HIPAA Regulatory Alert: Who says 'No good deed goes unpunished'?
HIPAA Regulatory Alert
Who says 'No good deed goes unpunished'?
You'd think that any hospital in the country would be pleased to have its nurses come forward when they notice a physician practicing in a manner that is less than optimal for his or her patients. In fact, a number of states even allow the sharing of protected health information if it's necessary for such whistle-blowers to state their case.
But given recent events in Texas, you might want to re-educate your staff as to what they are and are not allowed to do in these cases: Two nurses at Winkler County Memorial Hospital in Kermit, TX, have not only lost their jobs, but they've been indicted with a third-degree felony, carrying potential penalties of imprisonment and a maximum fine of $10,000. The charge was "misuse of official information."
Here's what happened: The Winkler Memorial nurses reported the physician for what was, in their minds, questionable practice to the Texas Board of Medical Examiners. "Consequently, we believe, the doctor that they reported was notified by the board that he was being investigated," says Clair Jordan MSN, RN, executive director of the Texas Nurses Association. "He went to the sheriff and said the nurses were harassing him."
Local media reports said the nurses had filed their complaint anonymously, and that in order to bolster their case they had included six medical record numbers of the hospital patients involved. "That is what we were led to believe," adds Jordan.
The sheriff subsequently launched an investigation to find out who made the anonymous complaint. He obtained a search warrant, seized the nurses' work computers, and found a copy of the letter to the medical board on one of them. That's what led to the felony charges and the firing of the nurses.
The Texas Nurses Association responded by establishing a legal defense fund for the nurses, and filing a formal complaint with the Texas Department of State Health Services against the hospital. The organization issued a statement that said: "The Nursing Practice Act, a Texas statute, gives registered nurses the right to report a licensed health care practitioner, agency or facility if they have reasonable belief (cause) that their patient may be exposed to harm."
According to Jordan, one of the criminal charges stated the nurses had violated HIPAA. "And another one was that the nurses had illegally used private information that belonged to the county hospital without asking county permission."
But did the nurses, in fact, violate HIPAA by sharing the medical record numbers? "I don't know that HIPAA makes an exception in these cases, but my understanding is that there is a relationship with the Texas medical board, and they allow people to bypass HIPAA to pass confidential information to them," says Jordan.
So far, she continues, the judge has yet to set a criminal court date for the nurses. "The HIPAA issue has not been addressed yet," Jordan tells HIPAA Regulatory Alert. In addition, she reports, the nurses' attorneys filed a federal lawsuit on Aug. 28 saying that the nurses were illegally retaliated against for their patient advocacy activities.
In light of this case, is there anything hospital leaders should say to their nursing staffs? "We believe nurses are protected [from HIPAA violations] in reporting practitioners they are concerned about," says Jordan. "You must be able to report enough information to substantiate your claims, and that clearly has to reference patients."
However, she adds, "I think they need to be clear on the policies of the licensing board they report to, understand their requirements, and always make sure that they are acting in good faith."
Despite the fact that she maintains nurses are allowed to share protected health information under these circumstances, Jordan concedes that news of the case "has a chilling effect on the rights of nurses to report to the correct authorities what they believe is a lack of quality patient care and delivery."
[For more information, contact:
Clair Jordan MSN, RN, Executive Director, Texas Nurses Association, 7600 Burnet Road, Suite 440, Austin, TX. Phone: (800) 862-2022.]
You'd think that any hospital in the country would be pleased to have its nurses come forward when they notice a physician practicing in a manner that is less than optimal for his or her patients. In fact, a number of states even allow the sharing of protected health information if it's necessary for such whistle-blowers to state their case.Subscribe Now for Access
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