Workplace Privacy, Data Management & Security Report : Privacy Lawyers & Attorneys : Jackson Lewis Law Firm : Data Security, HIPAA & Confidentiality Issues

Prepared by Jason Gavejian and Joseph Lazzarotti

In honor of National Data Privacy Day, we have laid out 13 key issues affecting businesses in 2013. While the list is by no means exhaustive, it does provide critical areas businesses will need to consider in 2013.

1. BYOD. As advancements in technology continue at a breakneck pace, many businesses are confronted with the idea of implementing a Bring Your Own Device (“BYOD”) program. Under these programs, employees are permitted to connect their own personal devices to the company’s networks and systems to complete job tasks either in the office or working remotely. While BYOD programs have advantages, they also have associated risks. Developing a thorough implementation strategy with appropriate policies is critical.
2. Bans On Requesting Social Media Passwords. As we have previously discussed  fourteen states introduced legislation in 2012 which would prohibit employers from requiring current, or prospective, employees to disclose a user name or password for a personal social media account. Six states have passed and/or enacted such legislation and it is anticipated that other states will pass similar measures in 2013.
3. Final HIPAA Regulations. On January 17, 2012, the Office for Civil Rights released final privacy and security regulations under the Health Insurance Portability and Accountability Act. In addition to incorporating the HITECH Act which, among other things, expands the application of the rules to business associates, the final rules also apply the rules to subcontractors and remove the risk of harm trigger for data breaches affecting unsecured protected health information.
4. Disaster Recovery Plans. Hurricane Sandy caused extensive damage on the east coast in 2012, greatly affecting not only personal residences, but many businesses up and down the coast. Unfortunately, protecting information and technology assets from natural disasters and other emergencies is often an afterthought. However, developing a comprehensive disaster recovery plan now can avoid the significant expense, and often irretrievable loss of data, associated with natural disasters.
5. Develop a Plan for Responding to a Breach Notification. All state and federal data breach notification requirements currently in effect require notice be provided as soon as possible. Delays in notification viewed as unreasonable could trigger an inquiry by the state’s Attorney General, or in the case of HIPAA protected health information, the Office of Civil Rights. This is true even when the number of individuals affected is relatively small.
6. Investigating Social Media. As the use of social media continues to grow throughout the world, it is only natural that social media content is being sought to aid in litigation. While public content may generally be utilized without issue, if private content is accessed improperly, serious repercussions can follow. This is especially true for attorneys and their staff who attempt to aid their clients by accessing social media content.
7. International Data Protection. More and more company information is being stored in electronic format and shared with various corporate divisions through company intranets or email. While U.S. law requires some safeguarding of this information, international protections on personal information can be much more stringent. When the transfer of data across international borders is possible, or actively occurring, companies should be advised on the potential risks and requirements associated with same.
8. Develop a Written Information Security Program. Even if adopting a written information security program (WISP) to protect personal information is not an express statutory or regulatory mandate in your state, having one is critical to addressing information risk. Not only will a WISP better position a company when defending claims related to a data breach, but it will help the company manage and safeguard critical information, and may even help the company avoid whistleblower claims from employees. For some companies, a WISP can be a competitive advantage. Of course, in states like Massachusetts, Maryland, Oregon, Texas, Connecticut and others, a WISP in one form or another is required.
9. Risk Assessment. Many businesses remain unaware of how much personal and confidential information they maintain, who has access to it, how it is used and disclosed, how it is safeguarded, and so on. Getting a handle on a business' critical information assets must be the first step, and is perhaps the most important step to tackling information risk. You simply can’t adequately safeguard something you are not aware exists. And failing to conduct a risk assessment may subject the business to penalties under federal and/or state law.
10. Insurance. Like many other risks, information risk can be addressed in part through insurance. More carriers are developing products dealing with personal information risk, and specifically data breach response. This kind of coverage should be a part of any CIO, privacy officer or risk manager’s toolkit for safeguarding information.
11. Training. A necessary component of any WISP and a required element under most federal and state laws mandating data security is training. In addition to meeting compliance requirements, training employees and supervisors also will aid in defending any potential breach of privacy claim that may be asserted against the company.
12. Carefully Integrate New Technologies. As businesses look for new technologies to increase productivity, cut costs, and gain a competitive advantage, how those technologies address information risk must be a factor in the decision to adopt.
13. Watch for New Legislation. Today, managing data and ensuring its privacy, security and integrity is critical for businesses and individuals, and is increasingly becoming the subject of broad, complex regulation. As no national law requiring the protection of personal information has yet to be passed in the U.S., companies are left to navigate the constantly evolving web of growing state legislation. Companies therefore need to stay tuned in order to continue to remain compliant and competitive in this regard.

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As we previously discussed, the Office of Civil Rights (“OCR”) continues to push forward with the HIPAA audits required by the HITECH Act.  To this end, the OCR recently posted the protocol which is used to conduct the HIPAA audits on its website. 

The HITECH Act requires HHS to provide for periodic audits to ensure covered entities and business associates are complying with the HIPAA Privacy and Security Rules and Breach Notification standards.  To implement this mandate, OCR piloted a program to perform audits of covered entities to assess privacy and security compliance.   This HIPAA audit program analyzes processes, controls, and policies of selected covered entities (e.g., health plans, health care clearinghouses, and certain health care providers) as well as the requirements to be assessed through these performance audits. The audit protocol is organized around “modules,” as follows:

• The first audit protocol covers Privacy Rule requirements for (1) notice of privacy practices for Protected Health Information (“PHI”), (2) rights to request privacy protection for PHI, (3) access of individuals to PHI, (4) administrative requirements, (5) uses and disclosures of PHI, (6) amendment of PHI, and (7) accounting of disclosures.
• The second protocol covers Security Rule requirements for administrative, physical, and technical safeguards.
• The third protocol covers requirements for the Breach Notification Rule.

Notably, the combination of these multiple requirements may vary based on the type of covered entity selected for review.  Healthcare providers, health plans, and business associates, all who could be affected by the HIPAA audits, need to not only be aware of the OCR’s audit activities, but also HHS’s efforts to increase enforcement of HIPAA.   

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In a novel approach to data breach notification requirements, Texas has amended its breach notification law (Business & Commerce Code, Section 521.053) to require notification to residents of not only Texas, but to residents of each of the 50 states.  The amendment becomes effective September 1, 2012, and applies to “all persons who conduct business in the state,” without further defining what “conducting business” would entail. 

The law was amended to require notification of a breach of system security to any individual whose sensitive personal information was, or is reasonable believe to have been, acquired by an unauthorized person.  A review of the amendment reflects the legislature’s intent to expand the notification requirement by its deletion of the language “resident of this state” from the current data breach notification law. 

This law has obvious far reaching import for residents of the four states which do not currently maintain data breach notification laws (Alabama, Kentucky, New Mexico, and South Dakota).  Under Texas’ law, residents of these states whose personal information is owned, licensed or maintained by a business/employer subject to Texas law would now receive notification of a breach of their personal information. 

Additionally, Texas’ breach notification law does not include a “risk of harm trigger.”  A number of state data breach notification laws only require notification where illegal use of the breached personal information has occurred, or is reasonably likely to occur and that creates a risk of harm to a person.  However, under Texas’ law, notification is required only upon acquisition, without regard to a risk of harm.  While Texas’ amended law appears to include some limiting language on its application to states that have their own breach notification laws, as worded, it is unclear whether this would include states whose risk of harm trigger would not require notification.  Accordingly, for those entities which conduct business in Texas, notification of those affected may be required even if the individual’s home state would not have required notice in the case of low-risk breaches 

The amendment also adds civil penalties for any person who fails to take reasonable actions to comply with the notification requirements.  These penalties are compounded by the number of individuals who are not notified and for each consecutive day notification is not provided, resulting in a maximum fine of $250,000.  Additionally, the amendment makes a violation a misdemeanor, unless the breached information is protected by HIPAA, which would elevate the violation to a felony. 

Companies, especially those that maintain vast amounts of personal information for persons in multiple states, must be aware of the various state laws which potentially impact there business and amendments like those highlighted above. See also recent amendments to the breach notification statutes in California and Illinois.

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Today the White House issued a Cybersecurity Legislative Proposal. The proposed legislation focuses on protecting the American people, the nation’s critical infrastructure, and the federal government's computers and networks.  While legislation of this nature would simplify the breach reporting process for businesses, and overall streamline cybersecurity laws, a number of legislative attempts to do this have previously failed.  It is important to note that while this proposal sets forth some guidelines, the specific details of how each provision would be instituted are not yet clear

Our critical infrastructure – such as the electricity grid, financial sector, and transportation networks that sustain our way of life – have suffered repeated cyber intrusion, and cyber crime has increased dramatically over the law decade. The President has thus made cybersecurity an Administration priority. 

1.  To protect the American people, the proposed legislation calls for a national data breach reporting law which would simplify and standardize the existing patchwork of 47 state laws that contain these requirements. Additionally, the proposal calls for penalties for computer criminals and clarifies the penalties for computer crimes, synchronizes them with other crimes, and sets mandatory minimums for cyber intrusions into critical infrastructure.
2. To protect our nation’s critical infrastructure the proposal calls on legislative changes to fully protect this infrastructure. Specifically, proposal will enable the Department of Homeland Security (DHS) to quickly help a private-sector company, state, or local government when that organization asks for its help. It also clarifies the type of assistance that DHS can provide to the requesting organization.

Additionally, the proposal permits businesses, states, and local governments to share information about cyber threats or incidents with DHS. To fully address these entities’ concerns, it also provides them with immunity when sharing cybersecurity information with DHS. At the same time, the proposal mandates robust privacy oversight to ensure that the voluntarily shared information does not impinge on individual privacy and civil liberties.

Further, the proposal emphasizes transparency to help market forces ensure that critical-infrastructure operators are accountable for their cybersecurity.

Finally, the proposal requires DHS to work with industry to identify the core critical-infrastructure operators and to prioritize the most important cyber threats and vulnerabilities for those operators. Critical infrastructure operators would then take steps to address cyber threats, develop risk mitigation plans, and permit DHS to modify the processes which are implemented if they are insufficient. 

3.  To protect federal government computers and networks the legislative proposal includes: an update to the Federal Information Security Management Act (FISMA) as well as formalizing DHS’ current role in managing cybersecurity for the Federal Government’s civilian computers and networks, in order to provide departments and agencies with a shared source of expertise; giving DHS more flexibility in hiring highly-qualified cybersecurity professionals; the permanency of DHS’s authority to oversee intrusion prevention systems for all Federal Executive Branch civilian computers while codifying strong privacy and civil liberties protections, congressional reporting requirements, and an annual certification process; and preventions on states requiring companies to build their data centers in that state, as opposed to in the cloud, except where expressly authorized by federal law.

The Administration’s proposal also attempts to ensure the protection of individuals’ privacy and civil liberties through a framework designed expressly to address the challenges of cybersecurity. Some of these provisions include: requiring federal agencies (and likely federal contractors) to follow privacy and civil liberties procedures; limitations on monitoring, collecting, using, retaining, and sharing of information; requiring efforts to remove identifying information unrelated to cybersecurity threats; as well as immunity provisions for those business which comply with the proposal’s requirements.  

As the proposal concludes: 

Our Nation is at risk… [t]he Administration has responded to Congress’ call for input on the cybersecurity legislation that our Nation needs, and we look forward to engaging with Congress as they move forward on this issue.

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In distinct efforts to strengthen data security requirements, the California and Massachusetts legislatures recently passed bills affecting data breach notification requirements and data security notification, respectively.  

On April 14, 2011, the California senate approved S.B. 24, requiring California businesses and agencies to notify the state attorney general if more than 500 California residents are notified of a data breach. The California bill also would require certain information be included in the notices.

While similar attempts to modify California’s data breach law have been vetoed by then-Gov. Arnold Schwarzenegger (R), the state’s new governor, Edmund G. “Jerry” Brown, Jr. (D) may likely sign S.B. 24. The bill also would amend the substitute notice provisions for breaches to require placing a notice that a breach has occurred on the business’s website and in major statewide media and notifying the California Office of Privacy Protection. 

While California’s current breach notice statute does not specify the information that must be included in an individual breach notification, S.B. 24 would mandate the notice include, among other things, the type of information breached, the time of the breach, and a toll-free telephone number of major credit reporting agencies.

On April 13, 2011, Massachusetts H.B. 3360 was referred for committee consideration. Under the bill, vendors of photocopiers in Massachusetts that fail to adequately notify purchasers of potential data security risks would be subject to a civil fine of up to $50,000 and could be sued by customers whose personal information is subsequently compromised.  Also, Massachusetts businesses that sell photocopiers must tell customers if a particular machine is equipped with a hard drive capable of retaining information from copied documents. Vendors must provide a notice stating that "the photocopier does or does not contain an eraser that deletes and destroys any previously captured picture from the copier's hard drive.” The notice must “inform the user of the risk of retention of such private data or images.” In addition, if a machine is such a “digital copier,” the vendor also must place a “conspicuous,” written data-security warning on the top of the copier.

H.B. 3360 also authorizes the state attorney general to enforce the law by filing a civil action seeking a fine of up to $50,000. Additionally, the bill would permit a lawsuit by customers who did not receive the required notification and warnings and whose private data was subsequently “misused.”

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In a uniquely timed second showing of enforcement authority, the Department of Health and Human Services (HHS) announced on February 24, 2011 a one million dollar settlement with a Massachusetts hospital that allegedly breached patient data.  This settlement announcement comes only days after HHS announced a 4.3 million dollar HIPAA Privacy Rule fine.  The Massachusetts hospital settlement resulted from a hospital employee who took home documents containing sensitive personal information on patients. The employee then lost those documents while commuting to work.  

While the settlement did not include an admission of liability, in addition to the monetary settlement, and submitting to HHS oversight, the hospital must also adopt more stringent privacy practices and retain an independent security and privacy monitor. The investigation of the incident found the hospital failed to implement reasonable and appropriate standards to protect the privacy of patient information removed from the facility.  Under the settlement, the hospital must present new privacy and data security administrative, physical, and technical safeguards policies and procedures for HHS approval. Specifically, these policies and procedures must address the physical removal and transportation of protected health information and encryption of portable storage devices.  Despite a general prohibition on employees physically removing protected health information from the hospital,  HHS permitted an exception when the information is removed by an employee to perform his or her job duties.  Additionally, the hospital must implement training for all employees.  

This settlement, when considered with the 4.3 million dollar fine, likely signals how HHS will approach future enforcement actions.  In light of this, covered entities must seriously examine their privacy and security obligations, including implementing appropriate policies and procedures regarding the safeguarding of information.

 

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Paintball Punks filed a class action suit against U.S. Bank  in Hennepin County, Minnesota. The case was subsequently removed on December 6, 2010, to the Minneapolis District Court. In the complaint, Paintball Punks alleges that between August and December 2009 it received 9 orders totaling approximately $11,000, which were fraudulently billed to U.S. Bank-issued cards. The amount was subsequently chargebacked (U.S. Bank tapped into Paintball Punks’ account to recoup the money after payment). 

The online retailer asserts that U.S. Bank failed to protect them and other merchants by failing to remedy a known data breach in the Bank’s system.   Despite knowledge of those breaches, U.S. Bank allegedly allowed compromised card accounts to remain active, which led to fraudulent credit card transactions with Paintball Punks and other merchants similarly situated, followed by chargebacks that U.S. Bank processed against the accounts of the merchants.

According to the complaint, the most likely explanation (allegedly consistent with statements obtained from two U.S Bank employees) is that the fraudulent activity resulted from a data breach at U.S. Bank. The complaint alleges that U.S. Bank could have corrected the data breach at several points before the losses were suffered by Paintball Punks and the rest of the class: when it learned of the breach it could have notified all of the affected cardholders at once and cancelled their cards. If that were the case, none of the information lost in the breach could have been used to defraud Paintball Punks.

The complaint alleges that concerns about fraud supersede that of terrorism, computer and health viruses and personal safety, and that the Banks “fear” of public repercussion motivated U.S. Bank’s decision to fail to remedy this breach.   Paintball Punks asserts that if U.S. Bank were to notify large numbers of its cardholders of a data breach in its facilities, then it would stroke the fears and concerns of credit card fraud among its cardholders, and they would associate that fear with U.S. Bank as an issuer.

This case is one of the first instances where a merchant has filed suit against a bank for a potential breach of information that did not directly implicate the merchant’s personal information, instead simply resulted in “damages” to the merchant.   Companies must be aware that the plaintiff’s bar is looking for new and creative ways to sue for damages based on data breaches. 

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In another favorable decision for companies, the Maine Supreme Court ruled on September 21, 2010 that consumers affected by a data breach could not claim damages from the company unless they suffered uncompensated financial losses or some other tangible injury. 

The Maine Supreme Court addressed the following:

In the absence of physical harm or economic loss or identity

theft, do time and effort alone, spent in a reasonable effort to

avoid or remediate reasonably foreseeable harm, constitute a

cognizable injury for which damages may be recovered under

Maine law of negligence and/or implied contract?

The Court ruled they do not. Additionally, the Court went on to state that "[t]he tort of negligence does not compensate individuals for the typical annoyances or inconveniences that are a part of everyday life….An individual's time alone, is not legally protected from the negligence of others."

The underlying suits were filed following a breach, and fraudulent use, which resulted when card holder data of nearly 4.2 million people was stolen. The lawsuits alleged the company was negligent in protecting card holder data and failed to notify of the breach in a timely fashion.  The above holding was issued when the District Court Judge who heard the underlying case, agreed to let the state Supreme Court decide whether the plaintiffs could sue the company for the time and effort put into avoiding or mitigating harm from fraudulent charges on their cards.

Two other cases are similarly instructive. In 2003 the Minnesota Supreme Court found that an invasion of privacy cause of action requires that the dissemination resulted in “publicity” of private facts. Because the disclosure was internal to other employees, and not to the public at large, the Court held the dissemination was insufficient publicity to support an invasion of privacy claim against the employer. Further, in Guin v. Brazos Higher Educ. Serv. Corp. Inc., 2006 U.S.Dist. LEXIS 4846(D. Minn. Feb. 2, 2006), the District Court dismissed plaintiff’s negligence claim holding that the threat of future harm not yet realized will not support a claim for negligence which requires a showing of an injury.

Companies and employers must be on notice of these decisions when faced with individual lawsuits following data breaches. 

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As we have discussed before, data breach notification is one of the most rapidly emerging areas of law. Good security incident procedures as well as effective training can help avoid the risk of data breach. (Sample data breach training). 

A case in point: Connecticut's Attorney General has filed a civil action against Health Net of the Northeast Inc. (“Health Net”) for failing to secure approximately 446,000 individuals’ patient information on a missing portable computer disk drive, and for failing to provide prompt notice of the breach. Among other things, the suit alleges Health Net violated the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended by the Health Information Technology for Economic and Clinical Health (HITECH) Act, when it failed to provide prompt notice, failed to encrypt the data, failed to provide for and implement appropriate policies to safeguard the information, and failed to supervise and train its workforce on safeguarding protected health information and personal information. 

As this suit demonstrates, state Attorneys General will use the authority granted by HITECH to enforce the privacy and security protections of HIPAA for protected health information, as many breaches involving such information may not be covered by state data breach laws. Such enforcement will only add to the cost of a data breach, which, according to the 2009 Ponemon Institute Annual Cost of a Data Breach study, continues to rise.

While a company’s first line of defense always should be a comprehensive data security policy, preparation should include an effective security incident procedure. Several key questions, some of which will form the foundation for any good security incident procedure, must be answered immediately following a breach: 

• How did the breach occur?
• Are measures in place to contain the breach?
• What information was compromised? 
• Whose information was compromised?
• Will the local authorities be alerted?
• What potential breach notice laws are implicated?
• Does notice of the breach have to be provided?
• If so, to whom and how will notice be provided?
• Does the company have applicable insurance to cover the notification process?
• Will any monitoring service be provided for affected individuals?
• Are measures in place for public relations implications?

However, a security incident procedure is only as strong as the awareness you create among your employees as to what constitutes a data breach and who to notify in the event of a possible breach. Therefore, in addition to an effective security incident procedure, it is essential that training, like the sample above, be provided to employees on a regular basis.   

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Less than one month into 2010 the trend to address data security, destruction, and encryption has continued among state lawmakers. Specifically, Florida, Michigan, Kentucky, Kansas, Pennsylvania, and New York all have introduced, reintroduced, or amended legislation of this kind. 

• The Florida and Michigan laws would amend personal data destruction rules for companies.
• The New York law would mandate data security and encryption measures.
• The Kentucky bill would require government agencies to protect all personal data under the Gramm-Leach-Bliley Act.
• The Michigan bill includes a state version of the Federal Trade Commission's Red Flags Rule and would require creditors in the state to implement programs aimed at spotting “red flags” of possible identity theft and put in place mitigation measures. Michigan is also considering a number of other measures. 
• The Kansas law would require state agencies to engage in periodic network security reviews.
• The Pennsylvania bill would require public agencies to notify state residents of a breach of their personal information within seven days of the discovery of the breach.

While 5 states remain without data breach notice bills (Alabama, Kentucky, Mississippi, New Mexico, and South Dakota), Congress is considering legislation, the Data Accountability and Trust Act (DATA) (H.R. 2221), that would preempt all state notification laws and instead establish a national breach notice standard.

As we have previously mentioned, we anticipate data privacy and security legislation and case law to be at the forefront of legal issues in 2010. Employers should begin by reading the Data Security Primer and consider implementing comprehensive data security policies and procedures that would allow them to comply with the various state laws that may impact their business. 

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New Hampshire’s new breach notification law builds on the breach notification requirements under the HITECH Act by requiring health care providers and business associates to notify individuals of disclosures of their protected health information that are prohibited by New Hampshire law, even if such disclosures are permitted under HIPAA or other federal law. This new health information protection was enacted with other measures relating to privacy of electronic medical records and allowing individuals to opt out of sharing their names, addresses, and protected health care information with e-health data exchanges.

H.B. 619 becomes effective for data breaches occurring on and after January 1, 2010. Individuals may sue for violations of the notification requirement and, significantly, seek damages of not less than $1,000 per violation. The law also expressly requires business associates to cover the costs of notification if the use or disclosure triggering notification was made by the business associate.

Now, when New Hampshire health care providers and business associates experience a possible data breach, they will have to consider a number of laws to determine the appropriate response. These include H.B. 619, the state’s general breach notification statute, and the breach notification rules under the HITECH Act and implementing regulations. This is even more complex for health care providers and business associates operating in multiple states as at least five other states (Arkansas, California, Delaware, Missouri, Texas) and Puerto Rico require notification in the event some form of medical information is breached.
 

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Co-Author:  Joseph J. Lazzarotti, Esq.

Health Net Inc., one of the nation’s largest publicly traded managed health care companies, recently notified authorities and informed affected persons, with a statement on its website, that the unencrypted personal information of 1.5 million current and former members, stored on a portable disk drive, is missing from the company's Connecticut office. The company is now working to send written notices to affected individuals in four states—Arizona, New York, New Jersey and Connecticut.

Coordinating a data breach response, responding to the questions and complaints of affected persons, and negotiating with vendors to provide monitoring services are time-consuming, tedious tasks that require a strong sense of an organization’s public image, good judgment and excellent communication skills. Having the right person to drive this effort internally is critical. 

Additionally, companies that experience data breaches increasingly are becoming subject to federal and state agency inquiries. In this case, at least two states have announced investigations. Connecticut Attorney General Richard Blumenthal said his office will investigate the loss of the portable disk drive that he believed held the unencrypted health, personal, and financial information of some 450,000 Connecticut residents. Blumenthal also vowed to probe a six-month lag in notifying affected individuals of the breach. In a letter dated November 19, 2009, Arizona Attorney General Terry Goddard’s office requested information about the breach from Health Net, also noting the time between the breach and when affected persons were notified. It is critical that an organization’s Privacy Officer be prepared to respond to these inquiries, with the assistance of internal or external counsel when appropriate.

A breach of personal information, particularly one of this size, reminds us of the need for companies to take steps to implement policies and practices that safeguard sensitive personal and company confidential information. The first step is to appoint a person to spearhead a data breach response– typically the Chief Privacy or Information Officer. Among the duties and responsibilities of a Privacy Officer is being the company’s first line of defense when responding to a data breach, including directing the investigation of the breach, coordinating the notification process, addressing the concerns of affected persons and responding to government agency inquiries. For a sample Privacy Officer job description, click here.  

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The Baltimore Sun reports that Baltimore police are investigating a security breach at Mercy Medical Center that left certain patient records open to possible identity theft. According to the article, affected former patients were sent a letter informing them that their personal patient records may have been accessed by a former employee in order to apply for credit cards and loans. A Maryland state law that became effective in 2008 would require Mercy Medical Center to notify these individuals promptly in the event of such a breach. 

This case is yet another example of personal information being accessed for improper purposes by hospital staff and demonstrates the need for hospitals to establish strict privacy controls and notification procedures.

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Joining the growing number of states which have enacted laws regulating the destruction of records to prevent possible identity theft, the Rhode Island Legislature passed H. 5092 on October 29, 2009. The bill requires businesses and government agencies to completely destroy records containing personal information, or render the personal information unusable, before disposing of records whether in electronic and paper form. Not surprisingly, H. 5092 comes on the heels of Texas’s Attorney General settling related violations for nearly $1,000,000 with Select Medical, and over $600,000 with Radio Shack.

As with most legislation of this nature, including the FTC’s data disposal rule, the law provides two means by which covered entities may destroy records: either by modifying the personal data to make it entirely unreadable or indecipherable through any means, or by taking reasonable steps to shred, erase, or otherwise destroy records. The bill also exempts certain covered entities whose destruction practices are covered by federal law or who contract with data disposal firms (who would be subject to the data disposal law). The need for such measures is further underlined by the overzealous office workers who used documents containing personal information as “confetti” during the New York Yankees World Series parade. 

Underlying the consequential nature of proper destruction, this bill permits individuals to sue to recover actual damages, and permits the state attorney general to seek fines or sue on behalf of individuals, with each record not properly disposed of being counted as a separate violation.

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Little more than one month after the HIPAA breach notification regulations became effective (September 23, 2009), covered entities (health care providers, health plans) and their business associates are struggling with the effects of these new rules. Many are asking:

• What is a breach?
• Do we have to notify in all cases, what are the exceptions?
• Who do we notify?
• Do we have to notify the government?
• Do we have to modify our business associate agreements?
• Do we have to create, update our policies and procedures?

Indeed, it is important to learn about these issues before a breach happens. However, if a reportable breaches happens, covered entities will need to know how and when to notify the Department of Health and Human Services (HHS). For breaches involving 500 or more individuals, the covered entity must notify HHS at the same time as the affected individuals. For breaches involving fewer than 500 individuals, the covered entity must maintain a log of the breaches during the calendar year and report them to the Secretary within 60 days following the end of that year.

HHS established a website for reporting breaches, with separate links for immediate and annual notifications. Note that in addition to gathering information specific to the breach, both forms ask about the safeguards in place prior to the breach and steps taken following the breach. Also, the instructions require covered entities to complete a separate on-line form for each breach.

Remember: Breaches triggering a notification requirement under HIPAA also may require notice under state law, including notice to certain state agencies and officials.

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