Florida Nurse Accused of Stealing HIPAA-Covered Data and Exploiting the Elderly

Access to Protected Health Information (PHI) is alleged to have been abused by a home health nurse from Lee County, Florida, who stands accused of accessing and using HIPAA-covered data and using that information to open credit card accounts and defraud at least 8 of her patients, according to a Lexicology report.

The woman opened fraudulent credit card accounts by using patient names and PHI and used the cards to go on a spending spree. According to police investigators, the woman purchased gift cards, electronic devices and made expensive repairs to her vehicle. While the woman could have been charged under HIPAA regulations, the charges filed against her are for the criminal use of personal information and exploitation of the elderly.

Improper use of Protected Health Information (PHI) and abuse of patients can be difficult to identify, especially when care is provided in-home. Patients may not feel safe enough to report abuse, and in the case of financial, medical and identity fraud, the patients may not even be aware that they are victims.

In-home care is necessary and it can greatly improve patient care as well as cut costs; however it is vital that patients are properly protected from abuse. One area of concern is the vetting process that takes place before nurses and home help workers are employed. In spite of there being considerable risks to patients’ well-being from care workers, criminal background checks and drug testing of employees are not mandatory under federal legislation and many states have not yet written that stipulation into legislation. Those that have mention specific groups of workers – such as home health aides – and this has potential to exclude other workers who may be employed and come into contact with the patient.

While many organizations do conduct security and background checks on staff as part of a pre-screening process, it is highly probable that the process will become mandatory in the near future. The Centers for Medicare and Medicaid Services (CMS) has already stipulated that hospice workers must be given background checks prior to being offered employment and CMS officials have reportedly started to advise the providers of long-term care that they too may have to perform screening tests in the future and that they should make preparations for a potential change in legislation.

Funding will soon be provided under the Patient Protection Affordable Care Act to allow background checks to be conducted free of charge under a new program, and this should go a long way to ensuring that patients receive quality care and are not placed at risk of abuse or fraud.

Author: Steve Alder has many years of experience as a journalist, and comes from a background in market research. He is a specialist on legal and regulatory affairs, and has several years of experience writing about HIPAA. Steve holds a B.Sc. from the University of Liverpool.