fines

CA proposes medical record privacy rules

Anne Zieger — Wed, 27 Aug 2008 10:42:12 -0400

The California legislature is considering a new bill that imposes health data privacy protections above and beyond those already required by HIPAA, alarmed by a recent rash of medical record snooping taking place at UCLA Medical Center. Legislators are responding to unauthorized peeping by employees at a wide range of records, including those of celebrities such as California First Lady Maria Shriver, Britney Spears and Farrah Fawcett.

Under a Senate measure, hospitals would be required to draft a plan to protect patient information. Meanwhile, the state would set up a new Office of Health Information Integrity, which would have the power to review plans and violations, as well as assess fines of up to $250,000 against people who violate patient record privacy. A companion bill, for its part, would allow fines of up to $250,000 against providers who breach patient record privacy.

To learn more about the bills:
- read this Los Angeles Times piece

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CA Blue plans will pay $13M in fines over cancellations

Anne Zieger — Fri, 18 Jul 2008 11:06:18 -0400

Two of the state of California's largest health plans have agreed to pay a combined total of $13 million in fines related to their practice of rescinding policies for members after those members became sick. The fines are the largest yet imposed by the state Department of Managed Health Care, which has been focused of late on stopping health plans from reviewing patient applications and canceling policies after the patient begins incurring large medical bills. In addition to the fines, the agreements will require the two plans, Anthem Blue Cross and Blue Shield, to offer new coverage to more than 2,200 beneficiaries. However, the two are not admitting any wrongdoing.

WellPoint-owned Blue Cross will pay a record $10 million fine, and will offer no-strings-attached coverage to 1,770 members whose policies were canceled since 2004. Competitor Blue Shield, meanwhile, will pay $43 million and offer new policies to 450 people whose policies were discontinued during the same period. Both health plans have agreed to set up a process to help ex-members recover medical bills paid out of pocket after they were dropped, as well as collect other damages, such as reimbursement for homes or business lost because unpaid medical bills ruined the patients' credit. The agreements follow on similar settlements with Kaiser Permanente, Health Net and PacifiCare.

To learn more about the agreements:
- read this Los Angeles Times piece

Related Articles:
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Indianapolis hospital fined $2M for drug violation

Fri, 27 Jul 2007 06:59:56 -0400

An Indianapolis, Ind.-based hospital has been fined $2 million by federal authorities for failing to accurately track stolen painkillers. Over the past two years, a pharmacy employee with St. Vincent Indianapolis Hospital allegedly stole 623,843 tablets of hydrocodone, turning them over to her adult son for street sale. Despite the high volume of drugs stolen--and tough laws mandating tight controls on this class of drugs--St. Vincent's wasn't aware the drugs were missing. The employee was caught when a local drug task force tracked the flow of drugs from the son to the hospital's outpatient clinic for low-income and uninsured patients, where his mother worked. The hospital has apologized for the weaknesses in its system which allowed the drugs to go missing unnoticed.

To learn more about the fine:
- read this piece in The Indianapolis Star

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Kaiser assessed record-breaking $3 million fine

Thu, 26 Jul 2007 06:59:58 -0400

Kaiser Permanente is being assessed a record $3 million fine by the state of California's Department of Managed Health Care (DMHC). The state says Kaiser hasn't done a good enough job of investigating problems--like questionable physician performance and patient complaints--that came to light when the health plan's kidney transplant program was forced to close.

State regulators said when they dug into how the kidney transplant debacle occurred, they found Kaiser was doing a grossly inadequate job of monitoring allegations of poor care. In particular, inspectors noted peer review standards varied tremendously from one Kaiser hospital to the other, with some hospitals referring problem cases to peer review 20 times more often than others.

Not only is the $3 million fine a record-setter, it's also the second in less than one year. Last August, DMHC fined Kaiser $2 million for its role in the transplant program collapse, as well as requiring it to donate $3 million more to promote organ donation.

To learn more about the fine:
- read this Los Angeles Times piece

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