University of California Settles Potential HIPAA Privacy and Security Violations with OCR for $865,500

Friday, 8 July 2011
The U.S. Department of Health and Human Services, Office for Civil Rights (OCR) announced that the University of California at Los Angeles Health System which includes UCLA Ronald Reagan Medical Center, UCLA Santa Monica Medical Center, and Orthopedic Hospital, Resnick Neuropsychiatric Hospital, and the Faculty Practice Group of UCLA (UCLAHS) has agreed to settle potential violations under the HIPAA Privacy and Security Rules for $865,500. Read the OCR press release.

The settlement highlights that hospitals, physicians, and other covered entities must understand the importance of monitoring the level of access workforce members have to medical and health information. Covered entities must have policies and procedures in place and educate workforce members about only accessing records for necessary and permissible purposes. This settlement resulted from an investigation by OCR after certain celebrity/VIP patients at the UCLA facilities complained that hospital staff, including unauthorized physicians, had inappropriately accessed their health and medical information.

UCLAHS agreed to a Corrective Action Plan for a period of three years under the terms of the Resolution Agreement. The Corrective Action Plan requires UCLAHS to review/update its current HIPAA policies and procedures, conduct follow up workforce training, monitor compliance and submit a monitoring plan, and submit an implementation report and annual reports to OCR. of can be found attached to the Resolution Agreement.

The Resolution Agreement described the events that occurred that lead to the settlement as follows:
On June 5, 2009 and June 30, 2009, HHS began investigations of two separate complaints alleging that the Covered Entity was in violation of the Privacy and/or Security Rules. The investigations indicated that the following conduct occurred (“Covered Conduct”):
(i) During the period from August 31, 2005 to November 16, 2005, numerous Covered Entity workforce members repeatedly and without a permissible reason examined the electronic protected health information of Covered Entity patients, and during the period from January 31, 2008 to February 2, 2008, numerous Covered Entity workforce members repeatedly and without a permissible reason examined the electronic protected health information of a Covered Entity patient.

(ii) During the period 2005-2008, a workforce member of Covered Entity employed in the office of the Director of Nursing repeatedly and without a permissible reason examined the electronic protected health information of many patients.

(iii) During the period 2005-2008, Covered Entity did not provide and/or did not document the provision of necessary and appropriate Privacy and/or Security Rule training for all members of its workforce to carry out their function within the Covered Entity.

(iv) During the period 2005-2008, Covered Entity failed to apply appropriate sanctions and/or document sanctions on workforce members who impermissibly examined electronic protected health information.

(v) During the period from 2005-2009, Covered Entity failed to implement security measures sufficient to reduce the risks of impermissible access to electronic protected health information by unauthorized users to a reasonable and appropriate level.
 More information and background can be found in the iHealthBeat article, UCLA Health System Agrees to Pay $865K over Privacy Breaches, including a link to a statement on the settlement issued by UCLH Health System.

4th Circuit Affirms Withholding of WV Medicaid Funds

Wednesday, 6 July 2011
Today the United States Court of Appeals for the 4th Circuit affirmed a ruling by the district court in West Virginia which sustained a disallowance of federal funding by the Centers for Medicare & Medicaid Services (CMS) against the West Virginia Medicaid Program.

The 4th Circuit Decision in West Virginia Department of Health and Human Resources, Bureau for Medical Services vs. Kathleen Sebelius, et al. ruled that CMS acted within its authority when it withheld from the West Virginia Department of Health and Human Resources, Bureau of Medical Services, West Virginia'a Medicaid Program (DHHR) approximately $634,000 (which was reduced to approximately $446,000)in Medicaid funding, which represented it share of overpayment made to providers as a result of Dey, Inc., a pharmaceutical company, alleged fraud. CMS notified DHHR of the disallowance after Dey entered into an $850,000 settlement of claims brought by the West Virginia Attorney General on behalf of West Virginia under West Virginia's Consumer Credit and Protection Act.

The disallowance by CMS was calculated by multiplying the state's estimated damages allocable to Medicaid, approximately 67% by the settlement amount adn then multiplied this figure by West Virginia's FMAP rate of 78.14% to arrive at the $446,000 amount. The HHS Department of Appeals Board concluded that this allocation methodology was reasonable.

I have only done an initial review of the decision and won't go into the merits of the arguments at this time. Read the full decision for a more complete understanding of the decision and check out today's article in the Charleston Daily Mail.

2011 AHLA Annual Meeting: How to Use Social Media with @BobCoffield

Tuesday, 28 June 2011
Welcome How to Use Social Media session students and others.

I hope you enjoyed my presentation during the afternoon health care social media sessions at the 2011 American Health Lawyers Association Annual Meeting in Boston. The health care social media sessions this afternoon were a great introduction to a variety of practical and legal issues surrounding the world of social media and its impact on the health care industry.

Now it is time for you to do your "out of the classroom" social media assignment using the SOCIAL MEDIA bucket list. Click on the linked Google Doc and get started. Good luck!

Below is a copy of the written materials from today's session which were posted here using Scribd. If you want to review my Prezi slides from my presentation watch it below and then go explore Prezi

If you have any questions send me a Tweet at @BobCoffield. Follow along with the tweets from the AHLA Annual Meeting at #AHLABoston. David Harlow (@HealthBlawg) also set up a Cover It Live Twitter feed for the Annual Meeting tweets. Thanks for attending the session.



How to Use Social Media (AHLA Annual Mtg - Coffield)

AHLA Boston "TWEETup"

Tuesday, 21 June 2011
Plans are set for a "TWEETup" during the American Health Lawyers Association 2011 Annual Meeting next week in Boston. All registered health lawyers are welcome along with other Boston area Twitter friends, Boston's Health 2.0 community, health care social media aficionados, and anyone else interested in the intersection of social media and the law.

Come join us at the #AHLABoston TWEETup on Tuesday, June 28 starting around 5:30pm at the BrasserieJO bar located across from the Prudential Center at The Colonnade Hotel, 120 Huntington Avenue. The BrasserieJO is located down Huntington Avenue near the Boston Marriott Copley Place, the location of the annual meeting.

Check out the TwtVite set up by David Harlow at HealthBlawg and RSVP that you will be attending. Help us spread the word.

The TWEETup follows an afternoon of health care social media and the law sessions held as a part of the AHLA Annual Meeting. For full details of the sessions and registration information check out the AHLA Annual Meeting schedule here (PDF version).The sessions run from 2pm - 5:30pm and will include:

A Legal Ethics Safety Line for Health Lawyers Online: How to Practice Safe Social Networking
Alan S. Goldberg (@GoldbergLawyer), Annie Hsu

E-Discovery Litigation
Gary L. Kaplan (@Gary_L_Kaplan), Joshua P. Kubicki (@JKubicki)

Cutting the PowerPoint Clutter: Using Zen-Like Visuals for more Compelling and Memorable Presentations
Susan Peterson

Should Health Lawyers Use Social Media?
David Harlow (@HealthBlawg)

HIPAA Privacy Issues in Social Media
Jodi Goldstein Daniel (@JodiDaniel), Daniel S. Goldman (@danielg280)

How to Use Social Media
Robert L. Coffield (@BobCoffield), David Harlow (@HealthBlawg), Gary L. Kaplan (@Gary_L_Kaplan)

Triaging Social Media in the Healthcare Workplace: Assessment, Analysis and Action
Mark W. Peters

A special thanks to @HealthBlawg for helping find the location for the TWEETup. Thanks to all the AHLA health lawyer and others spreading the word about the tweetup. Be sure to follow @HealthLawyers and use the AHLA Annual Meeting hashtag: #AHLABoston.

WVHCA: Notice of Public Comment Period on Proposed Amendments to CON Standards for Megavoltage Radiation Therapy Services/Units

Monday, 20 June 2011
The West Virginia Health Care Authority has issued a Notice of Public Comment Period to obtain comments on proposed amendments to Certificate of Need Standards for Megavoltage Radiation Therapy Services/Units.

Here are the "proposed amendments" to the Megavoltage Radiation Therapy Services/Units. Here is a link to the current CON Standards for Megavoltage Radiation Therapy Services/Unit (Approved by Governor on October 9, 2002).

Written comments must be submitted to Tim Adkins, Director of Certificate of Need, at the West Virginia Health Care Authority, 100 Dee Drive, Charleston, West Virginia 25311, no later than July 15, 2011.

The Twitter Trap: Are we outsourcing our brains to the cloud?

Friday, 17 June 2011
The Twitter Trap by Bill Keller (@NYTKeller), Executive Editor of The New York Times captures many of the thoughts I have been having lately about the impact social media and technology is having on our society. Where does it end? What will be the future? How will it change us as humans? As a society? Like Mr. Keller, I have had similar feelings as I watch the impact on my 7 and 10 year old children.

Recently I have been preparing a presentation for the AHLA Annual Meeting at the end of June on the practical ways health lawyers can and should use social media. As a result I have tried to step back from the social media explosion to examine some of these issues, including the parallels between Mark Zuckerberg and Johannes Gutenberg referenced in Mr. Keller's piece.

I love this quote from Mr. Keller's article that helps visualize the innovation/disruption/impact cycle:
"My father, who was trained in engineering at M.I.T. in the slide-rule era, often lamented the way the pocket calculator, for all its convenience, diminished my generation’s math skills. Many of us have discovered that navigating by G.P.S. has undermined our mastery of city streets and perhaps even impaired our innate sense of direction. Typing pretty much killed penmanship. Twitter and YouTube are nibbling away at our attention spans. And what little memory we had not already surrendered to Gutenberg we have relinquished to Google. Why remember what you can look up in seconds?"
I also like his explanation of Twitter as a tool, "So let me be clear that Twitter is a brilliant device — a megaphone for promotion, a seine for information, a helpful organizing tool for everything from dog-lover meet-ups to revolutions."

His question around whether these new social media instruments are genuinely social is a good one. It is hard to see the answer to this when you are sitting in the midst of the social media cloud. One question that he doesn't address is how the collection of all this "collective social media data" about you and me will be used in the future. Is Facebook just one big social experiment. It now knows more about my family and friends than I can probably remember.

Take time away from your Twitter and Facebook posts, go read the article, and then sit back and take some quiet time to reflect on his message. I will leave you with this quote from Mr. Keller's article:
"The things we may be unlearning, tweet by tweet — complexity, acuity, patience, wisdom, intimacy — are things that matter."
Thanks to Jason Keeling (@JasonKeeling) for pointing out this insightful piece that was published back in print on May 22, 2011.

JP Morgan Healthcare Conference HIT Panel Discussion with Schmidt, Chopra, and Park

Sunday, 12 June 2011
If you follow health information technology and are interested in the future of health care take time and listen to this panel discussion on Innovation Opportunities for the Health Information Technology Market with Eric Schmidt, Chairman of Google, Aneesh Chopra, Federal CTO for the United States, Todd Park, CTO of HHS, and moderated by John Doerr, venture capitalist at Kleiner Perkins.

The panel discussion was part of the Annual J.P. Morgan Healthcare Conference held in January 2011.

To start off moderator, John Doerr has the audience rattle off a bunch of great questions for the panel to address. Just listening to the questions will make you want to listen to the panel discussion.

Thanks to Susannah Fox and Claudia Williams for tweeting the link. Thanks to Brian Ahier (@Ahier) for posting the Vimeo link to the panel discussion.