Leaves of 3 Let Them Be: Poison Ivy Advice from Dr. Coffield

Sunday, 10 April 2011
Last week I was looking through some old printed emails and I ran across advice about poison ivy from my dad, LeMoyne Coffield. Since Spring is on the way and the poison ivy is starting to grow I thought I would share this with everyone (including some good advice for the golfers).

My dad was not only my dad but he was my (our) family doctor. He was a lot of peoples family doctor. He had a wonderful way of providing advice and recommendations to his patients. His medical advice wasn't always the easiest and quickest solution - but it was usually the best long term practical advice.

I wrote him an email back in the Spring of 2000. I had been cleaning up an area behind our house and had gotten a bad case of poison ivy on my arms, neck, and face. I started the email by saying, "Thought I would let you know that spring has arrived -- I got my first bout of poison ivy. Some lessons you taught me as a child (and adult) have never gotten through." As children he was always pointing out poison ivy, showing us what it looked like, and hoping that we would learn how to spot it from a distance. My email went on to say that I had gone to see my primary care doctor and he had prescribed an oral steroid (prednisone) and I said, "What do you think?" Like I often did - I was emailing him for his second opinion. Below is his advice back to me. Good advice for anyone who is starting their spring yard cleaning.

By the way - if you don't know what poison ivy looks like look at this and remember, "Leaves of 3 let them be."

OCR Seeks FY2012 Budget Increase of $5.6M for HIPAA Compliance and Enforcement

Thursday, 17 March 2011
HealthLeaders reports that the Office of Civil Rights (OCR) is seeking an additional $5.6 million in its Fiscal Year 2012 budget proposal to fund its HIPAA compliance and enforcement activities.

The article also details the most current reported numbers on breaches reported to OCR. As of March 16 there have been 249 entities that have reported breaches affecting 500 or more individuals. To view the current data and details on reported breaches go to the OCR Breaches Affecting 500 or More Individuals.

OCR Imposes $4.3M Penalty for Violation of HIPAA/HITECH Privacy Rule

Tuesday, 22 February 2011
UNTIL TODAY, many health care providers questioned whether HHS and the Office of Civil Rights (OCR) would ever issue any significant penalties for violations of the HIPAA Privacy Rule. However, will OCR ever be able to collect the penalties.

Today, HHS Office of Civil Rights (OCR) announced a civil money penalty (CMP) of $4.3 million against Cignet Health of Prince George's County, MD for violating the HIPAA Privacy Rule. This is the first ever civil money penalty issued by OCR for a violation of the HIPAA Privacy Rule. It is significant not only because it is the first - but also because of the size of the penalty and the basis for the violation.

OCR issued a Notice of Final Determination on February 4, 2011, outlining the procedure for payment of the $4.3 million civil money penalty. The Notice of Final Determination also indicates that Cignet failed to request a hearing on the matter or reach settlement with OCR. Prior to the issuance of the final notice, OCR had issued a Notice of Proposed Determination on October 20, 2010, which details the basis for the penalty, details the findings of fact, grounds for violation of HIPAA, and calculation of the penalty amount.

The Notice of Proposed Determination indicates that Cignet violated HIPAA by failing to provide individuals access to their health information under 45 CFR 164.524 and failed to cooperate with an investigation under 45 CFR 160.310(b). The Notice states:
1. Failure to Provide Access (45 C.F.R. § 164.524). Cignet failed to provide 41 individuals listed in Attachment A timely access to obtain a copy of the protected health information about them in the designated record sets (medical records) maintained by Cignet. These failures constitute violations of 45 C.F.R. § 164.524. Cignet's failure to provide each individual with access constitutes a separate violation of 45 C.F.R. § 164.524, and each day that the violation continued (that is, from the date specified in column 5 of Attachment A until April 7,2010) counts as a separate violation of 45 C.F.R. § 164.524.

2. Failure to Cooperate with an Investigation (45 C.F.R. § I60.310(b)). Cignet failed to cooperate with OCR's investigation of 27 complaints regarding Cignet's noncompliance described in paragraph 1 above. These failures to cooperate with an investigation constitute violations of 45 C.F.R. § 160.310(b). Cignet's failure to cooperate with OCR's investigation of each complaint constitutes a separate violation of 45 C.F.R. § 160.310(b), and each day that the violation continued (that is, from the date specified in column 7 of Attachment A until April 7, 2010) counts as a separate violation of 45 C.F.R. § 160.310(b). Each violation of 45 C.F.R. § 160.310(b) was due to Cignet's willful neglect of its obligation to comply with 45 C.F.R. § 160.310(b). Willful neglect means the conscious, intentional failure or reckless indifference to the obligation to comply with the administrative simplification provision violated. See 45 C.F.R. § 160.401.
The press release issued by HHS points out that the HIPAA Privacy Rule requires that health care providers must provide a patient with access and/or copy of their health information within 30 days (and no later than 60) days after the patient requests such information. Further, the press release indicates that covered entities and business associates must uphold their responsibility to provide patients with access to their own health information.

Read the HHS Press Release and OCR Press Release. More details via the OCR's Resolution Agreement page. For more background on Cignet Health check out David Harlow's post at HealthBlawg, HIPAA CMP's: What's the point?

WVDHHR Transfers OHFLAC Staff and Operations to OIG

Monday, 31 January 2011
According to the West Virginia Department of Health and Human Resources (DHHR), the West Virginia Office of Health Facility Licensure and Certification (OHFLAC) will be transferred to the West Virginia Office of Inspector General (OIG) effective February 1, 2010. OHFLAC oversees the state and federal licensure and certification process in West Virginia for hospitals, critical access hospitals, behavioral health facilities, home health agencies, hospice agencies, ESRD services, and other health care services.

All personnel and positions currently assigned to OHFLAC will be administratively transferred. DHHR has states that this action is to further enhance the integrity of the regulatory unit of the Department of Health and Human Resources.

Body Browser: Think Google Earth for the Human Body!

Friday, 17 December 2010
Yesterday Google released Body Browser. Think Google Earth for human anatomy.

Body Browser is described as a 3-dimensional multi-layered anatomical model of the human body that you can rotate, zoom in on, and search. More information about Body Browser is available in Google Labs.

Great to see Google developing this new tool that should be useful for educators, physicians, and others in the health care field. I can't wait to show this new tool to my kids.

Thanks to Brian Klepper over at Care and Cost for blogging about this new Google health tool.

Very cool!

West Virginia Connect

Sunday, 12 December 2010
Today's Charleston Gazette features an article on a new health care demonstration project, West Virginia Connect, funded by a $36 million federal Health Resources and Services Administration (HRSA) grant.

The article indicates that the funding will be for eight West Virginia primary care clinics to provide preventative care services to eligible health consumers for a flat $35 per month. The services will include unlimited doctor visits, immunizations and screenings, chronic disease management, and minor surgical procedures.

To be eligible to particpate a person must have a job, be between 19 and 64, and make less than $43,320 for a single person or $88,200 for a family of four. In return, participants have to let the state fold their medical data - blood pressure, blood sugar, etc. - into an anonymous 10,000-person database the state plans to use to make more informed choices as health-care reform unfolds.

The article indicates that the primary care centers involved say the project is intended to:
  • generate useful information about uninsured West Virginians and cost-effective ways to treat chronic diseases;
  • demonstrate lowered emergency room usage, hospital stays, and times when people don't show up for appointments;
  • develop an electronic patient tracking system other centers can use;create a catalogue of best practices that help people take better care of their own health;
  • help the health system get ready for 2014, when hundreds of thousands will be newly insured through federal reform.
This is the first I have heard about this demonstration project. Other than this Grantee Project Abstract at HRSA website, I was unable to find any additional information or links about the demonstration project online. The article indicates that the project is currently governed by a steering committee of the DHHR secretary, insurance commissioner, and director of the GO HELP office.

West Virginia PEIA: Innovative Steps to Improve Long Term Health of West Virginia

Sunday, 5 December 2010
This past week the West Virginia Public Employees Insurance Agency (PEIA) announced a creative and proactive health initiative to improve the health of West Virginians and move toward keeping future health care costs down for state and public school employees and ultimately for West Virginia taxpayer. Charleston Gazette's Phil Kabler reports on the initiative in "PEIA insurees can offset premiums increase."

The Improve Your Score initiative is a part of PEIA's Pathways to Wellness. PEIA announced that state and public school employees will have no health care premium increase this year if they comply with two requirements.The two requirements:
  • Undergo a four-step wellness screening to measure waist circumference, total cholesterol, blood pressure, and blood glucose. Completion of the screening provides a $10-a-month premium discount.
  • Submit an affidavit verifying they have filed an advanced directive for end-of-life care, sometimes called a "living will." That provides an additional $4-a-month discount.
Wonderful to see West Virginia, often more known nationally for unhealthy news, taking a proactive approach to improving West Virginians health by promoting a wellness activity and encouraging end of life care planning. Both initiatives will help to curb the long term impact on our state's health care cost problems and help West Virginia's become more active in understanding and managing their (un)healthy problems.