The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) secured a $2.175 million settlement from Sentara Hospitals, 12 acute care hospitals with more than 300 sites throughout Virginia and North Carolina, after its failure to accurately report a breach. This failure along with its other violations, even after advisement from OCR, increased the penalties Sentara received.
The initial complaint
HHS received a complaint April 2017 alleging that a Sentara patient was sent a bill containing another patient’s protected health information (PHI). Sentara initially reported 8 individuals affected, but the OCR investigation discovered 577 billing statements containing unsecured PHI were mailed erroneously after the information from 16,342 different mailing labels were merged.
OCR advised Sentara to report the breach as investigated, but the company would not comply, effectively augmenting their violations and penalties.
What rules were violated?
Sentara was in violation of accurate and timely self-reporting, breaking HIPAA Breach Notification Rule 45 CFR §§ 164.400–414. Under the Rule, businesses are required to notify all affected patients, HHS, and the media following a breach. Furthermore, Sentara Hospitals also failed to enact a business associate agreement with Sentara Healthcare (who sent the unsecured PHI) as required under HIPAA rule 45 CFR §§ 164.504(e)(2).
The penalties imposed on Sentara
The $2.175 million settlement is one of the largest fines so far this year, but Sentara also had to agree to create a corrective action plan. Policies and procedures had to be redeveloped and revised to comply with HIPAA. Sentara then has to communicate the changes to HHS within 90 days, implementing them within 60 days of approval. Finally, Sentara has to send OCR an implementation report within 120 days of initial implementation and for the next 6 years.
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