HIPAA Ruling in Tennessee Court

Failure to adhere to regulatory compliance can impact a litigation process, which in the case of Stevens vs, Hickman Community Hospital was prominent when the Tennessee Court of Appeals dismissed the case based on failure to comply with Tennessee’s Medical Malpractice Act and the Health Insurance Portability and Accountability Act of 1996. This paper will include an IRAC Brief that will explain the case in detail followed by a brief explanation of governmental principles of regulatory compliance requirements, a brief explanation of methods for managing the legal risks that arise from regulatory compliance issues, and how this case can be applied within a business managerial setting. IRAC Brief

Christine Stevens a Tennessee woman filed a malpractice lawsuit against Hickman Community Hospital, the emergency room services and physicians who cared for her husband Mark Stevens, which subsequently resulted in his demise. The case however is being challenged as a result of failing to comply with regulatory requirements set forth in the Tennessee Medical Malpractice Act and the Health Insurance Portability and Accountability Act of 1996. Case In accordance with the Tennessee Medical Malpractice Act, on April 11, 2011, counsel for Mrs. Christine Stevens the spouse of Steven Stevens, formally notified Hickman Community Hospital and Dr. Whitaker of the impending malpractice allegations in their care and treatment of Mark Stevens (FindLaw, 2013). The formal notice was also accompanied by a medical record release form allowing Mrs. Stevens legal counsel to obtain Mark Stevens medical records, however, the medical record request for was non complaint with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), form failed to denote key information (FindLaw, 2013).

On September 13, 2011 Mrs. Stevens filed a malpractice lawsuit in the Circuit Court of Hickman County against Hickman Community Hospital, Elite Emergency Services, and Dr. H. Whitaker, in her complaint she attested that she complied with the pre-suit notification and filed a certification of good faith, which are requirements set forth in the Tennessee Medical Malpractice Act (FindLaw, 2013). Defendants entered a motion to dismiss the case in November 2011 alleging that proper notice was not give based on Tenn. Code Ann. § 29-26-121(a), specifically § 29-26-121(a)(2)(E), and that Plaintiff’s noncompliance was not excused by extraordinary circumstances (FindLaw, 2013). In November 2013, the case was appealed to the Court of Appeals, Middle Section Circuit Court of Hickman County. Issue

Did Mrs. Stevens comply with the Tennessee malpractice pre-suit requirements and the HIPPA regulatory process? Mrs. Stevens filed a lawsuit because she believed Hickman Community failed to properly diagnosis Mr. Stevens and treat him. Hickman Community is requesting the case get dismissed as Ms. Stevens failed to comply with the Tennessee code to claim for medical malpractice by including a non-HIPPA complicate medical release form that limited the release of the medical records that prevented the defendant access to the records (Justia, 2014). Rule

The Supreme Court of Tennessee overruled the fact that a trial judge in Tennessee excused Mrs. Stevens from giving Hickman Community access to the medical records of her husband, and dismissed the case without prejudice (Oullette, 2013). Justice Lee who supported the majority in the case stated that only four of the five requirements for this case were met by the plaintiff and that because of this the defendant was not able to see the problem as a whole and that because the plaintiff did not meet all five requirements that the case was dismissed without prejudice according to Tenn. Code Ann. § 29-26-121(a)(2)(E), (Oullette, 2013).

HIPPA regulations require that all parties involved in malpractice suits have access to all records in order to fully understand and have all of the evidence. This is done with five requirements; one of these requirements is a HIPPA-compliant medical release form. The plaintiff did not provide this specific form and as such did not meet the requirements to file suit against the Hospital leading to dismissal of the case. Analysis

Christine Stevens filed a malpractice lawsuit against Hickman Community Hospital and the courts thoroughly observed the laws and considered all sides of the arguments that was on hand before them, but in order for the courts to determine the problems he or she had to interpret the significance of several provisions of the Tenn. Code Ann. 29-26-121, as well as evaluate de nova. The court had to determine, as well as effectuate the legislature’s intent (FindLaw). Christine Stevens provided a written report to Hickman Community Hospital stating a potential health care liability claim in which was based on neglectful treatment of Mark Stevens which was essential by the Tennessee Code Annotated, as well as sent notices to everyone in which it included an authorization form in which would allow everyone the right to use the medical records in which was a requirement under the Tennessee Code Annotated.

The medical form was not totally in compliance with the “Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), even though the claimant had a written notice there was no effort put forth in order to secure an approved medical authorization and the majority ruled, so therefore the plaintiff’s case was dismissed due to failure to act in accordance with HIPPA regulations. The majority basically focused on whether the notice was in compliance with Tennessee Code Annotated the provision directing possible claimants to include a HIPAA Compliant medical authorization in pre-suit notice (JUSTIA US Law). The court considers substantial evidence that is admissible in the court based on the facts that pertained to the case of Stevens vs. Hickman Community Hospital. One has to be able to provide evidence that the action was done intentional or un-willful. Every court has rules and there are conditions when those laws do not apply. Regulatory Compliance

Governance principles of regulatory compliance requirements are there for the specific purpose of guiding the nation in having a safe and fair environment in which to work and live (OECD, 2013). The regulatory compliance requirements allow for there to be a guideline in how companies and people do specific things, so that way people on both sides of a disagreement are able to follow these regulations and show proof of whether or not someone or something was really violated in some way, these requirements also allow for a court to see both sides, and make sure that both sides of a dispute are entitled to and receive all information from both sides to be able to present the best case possible for themselves and to help the truth to be known (OECD, 2013). Managing Legal Risk

Regulatory compliance is one of the highest legal risk areas in the company (Inside Counsel, 2014). In order for a company to stay up to date with any changes with regulatory compliance they need to prepare and develop a plan for the entire company to follow and keep updated with. An example of a methods a company can use is for a team to be made or set up to keep track of compliance records, stay up to date with the law, acts, or codes that may be revised or added so the company may be aware of any changes at all times. Another method to use would be for the company to evaluate their security measures. For a health care company it is very important to make sure all the employees and patient’s information is kept private to comply with certain acts and verification before relaying certain information to someone other than the patient. Applying Case to Management

When applying this case to management in the Stevens vs. Hickman Community Hospital case make sure that everyone knows the law, complies with the law, and knows what is legal and what is not legal. Many hospitals and healthcare facilities do just this by having Risk Managers/HIM Directors in place to safeguard personal health information ensuring that confidential patient information is secure and released only according to strict state and federal laws. It is also important to understand that while not only does a company need to know these laws and make sure that their employees follow them, but it is important for them to understand the laws and regulations on a personal level. Had Mrs. Steven’s submitted the correct form, the court could have ruled in her favor and not dismissed the case. Conclusion

In conclusion, failure to follow mandated laws/processes regardless of surrounding circumstances can impede an individual’s right to seek legal retribution. This case demonstrated that the Health Insurance Portability and Accountability Act maintains strict adherence to its provisions and all parties will be mandated to comply.

References

FindLaw. (2013, November). Stevens vs. Hickman Community Healthcare Services Inc. Retrieved from http://caselaw.findlaw.com/tn-supreme-court/1650862.html FindLaw. Stevens, Stevens v. Hickman Community Health Care Services, Inc. Retrieved from http:caselaw.findlaw.com/tn-supreme-court/1650862 Inside Counsel (2014). Retrieved from http://www.insidecounsel.com/2012/04/30/6-risk-and-compliance-challenges-for-global-organi JUSTIA US Law. Christine Stevens ex rel. Mark Stevens v. Hickman Community Health Care Services, Inc. et al.-CONCUR AND DISSENT (Dissenting). Retrieved from. http://law.justia.com/cases/tennessee/workers-Conpensation/2013/m2012-00582-sc-s 09-cv-0.html Justia US Law. (2014). Retrieved from http://law.justia.com/codes/tennessee/2010/title-29/chapter-26/part-1/29-26-121 Justia US Law. (2014). http://law.justia.com/cases/tennessee/workers-compensation/2013/m2012-00582-sc-s09-cv-0.html OECD. (2013). Principles for the Governace of Regulators. Retrieved from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CEMQFjAC&url=http%3A%2F%2Fwww.oecd.org%2Fgov%2Fregulatory-policy%2FGovernance%2520of%2520Regulators%2520FN%25202.docx&ei=R55fVJLODYayyQTSoIDgCw&usg=AFQjCNE3qa3AiTgqz74P9EmOSFQOvvattw&sig2=SGdMFnjYUZ0LBVrFWmHRoA&bvm=bv.79189006,d.aWw Oullette, P. (2013). Tennessee Supreme Court, trial court differ on HIPAA ruling. Retrieved from http://healthitsecurity.com/2013/12/02/tennessee-supreme-court-trial-court-differ-on-hipaa-ruling/