The HIPAA privacy rule has resulted in corrective actions being taken in more than 13,300 cases of alleged violations since the rule became effective in April 2003, says Susan McAndrew, deputy director for health information privacy in the Department of Health and Human Services' Office for Civil Rights.

Corrective action has often resulted in systemic changes being made at an offending organization, McAndrew told attendees at the federally sponsored Safeguarding Health Information conference in Washington. And OCR's insistence that organizations take corrective actions also has covered violations of the HIPAA security rule since the agency assumed enforcement duties in July 2009 from the Centers for Medicare and Medicaid Services. Under CMS, a large majority of security rule cases closed without corrective action-but now the large majority of closed cases include corrective action, McAndrew says.

OCR also enforces the breach notification rule and presently lists on a public Web site 272 major breaches of protected health information affecting 500 or more individuals that have occurred since September of 2009. The agency reviews all major breaches and has found two-thirds have resulted from theft or loss of data; 53 percent have involved portable devices such as flash drives, laptops and desktops; and 23 percent involve paper records.

All breaches must be reported to OCR, although those affecting less than 500 individuals are not listed on the Web site.

The agency has received reports of 31,000 smaller breaches since September 2009. Core lessons learned, McAndrew says, include:

* Do not neglect physical safeguards for paper and X-ray films,

* Reduce risk through network or enterprise storage as alternatives to local devices, and

* Encrypt data at rest on any desktop.

--Joseph Goedert


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