Assignment : answer real world case 9.1 and 9.2 questions; at least one

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Real-World Case 9.1   


HIPAA privacy breaches are of great concern and they occur too frequently. The Office for Civil Rights (OCR) in the Department of Health and Human Services reported in December 2018 that a critical access hospital in Colorado reached a settlement via a resolution agreement to pay $111,400 to HHS and to adopt a corrective action plan because it allowed a former employee to have continued remote access to ePHI, affecting 557 individuals. No business associate agreement had been signed with the former employee (HHS 2018b).


This case highlights that actions as simple as immediately terminating access to systems upon employment separation can avoid breaches. Procedures that incorporated a routine termination process would have prevented an incident of this nature.


The fact that this incident involved a critical access hospital, which is small by definition and in comparison, to its multi-hospital healthcare system counterparts, demonstrates that breaches and penalties resulting from breaches do not occur in large organizations only. Covered entities and business associates of all types and sizes can commit breaches and be penalized for them.

Real world case 9.1 questions


1.        What steps could a privacy officer have taken to prevent this breach?



2.         How would you have responded to the breach had it not been prevented at your healthcare organization?



3.         Should small healthcare organizations be charged fines for non-compliance with HIPAA? Justify your response.














Real-World Case 9.2       

Anndorie Cromar is a medical identity theft victim. A pregnant woman used Cromar’s medical identity to pay for maternity care at a nearby hospital. Because the infant was born with drugs in her ­system, the state’s child protective services (CPS) assumed she was Cromar’s infant and threatened to take Cromar’s four children away. It required a DNA test to get her name off of the infant’s birth certificate, but years to get her health records corrected. “That first stage was the most terrifying thing I’ve ever experienced in my life, getting the call from CPS and having them say, ‘We are coming to take your kids’” (Andrews 2016).


Medical identify theft is not detected and stopped readily like financial fraud, where the bank or credit card company calls when they see suspicious charges on a person’s account. Consumers therefore need to be particularly vigilant about information that can be stolen to commit medical identity theft: personal, medical, and insurance information. Consumers should do the following:


Scrutinize insurance company explanation of benefits forms and correspondence from healthcare providers and health insurers

Be suspicious of inaccurate statements and bills, including documentation relating to services they did not receive

Routinely review credit reports for debts that do not belong to them

Treat insurance cards and policy numbers with the same care as Social Security numbers, and not share them readily

Additionally, consumers should not post information about medical treatments on social media. A criminal could use that information, along with other personal data located online, to create a complete and accurate profile by which to exploit the victim. Once the perpetrator’s and victim’s medical information are intertwined, it is much more difficult to undo than simple financial identity theft cases. Further, because medical identity theft involves a person’s health profile, it cannot be shut down as quickly as a credit card number can (Andrews 2016).

Real world case 9.2 questions

1.         What could Anndorie Cromar, or any of us, do to prevent becoming a victim of medical identity theft?


2.         Why should healthcare organizations be interested in financial identity theft?

3.        What impact might medical identity theft have on the patient?


Health Information Management Technology,

An Applied Approach

Nanette Sayles, Leslie Gordon


Copyright ©2020 by the American Health Information Management Association. All rights reserved.

Except as permitted under the Copyright Act of 1976, no part of this publication may be reproduced,

stored in a retrieval system, or transmitted, in any form or by any means, electronic, photocopying,

recording, or otherwise, without the prior written permission of AHIMA, 233 North Michigan Avenue,

21st Floor, Chicago, Illinois 60601-5809 (


ISBN: 978-1-58426-720-1

AHIMA Product No.: AB103118



Privacy is a social value and is the right “to be let alone” (Rinehart-Thompson and Harman 2017). The US Constitution does not grant a right of privacy, but courts have interpreted it to give privacy rights in certain areas such as religion and child-rearing. Patients have a right to their privacy. ­Although there is no constitutional right of privacy to one’s health information, the health record is not a public document and – further – privacy protections to health information have been established through court cases as well as laws such as the Health Insurance Portability and Accountability Act (HIPAA), discussed in great detail in this chapter.

Confidentiality is similar to privacy, but it stems from the sharing of private thoughts in confidence with someone else. Legally, such sharing is protected when the communication is ­between parties such as physician and patient, attorney and client, or clergy and parishioner. Laws define those communications that are protected (Brodnik 2017a).


Use and Disclosure

Use is how a healthcare organization avails itself of health information internally, such as a nurse reviewing a patient’s health record. Disclosure is how health information is disseminated outside a healthcare organization. An example of disclosure is providing patient information to an insurance company. Use and disclosure are usually associated with the concepts of ownership and control of the health record because the organization that owns and controls the health record is also able to control the use and disclosure of its contents. Compliance with all applicable privacy and confidentiality laws and standards is important to avoid inappropriate use and disclosure of health information. Disclosure becomes very important when a healthcare organization is involved in litigation and health information becomes key evidence necessary for fact-finding during the discovery process and at trial, as described in chapter 8, Health Law.


State Laws—Privacy

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