July 15, 2019

July 15, 2019

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Employee’s Illegal Access to Patient Records Results in Data Breach of 15,000 Patients: Hospital System to Pay for Violations

UMass Memorial Medical Center, Inc., and UMass Memorial Medical Group, Inc. (collectively, UMass) has agreed to pay $230,000 to settle claims alleging that that they violated the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and various other state patient privacy laws.

The Massachusetts Attorney General’s complaint alleges that that two employees in separate incidents improperly accessed patients’ protected health information (PHI).

Specifically, the complaint alleges that UMass failed to properly investigate the claims that an employee was improperly accessing PHI, and as a result failed to adequately protect PHI. The complaint details that an employee was illegally accessing patient’s PHI even after an internal investigation, prompted by a whistleblower, was closed. It was not until patients themselves began to report the fraudulent use of their or their family members PHI, in connection with the opening of accounts for cable, cell phone, and other utility services, that UMass re-opened the investigation and concluded that the employee had accessed over 2,400 patient-files. The employee was terminated as a result.

The second data breach occurred in 2014 as a result of another employee accessing, without authorization, a batch of invoice payments that contained patients’ PHI, by fraudulently using the credentials of another UMass employee. Although UMass suspended the employee, the complaint alleges that it failed to deactivate the employee’s electronic access credentials as specified in UMass’ policies. The Worcester Police Department then recovered a backpack that contained the paper PHI of 79 patients and ultimately concluded that the documents were taken by the same employee being investigated. The Attorney General’s complaint again alleges that UMass’ inaction and ineffective privacy policies contributed to the breach of the patients’ PHI.

It was not until January 30, 2015, that UMass informed the Attorney General’s Office that the improper access may have resulted in the breach of 13,205 patient’s PHI, and that the affected patients were to be informed.

This incident is another reminder that it is vital for hospitals and health systems to not only design strong patient privacy and security policies, but also to properly implement and maintain those policies when confronted with potential data breaches.

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About this Author


Daniel L. Walbright assists major hospitals and health care systems with issues including federal and state fraud and abuse compliance. His experience includes researching and drafting memoranda, conducting due diligence review, and drafting legal motions. Daniel has also worked with corporate clients, assisting with matters including private stock acquisition, Stark Law claims, joint ventures, defamation claims and OIG compliance issues.

During law school, Daniel interned for the Carle Foundation Hospital in Champaign, Illinois. In this role, he...