HIPAA Violation and Hospital Employee viewing PHI

hospital employee who committed a HIPAA violation

HIPAA Violation rocks hospital!  An employee at St. Charles Health system accessed over 2400 patients’ medical records over a two-year period because they were curious. We all know that curiosity killed the cat and now it may have direr consequences for this curiosity seeker and the hospital system.

 

HIPAA Violation without intent to commit fraud

The employee who viewed the protected health information (PHI) without a legitimate reason to do so is in jeopardy of large civil fines, loss of their respective clinical license and criminal prosecution. Not to mention termination from their present position. The hospital system has to repair its damaged reputation while at the same time prepare to defend itself against potential civil/criminal lawsuits.  There are too many incidences were an organization is liable for HIPAA violations, even though they “didn’t do it”.

Now the local District Attorney has taken interest in this matter and is launching a criminal investigation. Under the HIPAA statute there is no individual right of action, however, the Attorney General of the state where the infraction took place may file charges on the individual(s) behalf.

The aforementioned employee signed an affidavit stating that the HIPAA violation they committed, and any of the information they accessed was not to commit fraud, however, that did not halt the criminal investigation.

 

Hospital employee viewing PHI

This real-life incident demonstrates how healthcare providers and their employees can face serious trouble for viewing records inappropriately. Just remember this incident when you want to be inquisitive about a patient that you are not treating or accessing a patient’s medical records for no business purpose.

When performing your job function, it is not a HIPAA violation if you release and/or access a patient’s PHI for treatment, payment or health operations (TPO). When accessing and/or releasing a patient’s PHI, ask yourself does this fall under the TPO exceptions? If it does, then you should just release the minimum information necessary to complete the task and if it does not, then you may need an authorization signed by the patient or his/her representative. In the event you are unsure if you can release and/or access a patient’s PHI, contact your supervisor or your organization’s Privacy Officer.

Finally, this violation reaffirms the need to conduct a HIPAA Risk Analyses, including monitoring the privacy/breach rule.  Use your policies and procedures for efficient and effective training, auditing and monitoring.

Remember there is no right way to do the wrong thing.  If you are now asking yourself could this happen to me, it may be time to re-examine your corporate compliance program.

When you need proven expertise and performance

Jeffery M. Scribner, BS, CHC, CRM

Jeffery M. Scribner has over 20 years’ experience in the compliance field. He has been the Chief Compliance and Privacy Officer for publicly traded companies, HMOs, large healthcare systems, skilled nursing facilities, home health agencies and physician practices.

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