The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), has recently concluded a settlement with Optum Medical Care of New Jersey, a multi-specialty physician group operating across New Jersey and Southern Connecticut. The settlement resolves numerous complaints filed with OCR regarding potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule’s Right of Access provision.
The Right of Access provision under the HIPAA Privacy Rule mandates that individuals or their personal representatives receive timely access to their health information at a reasonable cost. However, investigations by the OCR found that Optum failed to provide this access within the stipulated 30 calendar days. Consequently, Optum has agreed to pay $160,000 and implement a corrective action plan to ensure patients have timely access to their records.
“Healthcare providers must prioritize responding to requests for access to medical records from parents or patients in a timely manner,” stated OCR Director Melanie Fontes Rainer. “Access to medical records is a fundamental right under HIPAA, and OCR receives thousands of complaints about this every year. It’s the law—providers must proactively respond to record requests and ensure timely access.”
In Fall 2021, OCR received six complaints alleging that Optum Medical Care had not provided copies of medical records as requested by an adult patient or the parents of minor patients. An investigation was launched in February 2022, revealing that patients received their requested records between 84 and 231 days after submitting their requests, significantly exceeding the 30-day limit set by HIPAA.
As part of the settlement, Optum Medical Care will also implement a corrective action plan involving workforce training, reporting records requests to OCR, and reviewing and revising its Right of Access policies and procedures as necessary. OCR will monitor Optum Medical Care’s compliance with the plan for one year. The settlement marks OCR’s 46th enforcement action related to the Right of Access provision.
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