Vanderbilt University Medical Center is facing a federal investigation by the U.S. Office of Health and Human Services for civil rights, and a legal battle with transgender patients who say the unauthorized disclosure of their personal health information to Tennessee Attorney General Jonathan Scrimiti is an invasion of privacy.
why does it matter
In defense of his investigation into the VUMC’s transgender clinic, Scarmiti told the local NewsChannel5 Earlier this month, though he “understands optics,” his office is legally investigating medical coding fraud because they were aware of “billing issues” there.
He said during the telecast that it was about “protecting taxpayers’ money.” interviewadding that his office conducts dozens of investigations annually into medical coding fraud cases.
In a statement attributed to John Hauser, Chief Communications Officer, to CNNVUMC said the medical center is obligated to provide complete medical records.
“VUMC complies with all health care privacy and security requirements set forth in both federal and Tennessee law, including but not limited to HIPAA,” it reportedly said of the health system’s handover of de-identified patient records.
In a statement provided to Healthcare Information Technology NewsVUMC provided more details on the request.
“In November 2022, VUMC received a Civil Investigation Request or ‘CID’ from the Tennessee Attorney General,” VUMC said. “Two additional CIDs were received by VUMC in March 2023. The CIDs requested information to investigate VUMC’s billing practices for people enrolled in state-sponsored insurance plans who received gender-affirming health care at VUMC.”
Skrmetti explained that the investigation into VUMC’s trans clinic was launched by the founder who describes how she does the coding in a 2019 online video where she discusses documentation challenges.
He said investigators need to match patients’ names to claims information.
“For a patient who gets a large bill because their insurance doesn’t cover any transgender-related codes, I usually write ‘endocrine disorder – not otherwise specified’ to allow me to order the labs I want,” said Dr. Shane Siebold. Taylor was broadcast in the video clip with NewsChannel5’s Skrmetti interview.
in Reddit post Dated 2 months ago, an individual stated that the following communication was sent by VUMC through the health system’s MyHealth patient portal:
“The attorney general’s office is investigating VUMC billings for transgender care services provided to individuals enrolled in state-sponsored insurance plans. The attorney general has the legal authority to require medical providers, including VUMC, to provide copies of documents relevant to the investigation, including patient records Medical. The medical records required by VUMC cover the period from January 1, 2018 to the present.”
A VUMC spokesperson declined to comment on the contents of the Reddit post. Meanwhile, CID has requested more information regarding transgender services at VUMC, according to a health system statement today.
all alone News About the federal investigation, Abby Rubinfeld, a member of the legal team representing the plaintiffs in a class action lawsuit alleging that VUMC did not protect their HIPAA privacy rights, told the news outlet last week that she spoke with OCR.
Rubinfeld said that while there are exceptions to the Federal Health Privacy Act for Civilian Investigations, there are guidelines and limits. She noted that the AG’s office went too far in its enforcement authority under Tennessee’s false claims law and Tennessee’s Medicaid false claims law.
She said, “He’s not talking about any exceptions to fraud laws in politics; that’s nonsense.” “There is no exception to HIPAA for his political agenda.”
In earlier reports, Rubinfeld said NewsChannel5 that VUMC shared these records on three separate occasions and offered no resistance under HIPAA.
Healthcare Information Technology News I reached out to OCR for a statement about its investigation into VUMC, but a representative said the agency generally does not comment on open investigations.
Hauser’s statement confirmed CNN That OCR called VUMC. Reportedly, he also stated that since July 1, a new Tennessee law has passed that states, “All gender confirmation sponsorship of individuals under the age of 18 is now illegal.”
Last year, Republican leaders in Tennessee sent a letter to VUMC demanding that it stop all sex-reassignment surgeries for minors.
In a letter Sept Posted on the X social media platform By Jason Zakart, Representative of Tennessee for the 14th Legislative District, a group of state Republican leaders called it a “grave error of judgment” to “condone (and encourage) irreversible harmful actions to minor children in the name of profit.”
VUMC is an independent, nonprofit organization with multiple hospitals in Nashville, clinics, and facilities throughout Middle Tennessee and an academic affiliation with Vanderbilt University.
The health system said it is also responsible for assessing the needs of Bedford, Coffee, Davidson, Rutherford, Williamson and Wilson counties. Its Community Health Equity team partners with individual community members, local health departments, non-profit organizations and outside health systems to “address health inequities among marginalized, disadvantaged, and socially disadvantaged populations,” according to its website.
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The OCR has regularly investigated violations of HIPAA’s information embargo since HHS launched the Right of Access initiative in 2019 as well as cybersecurity breaches of providers that disclose protected health information.
HIPAA disclosure guidelines Information related to reproductive health care Last reviewed June 2022 HHS said:
“The privacy rule permits, but does not require, disclosure of healthy health information about an individual, without the individual’s permission, when such disclosure is required by another law and the disclosure complies with the requirements of the other law,” HHS said.
VUMC said in its statement to Healthcare Information Technology News Today that her legal counsel “is in ongoing discussions with the Attorney General’s Office about what information is relevant to their investigation.”
On the record
“As one of the nation’s leading academic health systems, VUMC is committed to providing welcoming and personalized care to every patient we serve, including the LGBTQIA community,” the health system allegedly said in a communication attributed to its MyHealth portal. “We regret that your records have become part of the Attorney General’s investigation and stand ready to answer questions you may have and continue to provide the care you need.”
Andrea Fox is Senior Editor, Healthcare News for IT.
Email: afox@himss.org
Healthcare IT News is a publication of HIMSS Media.