HIPAA The Battle Begins!

Over HIPAA, was it a violation or was it within the state rights to get the records? There is going to be a battle over this all the way to the Supreme Court!

Tennessee hospital faces civil rights investigation over release of transgender health records

AP News

By Kimberlee Kruesi and Jonathan Mattise

August 11, 2023

Vanderbilt University Medical Center is facing a federal civil rights investigation after turning the medical records of transgender patients over to Tennessee’s attorney general, hospital officials have confirmed.

The U.S. Department of Health and Human Services' investigation comes just weeks after two patients sued VUMC for releasing their records to Attorney General Jonathan Skrmetti late last year.

“We have been contacted by and are working with the Office of Civil Rights,” spokesperson John Howser said in a statement late Thursday. “We have no further comment since this is an ongoing investigation.”

VUMC has come under fire for waiting months before telling patients in June that their medical information was shared late last year, acting only after the existence of the requests emerged as evidence in another court case. The news sparked alarm for many families living in the ruby red state where GOP lawmakers have sought to ban gender-affirming care for transgender youth and limit LGBTQ rights.

The patients suing over the release of their information say VUMC should have removed personally identifying information before turning over the records because the hospital was aware of Tennessee authorities' hostile attitude toward the rights of transgender people.

But wait! There’s more…

Vanderbilt University Medical Center Investigated by OCR over Disclosure of Transgender Patients’ Medical Records

HIPAA Journal 

By Steve Alder

August 14, 2023

Vanderbilt University Medical Center is being investigated by the Department of Health and Human Services’ Office for Civil Rights (OCR) over the disclosure of the medical records of transgender patients to Tennessee Attorney General, Jonathan Skrmetti. VUMC provided the medical records of transgender patients to AG Skrmetti after receiving civil investigative demands for the data as part of an investigation into potential medical billing fraud. VUMC recently sent notifications to the affected patients informing them about the disclosure of their records, which started to be provided to AG Skrmetti in December last year.

The HIPAA Privacy Rule permits, but does not require, healthcare providers to disclose patients’ medical records for law enforcement purposes in certain circumstances, such as in response to an administrative request if the information being sought is relevant and material to a legitimate law enforcement inquiry. VUMC and AG Skrmetti both maintain that the disclosures were legal. AG Skrmetti said the records were requested in response to a run-of-the-mill investigation he was involved with. The investigation was launched in September 2022 after a VUMC doctor publicly described having manipulated medical billing codes to evade coverage limitations on gender-related treatments.

In another AP article…

Two patients sued Monday in Nashville Chancery Court, saying they were among more than 100 people whose records were sent by Vanderbilt to Attorney General Jonathan Skrmetti. His office has said it is examining medical billing in a “run of the mill” fraud investigation that isn’t directed at patients or their families. Vanderbilt has said it was required by law to comply.

[…]

Tennessee lawmakers then passed a ban on gender-affirming care for minors. A federal appeals court recently let it take effect after a lower court judge blocked it.

What is scary was in the old days doctors waived their hands over your records and all of a sudden just like magic we had our hormones and I imagine in some states they still do it.

Gazing in my crystal ball here is what I think will happen. 

Part A: The HIPAA violations.

1. Health and Human Services’ (HHS) Office for Civil Rights will find VUMC in violation to HIPAA.
2. VUMC will appeal to the courts.
3. Then to the Appeals Court.
4. Then to the Supreme Court.

Part B: The fraudulent claims

1. The state will find the VUMC made fraudulent claims to cover procedures not cover by the insurance.
2. VUMC will appeal to the courts.
3. Then to the Appeals Court.
4. Then to the Supreme Court.
5. But this one doesn’t look good for VUMC.

My Spironolactone was cover under high blood pressure meds which I have so that was legitimate and I had to get my estradiol on my own.