THANK YOU!!!

I blog regularly on medical privacy issues, medical records, HIPAA, and other related issues.  If you have any questions about your medical privacy, your ability to get copies of your medical records, privacy problems with your doctors, dentists, chiropractors, psychologists, etc., please send me an email at hipaadiva@yahoo.com — I would be honored to help.