Mental Health/substance abuse providers and providers treating HIV/AIDS patients are held to a higher standard when it comes to protecting medical records, requiring additional levels of consent and analysis prior to productions. However, recent settlements published by the Office of Civil Rights of the Department of Health and Human Services (OCR) on September 15, 2020 remind all providers that patients and their authorized representatives have a right to access their records.
Right to Access Initiative:
In 2019 OCR launched the Right to Access Initiative based on concerns that had arisen that health care providers were not responding to request for records in a timely manner. In 2019, OCR’s Right to Access Initiative resulted in financial penalties and corrective action plans for two providers who had failed to provide patients with timely access to their records as required under HIPAA. Bayfront Health St. Petersburg, a Florida hospital, paid $85,000 and adopted a corrective action plan requiring one year of monitoring after a patient’s complaint to OCR led to the release of records nine months after the initial request. Korunda Medical, LLC., a primary care and pain management provider, also in Florida, paid the same amount and agreed to a similar one-year compliance monitoring arrangement as a result of its delays in forwarding records to a third party, failure to provide records in an electronic format, and overcharging for the records.
The Right to Access Initiative suffered a setback on January 23, 2020 when a federal court vacated the “third-party directive” within the individual right of access “insofar as it expands the HITECH Act’s third-party directive beyond requests for a copy of an electronic health record with respect to [protected health information] of an individual . . . in an electronic format.” Additionally, the court ruled that the fee limitation set forth at 45 C.F.R. § 164.524(c)(4) will apply only to an individual’s request for access to their own records, and does not apply to an individual’s request to transmit records to a third party. Ciox Health, LLC v. Azar, et al., No. 18-cv-0040 (D.D.C. January 23, 2020). OCR has posted a notice that its previous third party directive guidance is restricted by the Ciox order but also reaffirmed that the right of individuals to access their own records and the fee limitations that apply when exercising this right has not changed.
Five New Settlements:
On September 15, 2020, OCR issued a press release announcing five additional settlements pursuant to its HIPAA Right to Access Initiative. All the settlements involved failure to produce records to just one individual. Three of the five settlements involved providers of mental health/psychiatric services, one provider treated HIV/AIDS patients and one provider helped with pain management. Additionally, three of the five settlement involved continued complaints from the same individual after “technical assistance” had been provided by OCR to the providers. The penalties ranged from $3,500 to $80,000. All providers also agreed to sign corrective action plans requiring government oversight for either one or two years.
These five additional settlements demonstrate that OCR continues to take the issue of right to access seriously, and that a complaint from one individual is enough to trigger monetary penalties and a correction action plan with government monitoring. Providers, including those who provide mental health and substance abuse services, should review their HIPAA policies and procedures and ensure that they are being followed and requested documents are being provided in a timely manner.