The Department of Health and Human Services (HHS) has imposed a $160,000 settlement on Optum Medical Care of New Jersey (OMCNJ), formerly known as Riverside Medical Group, following the 46th enforcement action related to a HIPAA complaint concerning the right of access to health records. Patients faced significant delays, up to seven months, in accessing their medical records, leading to this enforcement action. In response, the HHS’ Office for Civil Rights has mandated that OMCNJ implements a corrective action plan to prevent future violations of the HIPAA “right of access” provision.
This multi-specialty practice, operating in approximately 150 locations across New Jersey and southern Connecticut, is obligated to distribute its revised policies and procedures to its workforce and conduct training on the HIPAA privacy rule’s individual right of access to protected health information.
The enforcement action against OMCNJ arose from six complaints received by the HHS OCR within six weeks in the fall of 2021. Individuals filing complaints alleged that OMCNJ refused to provide copies of their medical records or the medical records of their minor children. The investigation revealed that the medical practice failed to provide timely access to protected health information, with some patients waiting between 84 and 231 days for their requested records. The corrective action plan also requires OMCNJ to ensure that it responds promptly to record requests, emphasizing the importance of timely access to medical records as a fundamental right under HIPAA.
Notably, this settlement is not an admission of liability by OMCNJ, nor is it a concession by HHS that the medical group is not in violation of HIPAA rules or not liable for civil money penalties. In a statement, OMCNJ, a medical group within Optum, which is part of the UnitedHealth Group, expressed regret for any inconvenience caused, emphasizing their commitment to supporting patients’ timely access to health information and addressing the root cause of the access issues.
