In late August, the HHS Office for Civil Rights ("OCR") announced an $80,000 settlement with United Healthcare Insurance Company ("United") relating to OCR's right of access initiative (the "Initiative") which requires that patients be able to access their health information in a timely manner. United admitted no wrongdoing as part of the settlement but it did agree to enter into a one-year corrective action plan ("CAP") with OCR.
United is the 45th settlement that OCR has entered into pursuant to the Initiative.
What You Need to Know:
- National Payor enters into an $80,000 settlement and corrective action plan with HHS OCR.
- Payors of all sizes must timely respond to individuals' requests for copies of their medical records.
- OCR is aggressively enforcing the rights of individuals to have timely access to their protected health information.
In March 2021, OCR received a complaint that United did not respond to an individual's request for a copy of their medical record. According to the OCR press release announcing the United settlement, the individual initially requested a copy of their records in January 2021 but did not receive their records until July 2021, and only after OCR initiated its investigation of United's conduct.
In addition to paying the $80,000 settlement, as part of the CAP United agreed to do each of the following:
- review and revise, as necessary, its policies and procedures related to an individual's timely right of access to their protected health information to assure compliance with the Initiative;
- as part of the release of the policies and procedures, require a signed compliance certification from all United workforce members who received the policies and procedures that they have read, understand and will abide by the policies and procedures;
- provide workforce training to United workforce members, including a certification by these members that they received the training;
- submit every 90 days for the duration of the CAP a report to HHS of the written requests for an individual's records received by United, including the date the request was made and the date the request was fulfilled; and
- during the term of CAP, report to HHS each instance when a member of the United workforce failed to comply with the policies and procedures.
A copy of the United CAP is located here.
OCR has been aggressive in enforcing the Initiative and pursuing settlements where appropriate. Covered entities – payors and providers – of all sizes need to timely reply to individuals' requests for copies of their medical records.
Saul Ewing attorneys regularly assist covered entities and business associates with implementing and updating their HIPAA policies and responding to OCR inquiries. Please reach out to the authors of this alert or the attorney at Saul Ewing with whom you are regularly in contact.
