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.
 

Continue Reading New Hampshire Enacts Strict Data Breach Notification Law Affecting Health Care Providers and Business Associates

The U.S. Supreme Court’s recent grant of certiorari in City of Ontario, Ontario Police Department, and Lloyd Scharf v. Jeff Quon, et al. highlights the effects new technologies continue to have on workplace privacy issues. One issue the Court will consider is whether a California police department violated the privacy of one of its officers when it read the personal text messages on his department issued pager. The U.S. Court of Appeals for the Ninth Court sided with the police officer when it ruled that users of text messaging services “have a reasonable expectation of privacy” regarding messages stored on the service provider’s network.

The underlying suit was filed by police Sgt. Jeff Quon, his wife, his girlfriend, and another police sergeant after one of Quon’s superiors audited his messages and found that many of them were sexually explicit and personal in nature.   Among the defendants were the City of Ontario, the Ontario Police Department, and Arch Wireless Operating. Co. Inc. Plaintiffs sought damages for alleged violation of their privacy rights.

While this case involves a public sector entity, its outcome is likely to affect electronic communications policies and practices across the country, whether by public or privacy employers.  

Continue Reading Texting & Sexting – Supreme Court to Consider Employees’ Expectation of Privacy in Text Messages

The New Jersey Appellate Division (Doe v. XYC Corporation) and the Court of Appeals of Wisconsin (Maypark v. Securitas Serv. USA Inc. & Sigler v. Kobinsky) have both examined an employer’s duty to monitor employees conduct while at work, and have reached drastically different results. Additionally, at least seven states—Arkansas, Illinois, Missouri, North Carolina, Oklahoma, South Carolina, and South Dakota—have enacted laws requiring computer technicians or Internet service providers to report child pornography if they encounter it in the scope of their work. 

New Jersey. In Doe v. XYC, the company’s IT department noticed an employee was accessing pornographic web pages while at work. Despite numerous complaints and suspicious usage by the employee, management took no formal action except to instruct the employee to stop visiting inappropriate web pages. Following the employee’s marriage to the Plaintiff, the employee took nude and semi-nude pictures of Plaintiff’s 10-year-old daughter and uploaded the photos to child porn web pages using his work computer. The employee was arrested and charged, and the Plaintiff sued the company, alleging that it knew or should have known of the employee’s conduct and had a duty to report it. The state Appellate Division reversed the trial court’s decision that no duty existed. It held that XYC Corporation knew or should have known the employee was accessing child pornography at work, and further had a duty to investigate and report it. Thus, in New Jersey, where an employer has the right and ability to monitor Internet usage and the employee has no expectation of privacy, employers have a duty to investigate and report the access of child pornography if they know or should have known an employee was doing so. For a detailed analysis of Doe, click here. 

Wisconsin. In Maypark v. Securitas, the plaintiff sued an employer for allowing a former employee, a security guard, to post photographs of the plaintiff’s employees on an adult website.   An earlier Wisconsin case, Sigler v. Kobinsky, held that a company could not be held liable for alleged negligent supervision leading to an employee’s use of a company computer to harass plaintiffs where there is no probability of harm. Specifically, a company had no duty to monitor because it was not reasonably foreseeable that providing employees with unsupervised Internet access would probably result in harm.   Relying on Sigler, the Court in Maypark overturned a $1.4 million negligence verdict against the security company, finding the guard’s action were not foreseeable.

Given the unsettled law on this issue, employers should consider several important factors when it comes to monitoring of employees. The Society for Human Resource Management published an article (*registration required) analyzing this issue. The article provides a number of suggestions, including that of our own Nadine Abrahams, a Jackson Lewis Partner in our Chicago office, who suggests the first step should be setting up a procedure for the immediate reporting of child pornography that has been discovered and the designation of a company representative who should be notified.   Additional steps include:

  • Institution of clear, effective and thorough computer usage and monitoring polices, which also address employee expectation of privacy;
  • Training of employees conducting any monitoring;
  • Prompt investigation of computer usage and allegations of unlawful conduct; and
  • Consultation with legal counsel regarding the duty to report to authorities. 

 

As passed by the House of Representatives on December 8, 2009, the Data Accountability and Trust Act would create federal data security standards, a national breach notification requirement, data destruction mandates, and special requirements for "information brokers." 

Thumbnail for version as of 23:34, 16 January 2008The Act will now move to the Senate, where it likely will be considered together with recent bills from various Senate Committees, two such bills we discussed in a recent post.

The Act would apply to each person engaged in interstate commerce that owns or possesses data in electronic form containing personal information (or contracts to have any third party entity maintain such data). In short, most businesses in the United States would be subject to the Act and required to establish and implement data security policies and procedures. Like other data security regulations, the Act would permit covered persons, when developing their policies and procedures, to take into account:

  • the size of, and the nature, scope, and complexity of the activities engaged in by, such person;
  • the current state of the art in administrative, technical, and physical safeguards for protecting such information; and
  • the cost of implementing such safeguards.

These new standards will be regulated by the Federal Trade Commission (FTC). Violations of the Act would be enforced primarily by state Attorneys General, although the FTC maintains a right to intervene in those actions. Penalties can be substantial. For example, in the case of a violation of the breach notification requirement, the penalty amount would be calculated by multiplying the number of violations by an amount not greater than $11,000. Each failure to send notification would be treated as a separate violation, with a maximum civil penalty of $5,000,000.

Of course, it will be some time before the Act would become effective, if at all, and it may be substantially modified prior to enactment. Still, recent actions by Congress (for example the enhancements to HIPAA under the American Recovery and Reinvestment Act of 2009) and the states suggest a national standard for protecting personal information is only a matter of time. Companies should be gearing up to deal with these emerging information risks.

Continue Reading House of Representatives Passes the Data Accountability and Trust Act

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.

Continuing our thoughts on how disclosures of private or confidential information may adversely impact the institution and the persons affected by such disclosure, we now focus on something near and dear to lawyers’ hearts: paper shredding.

Many businesses regularly shred documents they no longer need to protect them from disclosure. While this may secure the information contained in those documents, an additional concern exists for HIPAA-covered entities, such as hospitals, medical providers or their business associates. Often, those documents might consist of old medical records, charts, notes, or other information containing protected health information (“PHI”) specifically protected from disclosure under HIPAA.  

Shredding frequently is done by outsourced vendors.  They shred what is provided to them and then resell it as fill, packaging material or for other recyclable-type uses. But shredding alone may not be sufficient to secure data under HIPAA. This can cause a HIPAA headache, as suggested by recent occurrences overseas.  A gift-wrapping company owner in England discovered protected health data (including names of patients) from a local hospital on the shredding she used for work. In another situation being investigated by British authorities, an outsourced medical transcription company in India disclosed shredded health data. Although those situations occurred abroad, they could just as easily happen in the U.S., or occur outside the U.S. but affect information involving U.S. citizens.

If a data breach is discovered by the unauthorized disclosure of PHI through shredding or otherwise, under the American Recovery and Reinvestment Act of 2009 (“ARRA”), covered-entities and business associates must notify those affected by the disclosure of unsecured PHI within 60 days after a breach. If the breach involves disclosure of PHI for over 500 persons, a covered-entity and/or a business associate must also notify Department of Health and Human Services and the media. “Unsecured” under ARRA means any data not rendered unusable, unreasonable or indecipherable. Thus, an individual’s name legible on a snippet of shredded paper together with some health information may be enough to trigger ARRA’s disclosure requirements and constitute a HIPAA violation. For more information about data breaches under HIPAA, click here.

We therefore remind HIPAA-covered entities to ensure that their vendors are compliant with the HIPAA security requirements, that they have appropriate business associate agreements where necessary, and that they actively monitor compliance with those agreements.

In a key step toward developing a proposed U.S. health information technology (HIT) infrastructure, the Centers for Medicare & Medicaid Services has announced that Iowa’s Medicaid program is the first to receive federal matching funds for planning activities necessary to implement the electronic health record (EHR) incentive program established by the American Recovery and Reinvestment Act of 2009 (ARRA).

 

ARRA was signed into law by President Obama on February 17, 2009. Among its various parts, ARRA includes provisions for the improvement of our nation’s health care through health information technology (also known as Health IT or HIT), Medicare and Medicaid Health IT provisions which provide incentives and support for the adoption of certified electronic health records (EHRs); and provisions to expand, enforce, and enhance the privacy and security safeguards required by HIPAA. The proposed goal of a switch to EHRs is to improve the quality of health care for individuals, make care more efficient by making it easier for providers treating a patient to coordinate care, and make it easier for individual patients to access the information they need to make decisions about their own health care. Responsibility for implementing this program falls to the National Coordinator for Health Information Technology, a position currently filled by Dr. David Blumenthal at the Department of Health and Human Services (“HHS”). In furtherance of this goal, Mr. Blumenthal recently announced $80 million in grants to develop a HIT workforce. Additionally, the HHS has created a helpful website on the topic of health information technology with links to resources on privacy issues.

In discussing the approximately $1.16 million in federal matching funds Iowa will receive, Cindy Mann, director of the Center for Medicaid and State Operations at CMS said, “While Iowa is the first state to receive approval of its plan for implementing the Recovery Act’s EHR incentive program, a number of other states have submitted plans as well, meaningful and interoperable use of EHRs in Medicaid will increase health care efficiency, reduce medical errors and improve quality-outcomes and patient satisfaction within and across the states.”   As the first state to receive federal funding, Iowa will use the funds to focus on planning, information gathering, analysis, and assessment with respect HIT and the use of EHR within the state.  

A HIT Infrastructure is likely to raise a range of new issues involving the handling of sensitive personal information. For instance, anytime extensive personal and medical information is placed in electronic form, the chance of a data breach or information misuse rises significantly. This is especially true given the recent growth in the area of medical identity theft. Additionally, as some commentators have reported, physicians, hospitals, and clinics have all expressed concerns regarding the technical feasibility of the system, potential for patient mix-ups, as well as the extensive cost to make the switch to EHR. How such a system would affect employers and group health plan administration remains unclear.  

With such an emphasis on a switch to EHR, and billions of federal dollars fueling the conversion, all businesses, particularly health care providers, need to be consider how they will be affected by the new HIT infrastructure. 

Based on recent events, the University of East Anglia likely will agree that data privacy and security requires a comprehensive approach, as data breaches are not limited to incidents involving personal information and identity theft. In fact, the effects of a breach to an organization’s information systems involving confidential company information can be far worse on the organization as a whole than if the breach involved personal information.

Take, for example, a report by The New York Times reporter Lauren Morello concerning a breach involving thousands of emails and documents of the Climatic Research Unit (CRU) at University of East Anglia. Apparently, hackers obtained and posted on the Internet emails and documents calling into question some of the positions about climate change and global warming held by the CRU. Whatever the truth or perception of the information contained in the posted emails and documents, the CRU surely is in an uncomfortable position of having to defend its statements and address their context. 

Last month we reported a data breach involving personal information of a different kind – ethics investigations of members of the United States Congress. Again, while not the kind of personal information that would lead to identity theft, or require notification be sent to the affected individuals, it is the kind of information that could have significant adverse consequences for the institution and the persons affected.

For this reason, organizations need to address "information risk" on an organization-wide basis, making sure that their written information security programs take into account how information of any kind, maintained in any medium by the organization, can, if misused, caused the organization harm. While remedies may be available through the criminal justice system or civil litigation under such laws as the Computer Fraud and Abuse Act, avoiding the breach in the first place obviously is preferred.

More companies are becoming a part of the social networking community – setting up Facebook pages, “friending” their employees and customers, and so on. Businesses use these sites for a variety of purposes including marketing; client, employee and government relations; and community involvement. With lawmaking bodies and courts just beginning to struggle with the range of issues these new media create, companies should exercise caution and monitor the legal, technical, and other developments that may affect their involvement.

Companies already a part of (or thinking of joining) the social networking community should consider the effects on employee relations. In theory, the risks inherent in interactions between/among the company and/or its employees in a social networking environment are similar to risks the company faces in more traditional workplace settings such as the office or company-sponsored events. Online media, however, create some interesting questions:

  • Are all of your employees aware of the company site so as not to feel left out?
  • Do employees feel as if they must participate on the site – such as accepting other employees as “friends,” or agreeing with company posts? Do they need to be compensated for participation?
  • Does a supervisor accepting some employees as friends and not others raise discrimination risks and morale concerns?
  • Are employees free to dissent from company positions on its site? How far can employees go? Disciplining or terminating an individual’s employment with the company for activity on the company’s site or some other online social media can be risky on a number of grounds – such as under whistleblower laws (e.g., Sarbanes-Oxley and state/local laws), the National Labor Relations Act, and anti-discrimination and anti-retaliation laws.
  • Does active company management of the site constitute monitoring of employee communications?
  • How does the company handle the information about employees (and their dependents, friends and others) it may have access to as part of the employees’ participation in the network?

For sure, there are many areas about which companies need to think through as they consider their direct participation in the social networking community – the services of the social network provider, promoting the company’s presence in the community, consumer protection, copyright protections, and so on. Even the list above only begins to scratch the surface of the range of employment law issues that arise when an employer participates in this media.

914335The Genetic Information Nondiscrimination Act (GINA) [pdf], signed into law in May 2008, prohibits discrimination by health insurers and employers based on individuals’ genetic information. Genetic information includes the results of genetic tests to determine whether someone is at increased risk of acquiring a condition (such as some forms of breast cancer) in the future, as well as an individual’s family medical history. It is family medical history information that presents the biggest challenge for employers.

In its announcement about the effective date of the regulations, the Equal Employment Opportunity Commission Acting Chair Stuart J. Ishimaru writes: 

GINA affirms the principle central to all employment discrimination laws – that all people have the right to be judged according to their ability to do a job, not on stereotypical assumptions . . . No one should be denied a job or the right to be treated fairly in the workplace based on fears that he or she may develop some condition in the future.

Specifically, the law prohibits the use of genetic information in making employment decisions, restricts the acquisition of genetic information by employers and others, imposes strict confidentiality requirements, and prohibits retaliation against individuals who oppose actions made unlawful by GINA or who participate in proceedings to vindicate rights under the law or aid others in doing so. The same remedies, including compensatory and punitive damages, are available under Title II of GINA as are available under Title VII of the Civil Rights Act and the ADA.

Acting Vice Chair Christine Griffin said,

Title II of GINA is an ideal complement to the ADA Amendments Act. With both laws now effective, American workers are protected if they experience discrimination because of their disability or because of impairments they may develop.

To date, employers’ only regulatory guidance for the employment provisions of GINA (Title II) is a Notice of Proposed Rulemaking, published by the EEOC March 2, 2009. For health plans, which are subject to Title I of GINA, interim final regulations become effective for plan years beginning on and after December 7, 2009.

Employers should be reviewing their employment practices and health plans and wellness plans for compliance with GINA as soon as possible.

Click here for more information about how GINA affects employers.

Click here for more information about how GINA affects health plans. 

Click here for more information about how GINA affects wellness programs.

Click here for information about the new Equal Employment Opportunity Poster that includes information about GINA.