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OIG recommends OCR strengthen oversight, implement permanent audit program

HIM-HIPAA Insider, November 9, 2015

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The Office for Civil Rights (OCR) enforcement and oversight policies are inadequate, according a report published by the Office of the Inspector General (OIG). The report criticizes OCR’s investigations as primarily reactive, meaning that noncompliance can only be addressed after it’s already caused harm. The lack of a permanent audit system contributes to OCR’s inability to proactively assess whether a covered entity (CE) is compliant, the report says.

In roughly half of the closed privacy cases, OCR found that the CE was noncompliant with at least one privacy standard, the OIG notes. Among the sample of cases the OIG looked at, the two most common types of noncompliance involved restricting the uses and disclosure of PHI and implementing safeguards. The most frequent offenders, according the report, were hospitals and individual providers.

The report goes on to criticize OCR’s lack of documentation of corrective actions. Without this documentation, OCR can’t be certain what, if any, actions CEs actually took to address noncompliance. Additionally, the OIG found that 29% of OCR staff “rarely or never” checked whether a CE under investigation had been previously investigated. While OCR staff are able to search for this information, the agency’s case-tracking system has serious limitations, according to the report. Variations in how OCR staff enter a CE’s name into the system mean that another staff member might have to search for all possible variations of the name in order to collect a complete history of prior investigations and corrective actions.

The OIG recommended that OCR:

• Fully implement a permanent audit program
• Maintain complete documentation of corrective action
• Develop an efficient search system
• Require OCR staff to check if CEs have been previously investigated
• Expand outreach and education efforts to CEs
   

OCR has agreed with the OIG’s findings and recommendations. It has upgraded its case-tracking system and is developing policies to train staff to search for prior investigations, according to the report. OCR also restated their plan to begin Phase 2 audits in 2016.

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