PRIVACY + SECURITY BLOG

News, Developments, and Insights

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Speaking at the FTC Hearing on Data Security on December 12

12/13/18 Update: Here is the video from the session described below.

On Wednesday, December 12, 2018, I’ll be speaking at the Data Security hearing, part of the FTC Hearings on Competition and Consumer Protection in the 21st Century.  My panel begins at 1:00 PM:

The U.S. Approach to Consumer Data Security

Wednesday, December 12, 2018 from 1:00 PM to 2:30 PM

Participants:

Chris Calabrese
Center for Democracy & Technology

Daniel J. Solove
George Washington University Law School

David Thaw
University of Pittsburgh

Janis Kestenbaum
Perkins Coie LLP

Lisa J. Sotto
Hunton Andrews Kurth LLP

Moderator: James Cooper
Federal Trade Commission, Bureau of Consumer Protection

I previously spoke at an earlier hearing in this series back in September on a panel about consumer privacy protection (video / transcript).  The upcoming hearing focuses on data security.

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Yes, HIPAA Requires Medical Records to Be Emailed to Patients if Requested

Email Medical Records

Have you ever asked your healthcare provider to send you medical records by email?  Most likely, you’ve received the reply: “We can’t do that.  We can only fax them to you or provide you with a paper copy.”  This answer is wrong.

HIPAA’s right for individuals to access their health information, 45 CFR § 164.524, provides:

The covered entity must provide the individual with access to the protected health information in the form and format requested by the individual, if it is readily producible in such form and format; or, if not, in a readable hard copy form or such other form and format as agreed to by the covered entity and the individual.

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The Persistent Problems with Access to Records Under HIPAA

HIPAA Access to Medical Records

A study released last month in Jama Open Network entitled Assessment of US Hospital Compliance With Regulations for Patients’ Requests for Medical Records demonstrates that compliance with HIPAA’s right to access medical records remains woeful.  In the second half of 2017, researchers contacted 83 US hospitals and conducted a simulated patient experience to ask for medical records. Among the hospitals, the researchers found that “there was discordance between information provided on authorization forms and that obtained from the simulated patient telephone calls in terms of requestable information, formats of release, and costs.”  On forms, “only 53% provided patients the option to acquire the entire medical record.”  The study concluded that “Requesting medical records remains a complicated and burdensome process for patients despite policy efforts and regulation to make medical records more readily available to patients. Our results revealed inconsistencies in information provided by medical records authorization forms and by medical records departments in select US hospitals, as well as potentially unaffordable costs and processing times that were not compliant with federal regulations.”

I addressed this topic in a blog post about 2 years ago. At that time, I said:

HIPAA doesn’t handle patient access to medical records very well. There are many misunderstandings about patient access under HIPAA that make it quite difficult for patients to obtain their medical information quickly and conveniently. Getting records is currently like a scavenger hunt. Patients have to call and call again, wait seemingly forever to get records, and receive them via ancient means like mail and fax. I often scratch my head at why fax is still used today — it’s one step more advanced than carrier pigeon.  Many covered entities do not send records by email, and getting electronic copies can be quite difficult. Many healthcare providers still maintain paper records in handwriting, and healthcare lags far behind most other industries in the extent to which it has moved to digital records.

Sadly, as this study confirms, little has changed.

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HIPAA Enforcement Case – Allergy Associates

HIPAA Enforcement

Allergy Associates of Hartford has agreed to pay $125,000 to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) for an alleged violation of HIPAA. The incident occurred in February 2015.  A patient reached out to a local TV station about a dispute with a doctor at Allergy Associates. When the reporter contacted the doctor for comment, the doctor improperly disclosed the patient’s PHI.  After Allergy Associates learned that HHS was investigating this incident, no disciplinary action was taken against the doctor.  According to the Resolution Agreement:

(1) Allergy Associates impermissibly disclosed the Complainant’s PHI to an unauthorized third party. See 45 C.F.R. § 164.502(a).

(2) Allergy Associates failed to apply appropriate sanctions against its Workforce Member who failed to comply with the entity’s privacy policies and procedures and the Privacy Rule. See 45 C.F.R. §164.530(e)(l).

According to the HHS press release:

“When a patient complains about a medical practice, doctors cannot respond by disclosing private patient information to the media,” said OCR Director Roger Severino. “Because egregious disclosures can lead to substantial penalties, covered entities need to pay close attention to HIPAA’s privacy rules, especially when responding to press inquiries.”

The press release can be viewed here.  The Notice of Proposed Determination can be viewed here. The Resolution Agreement can be viewed here.

Also of Interest Regarding HIPAA

HIPAA Enforcement Guide

HIPAA Training Guide

HIPAA Enforcement 2017: Another Big Year for HIPAA Enforcement

Why Is HIPAA Data Breach Enforcement Increasing? An Insurer’s View from Katherine Keefe

HIPAA Training Courses

HIPAA Training Requirements FAQ

HIPAA Whiteboard

HIPAA Resources

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Key EDPB (European Data Protection Board) Documents for GDPR

EU Article 29 Working Party GDPR Guidance

The EDPB (European Data Protection Board) was created by the EU Data Protection Directive in 1996.  Its purpose is to provide advice, opinions, and guidance about data protection.  The EDPB (European Data Protection Board) is composed of a representative from each EU member state.

Below are some of the most important guidelines to be issued by the EDPB (European Data Protection Board) about the General Data Protection Regulation (GDPR).

Right to Data Portability (WP 242)

Guidelines on the right to “data portability” (wp242rev.01)

Data Protection Officers (WP 243)

Guidelines on Data Protection Officers (‘DPOs’) (wp243rev.01)

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The Mail Machine Ate My Thumb Drive

USB zDrive - Thumb DriveIn the annals of what must be one of the most ridiculous data security incidents, a law firm employee sent a client file on an unencrypted thumb drive in the mail.  The file contained Social Security information and other financial data.

Seriously?

Envelope

The envelope arrived without the USB drive. The firm contacted the post office.

What happened next is most bizarre.  Here’s an excerpt from the law firm’s letter notifying the state attorney general:

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HIPAA Cartoon: Notice of Privacy Practices

Cartoon HIPAA Notice - TeachPrivacy HIPAA Training 02 medium

This HIPAA cartoon involves the notice of privacy practices (NPP) under HIPAA.  HIPAA has a set of detailed requirements for the NPP.  See 45 CFR 164.520 for the text of HIPAA’s requirement for NPPs.

The biggest challenge regarding privacy notices is that hardly anyone actually reads the notice, and notices are often a chore to read.

There is a Hobson’s choice when it comes to such notices, whether under HIPAA or otherwise.  As I wrote in Privacy Self-Management and the Consent Dilemma, 126 Harvard Law Review 1880 (2013): “[M]aking [notices] simple and easy to understand conflicts with fully informing people about the consequences of giving up data, which are quite complex if explained in sufficient detail to be meaningful.  People need a deeper understanding and background to make informed choices.”  Sadly, there’s no easy way to win on this one.

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The Future of Cybersecurity Insurance and Litigation: An Interview with Kimberly Horn

Cybersecurity litigation is currently at a crossroads. Courts have struggled in these cases, coming out in wildly inconsistent ways about whether a data breach causes harm. Although the litigation landscape is uncertain, there are some near certainties about cybersecurity generally: There will be many data breaches, and they will be terrible and costly. We thus have seen the rise of cybersecurity insurance to address this emergent and troublesome risk vector.

I am delighted to be interviewing Kimberly Horn, who is the Global Focus Group Leader for Cyber Claims at Beazley. Kim has significant experience in data privacy and cyber security matters, including guiding insureds through immediate and comprehensive responses to data breaches and network intrusions. She also has extensive experience managing class action litigation, regulatory investigations, and PCI negotiations arising out of privacy breaches.

 

Kimberly Horn

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