Which of the following would be HealthCo’s best response to the attorney’s discovery request?

SCENARIO

Please use the following to answer the next QUESTION:

You are the chief privacy officer at HealthCo, a major hospital in a large U.S. city in state

A. HealthCo is a HIPAA-covered entity that provides healthcare services to more than 100,000 patients. A third-party cloud computing service provider, CloudHealth, stores and manages the electronic protected health information (ePHI) of these individuals on behalf of HealthCo.

CloudHealth stores the data in state

B. As part of HealthCo’s business associate agreement (BAA) with CloudHealth, HealthCo requires CloudHealth to implement security measures, including industry standard encryption practices, to adequately protect the data. However, HealthCo did not perform due diligence on CloudHealth before entering the contract, and has not conducted audits of CloudHealth’s security measures.

A CloudHealth employee has recently become the victim of a phishing attack. When the employee unintentionally clicked on a link from a suspicious email, the PHI of more than 10,000 HealthCo patients was compromised. It has since been published online. The HealthCo cybersecurity team quickly identifies the perpetrator as a known hacker who has launched similar attacks on other hospitals C ones that exposed the PHI of public figures including celebrities and politicians.

During the course of its investigation, HealthCo discovers that CloudHealth has not encrypted the PHI in accordance with the terms of its contract. In addition, CloudHealth has not provided privacy or security training to its employees. Law enforcement has requested that HealthCo provide its investigative report of the breach and a copy of the PHI of the individuals affected.

A patient affected by the breach then sues HealthCo, claiming that the company did not adequately protect the individual’s ePHI, and that he has suffered substantial harm as a result of the exposed data. The patient’s attorney has submitted a discovery request for the ePHI exposed in the breach.

Which of the following would be HealthCo’s best response to the attorney’s discovery request?

A. Reject the request because the HIPAA privacy rule only permits disclosure for payment, treatment or healthcare operations

B. Respond with a request for satisfactory assurances such as a qualified protective order

C. Turn over all of the compromised patient records to the plaintiff’s attorney

D. Respond with a redacted document only relative to the plaintiff

View Answer

Answer: B

Explanation:

The HIPAA privacy rule establishes national standards to protect individuals’ medical records and other individually identifiable health information (collectively defined as “protected health information”) and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically (collectively defined as “covered entities”)1 The rule requires appropriate safeguards to protect the privacy of protected health information and sets limits and conditions on the uses and disclosures that may be made of such information without an individual’s authorization1 The rule also gives individuals rights over their protected health information, including rights to examine and obtain a copy of their health records, to direct a covered entity to transmit to a third party an electronic copy of their protected health information in an electronic health record, and to request corrections1

The HIPAA privacy rule permits a covered entity to disclose protected health information for the litigation in response to a court order, subpoena, discovery request, or other lawful process, provided the applicable requirements of 45 CFR 164.512 (e) for disclosures for judicial and administrative proceedings are met2 These requirements include:

In response to a court order or administrative tribunal order, the covered entity may disclose only the protected health information expressly authorized by such order2

In response to a subpoena, discovery request, or other lawful process that is not accompanied by a court order or administrative tribunal order, the covered entity must receive satisfactory assurances that the party seeking the information has made reasonable efforts to ensure that the individual who is the subject of the information has been given notice of the request, or that the party seeking the information has made reasonable efforts to secure a qualified protective order2

A qualified protective order is an order of a court or administrative tribunal or a stipulation by the parties to the litigation or administrative proceeding that prohibits the parties from using or disclosing the protected health information for any purpose other than the litigation or proceeding for which such information was requested and requires the return to the covered entity or destruction of the protected health information (including all copies made) at the end of the litigation or proceeding2

Option A is incorrect because the HIPAA privacy rule does not only permit disclosure for payment, treatment or healthcare operations. The rule also allows disclosure for other purposes, such as public health, research, law enforcement, judicial and administrative proceedings, as long as the applicable conditions and limitations are met1

Option B is correct because it is consistent with the HIPAA privacy rule’s requirement for disclosures for judicial and administrative proceedings. By responding with a request for satisfactory assurances such as a qualified protective order, HealthCo is ensuring that the protected health information will be used only for the litigation and will be returned or destroyed afterwards2

Option C is incorrect because it is not consistent with the HIPAA privacy rule’s requirement for disclosures for judicial and administrative proceedings. By turning over all of the compromised

patient records to the plaintiff’s attorney, HealthCo is disclosing more information than necessary and may violate the privacy rights of other individuals who are not parties to the lawsuit2 Option D is incorrect because it is not consistent with the HIPAA privacy rule’s requirement for disclosures for judicial and administrative proceedings. By responding with a redacted document only relative to the plaintiff, HealthCo is not providing satisfactory assurances that the protected health information will be used only for the litigation and will be returned or destroyed afterwards2

Reference: 1: Summary of the HIPAA Privacy Rule | HHS.gov 2: May a covered entity use or disclose protected health information for litigation? | HHS.gov