Becker's ASC Review

53 HEALTHCARE NEWS Connecticut city pays $202K HIPAA fine for failing to terminate former health department employee's PHI access By Jackie Drees T he New Haven (Conn.) Health Department has agreed to pay HHS' Office for Civil Rights $202,400 over a 2017 HIPAA breach related to improper termination of a former employee's access to patient medical records. The health department filed a breach report with OCR in January 2017 stat- ing that a former employee may have accessed a file on its computer system that contained the protected health information of 498 individuals, accord- ing to the Oct. 30 news release. An OCR investigation discovered that on July 27, 2016, a former employee returned to the New Haven Health Department eight days after being fired and logged into her old comput- er using her still-active user account information. She then downloaded PHI including patient names, addresses, dates of birth, gender and sexually transmitted disease test results onto a USB drive. The former employee also shared her user ID and password with an intern, who continued to use the credentials to access PHI on the de- partment's network after the employee was terminated. OCR determined that the health department failed to conduct an enterprise-wide risk analysis and failed to implement termination procedures, access controls and HIPAA privacy rule policies and procedures. In addition to the financial settlement, the depart- ment has also agreed to a corrective action plan and two years of monitor- ing by the OCR. n ACA legality case has first encounter with Supreme Court: 6 takeaways By Kelly Gooch e U.S. Supreme Court heard the first arguments Nov. 10 in a case questioning the legality of the ACA. Six things to know: 1. In California v. Texas, a coalition of Republican-leaning states, led by Texas and backed by the Trump administration, argue the entire ACA is invalid because in December 2017, Congress eliminated the ACA's tax penalty for failing to purchase health insurance. e states argue the individual mandate requiring Americans to gain health insurance or pay a penalty is inseverable from the rest of the law and became unconstitutional when the tax penalty was eliminated; therefore, the entire health law should be struck down. 2. California Attorney General Xavier Becerra is leading a coalition of more Democratic states to defend the ACA before the Supreme Court. The coalition ar- gues the individual mandate leaves the decision of whether to carry insurance up to individual Americans, but even if eliminating the penalty makes the insurance requirement unconstitutional, the entire health law should not be struck down, and protections for preexisting conditions should remain intact, according to The Wall Street Journal. 3. e Republican officials brought their challenge to U.S. District Judge Reed O'Connor, with the Northern District of Texas, who ruled the ACA unconstitutional. Subsequently, in December 2019, the 5th Circuit Court of Appeals ruled the ACA's individual mandate is unconstitutional, but did not issue a decision on whether the entire law is therefore unconstitutional. Instead, the 5th Circuit sent that decision back to the Northern District of Texas to determine which portions of the ACA are inseverable from the individual mandate. e coalition led by Mr. Becerra filed a peti- tion to the U.S. Supreme Court seeking review of the 5th Circuit's decision, which was granted by the Supreme Court in March. 4. On Nov. 10, at least five Supreme Court justices indicated support for not striking down the entire ACA, according to The New York Times. The publication reported that Chief Justice John Roberts Jr. and Justice Brett Kavanaugh suggested striking down the individual mandate did not require striking down the rest of the law. "It does seem fairly clear that the proper remedy would be to sever the mandate provision and leave the rest of the act in place, the provisions regard- ing preexisting conditions and the rest," Justice Kavanaugh said, according to the Times and Journal. 5. According to the Times, Justices Stephen Breyer, Sonia Sotomayor and Elena Kagan also indicated they backed the ACA. e Journal reported that Justice Kagan noted the Supreme Court previously upheld the individual mandate when the penalty was several hundred dollars and said: "e only thing that's changed is something that made the law less coercive." 5. Justices Clarence omas, Samuel Alito Jr. and Neil Gorsuch appeared more likely to side with the argument from Republican officials, according to the Times, while Justice Amy Coney Barrett did not indicate a clear stance. 6. According to the Times, the Supreme Court is not expected to decide the case until June 2021. n

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