The Department of Health and Human Services investigated a complaint that a Lincare manager allowed her estranged husband unauthorized access to protected health information of Lincare patients. Following an investigation, the Office for Civil Rights determined that Lincare violated HIPAA by failing to implement policies to safeguard patient records and failing to protect 278 patients' information from unauthorized disclosure. OCR proposed a $239,800 civil money penalty against Lincare. Lincare appealed and OCR filed a motion for summary judgment, which Lincare opposed.
BIA Remands of Immigration Judge Michael Baird from 01/01/2014 to 05/26/2016Bryan Johnson
- The respondent, a native and citizen of Zimbabwe, appealed the denial of her applications for withholding of removal and cancellation of removal by the Immigration Judge.
- The Board upheld the finding that she did not show the government of Zimbabwe was unable or unwilling to protect her from persecution. However, the case was remanded for further consideration of her application for cancellation of removal based on the passage of time.
- On remand, the parties were instructed to further address issues such as good moral character, hardship if relocated to Zimbabwe, and whether relief should be granted as a matter of discretion based on an updated record.
Un juge fédéral Texan a interdit lundi au département américain de la Défense de punir un groupe de Navy Seals et d'autres membres des forces spéciales qui ont refusé les vaccins pour des motifs religieux.
The Department of Justice advocates for ICE's right to place children in solitary confinement if their mother engage in protests against their unlawful detention.
This document summarizes several recent North Carolina health law cases from 2015. It discusses cases related to medical malpractice, certificate of need, licensing boards, hospital peer review, Stark law, and constitutional issues. Specifically, it provides an in-depth summary of two medical malpractice cases - Hawkins v. Emergency Med. Physicians and Stephen C. Nicholson v. Arleen Kay Thom. In Hawkins, the court affirmed summary judgment for defendants due to lack of expert testimony on causation. In Nicholson, the court found no error on negligence but remanded on damages, disallowing medical bills not actually incurred. The document analyzes the key holdings and reasoning of these two cases.
Par JULIEN G. - Vendredi 12 novembre, dans une décision nationale, la Cour d’Appel fédérale du 5e circuit de la Nouvelle Orléans, a ordonné l’interruption de l’obligation vaccinale, imposée par l’administration Biden, dans le secteur privé. C’est un nouveau revers de taille pour Joe Biden, dont le seul recours possible est maintenant la Cour Suprême des États-Unis (SCOTUS)
This memorandum supports the plaintiff's motion to compel further discovery from the defendants. It summarizes that the plaintiff, Izabella Danielli, was seriously injured in a car accident caused by the defendant's tractor-trailer. While the defendants objected to the plaintiff's requests for production, they failed to provide any responses or a privilege log. The memorandum argues that the plaintiff is entitled to any statements made to the defense, as they are neither privileged nor protected work product. It also argues that sanctions should be awarded against the defendants for failing to meet and confer in good faith or provide a privilege log. The plaintiff is requesting an order compelling responses to requests for production and monetary sanctions of $1,500.
BIA Remands of Immigration Judge William Cassidy 01/01/2014-05/26/2016Bryan Johnson
EOIR FOIA ID # 2016-23184. Also, see acknowledgment letter at following link: http://www.slideshare.net/abogadobryan/eoir-acknowledgment-letter-for-201623284
BIA Remands of Immigration Judge Madline Garcia from 01/01/2014 to 05/26/2016Bryan Johnson
EOIR FOIA ID # 2016-23184. Also, see acknowledgment letter at following link: http://www.slideshare.net/abogadobryan/eoir-acknowledgment-letter-for-201623284
BIA Remands of Immigration Judge Michael Baird from 01/01/2014 to 05/26/2016Bryan Johnson
- The respondent, a native and citizen of Zimbabwe, appealed the denial of her applications for withholding of removal and cancellation of removal by the Immigration Judge.
- The Board upheld the finding that she did not show the government of Zimbabwe was unable or unwilling to protect her from persecution. However, the case was remanded for further consideration of her application for cancellation of removal based on the passage of time.
- On remand, the parties were instructed to further address issues such as good moral character, hardship if relocated to Zimbabwe, and whether relief should be granted as a matter of discretion based on an updated record.
Un juge fédéral Texan a interdit lundi au département américain de la Défense de punir un groupe de Navy Seals et d'autres membres des forces spéciales qui ont refusé les vaccins pour des motifs religieux.
The Department of Justice advocates for ICE's right to place children in solitary confinement if their mother engage in protests against their unlawful detention.
This document summarizes several recent North Carolina health law cases from 2015. It discusses cases related to medical malpractice, certificate of need, licensing boards, hospital peer review, Stark law, and constitutional issues. Specifically, it provides an in-depth summary of two medical malpractice cases - Hawkins v. Emergency Med. Physicians and Stephen C. Nicholson v. Arleen Kay Thom. In Hawkins, the court affirmed summary judgment for defendants due to lack of expert testimony on causation. In Nicholson, the court found no error on negligence but remanded on damages, disallowing medical bills not actually incurred. The document analyzes the key holdings and reasoning of these two cases.
Par JULIEN G. - Vendredi 12 novembre, dans une décision nationale, la Cour d’Appel fédérale du 5e circuit de la Nouvelle Orléans, a ordonné l’interruption de l’obligation vaccinale, imposée par l’administration Biden, dans le secteur privé. C’est un nouveau revers de taille pour Joe Biden, dont le seul recours possible est maintenant la Cour Suprême des États-Unis (SCOTUS)
This memorandum supports the plaintiff's motion to compel further discovery from the defendants. It summarizes that the plaintiff, Izabella Danielli, was seriously injured in a car accident caused by the defendant's tractor-trailer. While the defendants objected to the plaintiff's requests for production, they failed to provide any responses or a privilege log. The memorandum argues that the plaintiff is entitled to any statements made to the defense, as they are neither privileged nor protected work product. It also argues that sanctions should be awarded against the defendants for failing to meet and confer in good faith or provide a privilege log. The plaintiff is requesting an order compelling responses to requests for production and monetary sanctions of $1,500.
BIA Remands of Immigration Judge William Cassidy 01/01/2014-05/26/2016Bryan Johnson
EOIR FOIA ID # 2016-23184. Also, see acknowledgment letter at following link: http://www.slideshare.net/abogadobryan/eoir-acknowledgment-letter-for-201623284
BIA Remands of Immigration Judge Madline Garcia from 01/01/2014 to 05/26/2016Bryan Johnson
EOIR FOIA ID # 2016-23184. Also, see acknowledgment letter at following link: http://www.slideshare.net/abogadobryan/eoir-acknowledgment-letter-for-201623284
BIA Remands of Immigration Judge V. Stuart Couch from 01/01/2014 to 05/26/2016Bryan Johnson
EOIR FOIA ID # 2016-23184. Also, see acknowledgment letter at following link: http://www.slideshare.net/abogadobryan/eoir-acknowledgment-letter-for-201623284
BIA Remands of Immigration Judge James Nugent from 01/01/2014 to 05/26/2016Bryan Johnson
EOIR FOIA ID # 2016-23184. Also, see acknowledgment letter at following link: http://www.slideshare.net/abogadobryan/eoir-acknowledgment-letter-for-201623284
How to get judicial relief under 8 usc 1447(b) for a stalled naturalization i...Umesh Heendeniya
The document provides guidance on obtaining judicial relief under 8 U.S.C. § 1447(b) when a naturalization application has been stalled by U.S. Citizenship and Immigration Services (USCIS). It outlines the key elements of § 1447(b), including that: (1) USCIS must have failed to make a decision on the application within 120 days of the applicant's initial interview; (2) the applicant can file suit in the district court where they reside; and (3) the court has jurisdiction to decide the application or remand it to USCIS with instructions. The document also discusses issues that have arisen in litigation, such as whether USCIS retains jurisdiction after a § 1447(
BIA Remands of Immigration Judge Theresa Holmes-Simmons from 01/01/2014 to 05...Bryan Johnson
EOIR FOIA ID # 2016-23184. Also, see acknowledgment letter at following link: http://www.slideshare.net/abogadobryan/eoir-acknowledgment-letter-for-201623284
- The Immigration Judge found that they did not have jurisdiction to adjudicate the respondent's application for adjustment of status because the respondent was an arriving alien.
- The respondent appealed, arguing that the Immigration Judge erred in finding a lack of jurisdiction. The respondent also filed a motion to remand.
- The Board of Immigration Appeals granted the respondent's motion to remand, finding that the Immigration Judge did have jurisdiction. The Board remanded the case back to the Immigration Court for further proceedings.
The petitioner, a Laotian citizen residing illegally in the U.S., sought cancellation of removal but was found ineligible due to two convictions. Specifically, the petitioner was convicted of shoplifting and using another person's social security number. The BIA found the petitioner deportable for having two or more convictions for crimes involving moral turpitude. On appeal, the questions presented are 1) whether the appropriate evidentiary standards were used to determine the petitioner's eligibility for cancellation of removal, and 2) whether using another's social security number with intent to deceive constitutes a crime of moral turpitude.
This document is an answer filed by Illinois Midwest Insurance Agency, LLC to the applicant Marcela Acosta's petition for reconsideration of a workers' compensation claim. It summarizes the case history, including that Acosta alleged a cumulative trauma injury and is receiving temporary total disability benefits. It disputes the rate that benefits are being paid at. The answer argues that the original ruling should stand as it is based on substantial evidence, including Acosta's tax documents showing lower earnings than she claims, while she provided no documentation to support her testimony claiming higher earnings. It aims to show the original ruling was reasonably based on the evidence presented.
This document summarizes a court case regarding a dispute over land use jurisdiction between the City of Tontitown, Arkansas and landowners Jay and Connie Potter. The Potters purchased 19 acres outside Tontitown city limits and sought approval to build an RV park. They withdrew their application to Tontitown and received approval from the Washington County Planning Board, but the approval stated it would be void if Tontitown had jurisdiction. Tontitown claimed jurisdiction and sought an injunction to stop construction, arguing it had properly designated its planning area boundaries. The circuit court granted the injunction, finding Tontitown likely to succeed on the merits. The Potters appealed.
The document is a decision by the Board of Immigration Appeals regarding an appeal by Joy Atila Litaba, a citizen of Kenya, of an immigration judge's denial of a continuance. The Board of Immigration Appeals remanded the case to allow Litaba more time to consult with her attorney and seek relief from removal, noting her youth, desire for more time to seek counsel, and the absence of a formal notice of representation. The Board ordered further proceedings consistent with providing Litaba a meaningful opportunity to consult with counsel and seek relief.
This document is a court opinion from the District Court of Appeal of Florida regarding a petition for writ of certiorari filed by Andrea Kidder seeking to quash a discovery order requiring her to disclose the results of a blood alcohol test. The court denied the petition, finding that under Florida Rule of Criminal Procedure 3.220(d)(1)(B)(ii), Kidder was required to disclose the results of the scientific blood alcohol test to the prosecution as part of the reciprocal discovery process after electing to participate in discovery. The court rejected Kidder's argument that the test results were protected work product, determining that the rule requires disclosure of scientific test results regardless of whether the expert conducting the test will be called as a witness.
This document summarizes a court case involving Judy Craig suing TC Ambulance Corporation over injuries suffered by her infant during birth. TC Ambulance moved for summary judgment. The court granted TC Ambulance's motion for reargument and dismissed all claims against them, finding that the plaintiff's expert opinion that TC Ambulance departed from accepted standards by not radioing ahead was speculative and unsupported. The records showed TC Ambulance timely responded, transported the mother to the hospital, and relayed all appropriate information to ER staff. Any delay in treatment occurred after the mother arrived at the hospital.
The document is a memorandum analyzing a products liability case. A college football player, Joseph Green, died from heat stroke after practicing in a football helmet and shoulder pads manufactured by Sports Equipment, Inc. Green's mother brought a lawsuit against the company. The memorandum examines the company's motion for summary judgment on several claims. For the failure to warn claim, the court should grant summary judgment because the plaintiff failed to provide sufficient evidence that the lack of warning on the helmet and pads was the proximate cause of Green's death. The court should also grant summary judgment that the risk of heat illness was open and obvious. However, the learned intermediary defense does not apply in this case.
The document is a decision by an Immigration Judge denying the respondent's motion to reopen removal proceedings. It provides background on the case, including that the respondent was ordered removed in absentia on March 7, 2011 for failing to appear at a hearing. The respondent filed a motion to reopen, arguing he did not receive notice of the hearing. The Judge denies the motion, finding the respondent's affidavit alone is insufficient to overcome the presumption of delivery of the hearing notice by regular mail, as no additional corroborating evidence was provided.
60 Minutes and New England Compounding Pharmacymzamoralaw
This order grants plaintiff Chad Green's motion to conduct an expedited inspection of defendant New England Compounding Pharmacy's (NECC) facility in Framingham, Massachusetts, subject to certain parameters. The court found good cause for early discovery through an inspection, as time is of the essence and further delay could make it difficult for Green to obtain scientifically valid information. The court also found that the proposed inspection and testing are reasonably calculated to lead to the discovery of admissible evidence. The inspection will be allowed to proceed within four days according to specified restrictions to avoid interfering with ongoing government investigations.
Chad Green adv. New England Compounding Pharmacymzamoralaw
This order grants plaintiff Chad Green's motion to conduct an expedited inspection of defendant New England Compounding Pharmacy's (NECC) facility in Framingham, Massachusetts, subject to certain parameters. The court found good cause for early discovery through an inspection, as time is of the essence and further delay could make it difficult for Green to obtain scientifically valid information. The court also found that the proposed inspection and testing are reasonably calculated to lead to the discovery of admissible evidence. The inspection will be allowed to proceed within four days according to specified restrictions to avoid interfering with ongoing government investigations.
The Supreme Court of India heard a case regarding the death of an inmate in Tihar Jail, Delhi. The Court directed the Jail Superintendent to file an affidavit by April 5th providing details about CCTV camera coverage, contraband entering the jail, and the incident. The Court also directed statements from medical officers regarding medical treatment of the inmate. The Court noted the father of the deceased has not received compensation and the government lawyer assured this would be addressed. The case will be heard again on April 8th.
The Supreme Court of Florida ruled on whether the attorney-client privilege protects a party from having to disclose that their attorney referred them to a treating physician. The court determined that such a disclosure implicates confidential communication between the attorney and client and is therefore protected by attorney-client privilege. This decision quashes the ruling of the Fifth District Court of Appeal, which had ordered the disclosure.
This document outlines the procedures and legal standards for deprivation proceedings in juvenile court in Georgia. It discusses pleading requirements, service of petitions, parties to the proceedings, appointment of guardians, the right to counsel, recordation requirements, preliminary protective custody, detention hearings, adjudicatory hearings, and the clear and convincing evidence standard required to prove deprivation.
This document is an appellant's opening brief for a case in the California Court of Appeal regarding a trust. Robert Quick (the appellant) alleges that Andrea Pearson (the respondent), as trustee, breached the trust by concealing its existence from him and failing to provide him distributions as a beneficiary. The brief argues that Quick sufficiently alleged facts to state a cause of action and overcome defenses of statute of limitations and laches. It maintains the trial court erred in sustaining Pearson's demurrer without leave to amend.
Kindred Kentucky Supreme Court 16 32-op-bel-kyZ Research
The Supreme Court denied interlocutory relief to two nursing homes seeking to compel arbitration based on arbitration agreements signed by attorneys-in-fact during admission to the nursing homes. The Court found that the power-of-attorney instruments did not grant the attorneys-in-fact authority to waive the residents' right to access the courts. Additionally, the Court reaffirmed that wrongful death beneficiaries cannot be bound by arbitration agreements signed on behalf of the deceased.
BIA Remands of Immigration Judge V. Stuart Couch from 01/01/2014 to 05/26/2016Bryan Johnson
EOIR FOIA ID # 2016-23184. Also, see acknowledgment letter at following link: http://www.slideshare.net/abogadobryan/eoir-acknowledgment-letter-for-201623284
BIA Remands of Immigration Judge James Nugent from 01/01/2014 to 05/26/2016Bryan Johnson
EOIR FOIA ID # 2016-23184. Also, see acknowledgment letter at following link: http://www.slideshare.net/abogadobryan/eoir-acknowledgment-letter-for-201623284
How to get judicial relief under 8 usc 1447(b) for a stalled naturalization i...Umesh Heendeniya
The document provides guidance on obtaining judicial relief under 8 U.S.C. § 1447(b) when a naturalization application has been stalled by U.S. Citizenship and Immigration Services (USCIS). It outlines the key elements of § 1447(b), including that: (1) USCIS must have failed to make a decision on the application within 120 days of the applicant's initial interview; (2) the applicant can file suit in the district court where they reside; and (3) the court has jurisdiction to decide the application or remand it to USCIS with instructions. The document also discusses issues that have arisen in litigation, such as whether USCIS retains jurisdiction after a § 1447(
BIA Remands of Immigration Judge Theresa Holmes-Simmons from 01/01/2014 to 05...Bryan Johnson
EOIR FOIA ID # 2016-23184. Also, see acknowledgment letter at following link: http://www.slideshare.net/abogadobryan/eoir-acknowledgment-letter-for-201623284
- The Immigration Judge found that they did not have jurisdiction to adjudicate the respondent's application for adjustment of status because the respondent was an arriving alien.
- The respondent appealed, arguing that the Immigration Judge erred in finding a lack of jurisdiction. The respondent also filed a motion to remand.
- The Board of Immigration Appeals granted the respondent's motion to remand, finding that the Immigration Judge did have jurisdiction. The Board remanded the case back to the Immigration Court for further proceedings.
The petitioner, a Laotian citizen residing illegally in the U.S., sought cancellation of removal but was found ineligible due to two convictions. Specifically, the petitioner was convicted of shoplifting and using another person's social security number. The BIA found the petitioner deportable for having two or more convictions for crimes involving moral turpitude. On appeal, the questions presented are 1) whether the appropriate evidentiary standards were used to determine the petitioner's eligibility for cancellation of removal, and 2) whether using another's social security number with intent to deceive constitutes a crime of moral turpitude.
This document is an answer filed by Illinois Midwest Insurance Agency, LLC to the applicant Marcela Acosta's petition for reconsideration of a workers' compensation claim. It summarizes the case history, including that Acosta alleged a cumulative trauma injury and is receiving temporary total disability benefits. It disputes the rate that benefits are being paid at. The answer argues that the original ruling should stand as it is based on substantial evidence, including Acosta's tax documents showing lower earnings than she claims, while she provided no documentation to support her testimony claiming higher earnings. It aims to show the original ruling was reasonably based on the evidence presented.
This document summarizes a court case regarding a dispute over land use jurisdiction between the City of Tontitown, Arkansas and landowners Jay and Connie Potter. The Potters purchased 19 acres outside Tontitown city limits and sought approval to build an RV park. They withdrew their application to Tontitown and received approval from the Washington County Planning Board, but the approval stated it would be void if Tontitown had jurisdiction. Tontitown claimed jurisdiction and sought an injunction to stop construction, arguing it had properly designated its planning area boundaries. The circuit court granted the injunction, finding Tontitown likely to succeed on the merits. The Potters appealed.
The document is a decision by the Board of Immigration Appeals regarding an appeal by Joy Atila Litaba, a citizen of Kenya, of an immigration judge's denial of a continuance. The Board of Immigration Appeals remanded the case to allow Litaba more time to consult with her attorney and seek relief from removal, noting her youth, desire for more time to seek counsel, and the absence of a formal notice of representation. The Board ordered further proceedings consistent with providing Litaba a meaningful opportunity to consult with counsel and seek relief.
This document is a court opinion from the District Court of Appeal of Florida regarding a petition for writ of certiorari filed by Andrea Kidder seeking to quash a discovery order requiring her to disclose the results of a blood alcohol test. The court denied the petition, finding that under Florida Rule of Criminal Procedure 3.220(d)(1)(B)(ii), Kidder was required to disclose the results of the scientific blood alcohol test to the prosecution as part of the reciprocal discovery process after electing to participate in discovery. The court rejected Kidder's argument that the test results were protected work product, determining that the rule requires disclosure of scientific test results regardless of whether the expert conducting the test will be called as a witness.
This document summarizes a court case involving Judy Craig suing TC Ambulance Corporation over injuries suffered by her infant during birth. TC Ambulance moved for summary judgment. The court granted TC Ambulance's motion for reargument and dismissed all claims against them, finding that the plaintiff's expert opinion that TC Ambulance departed from accepted standards by not radioing ahead was speculative and unsupported. The records showed TC Ambulance timely responded, transported the mother to the hospital, and relayed all appropriate information to ER staff. Any delay in treatment occurred after the mother arrived at the hospital.
The document is a memorandum analyzing a products liability case. A college football player, Joseph Green, died from heat stroke after practicing in a football helmet and shoulder pads manufactured by Sports Equipment, Inc. Green's mother brought a lawsuit against the company. The memorandum examines the company's motion for summary judgment on several claims. For the failure to warn claim, the court should grant summary judgment because the plaintiff failed to provide sufficient evidence that the lack of warning on the helmet and pads was the proximate cause of Green's death. The court should also grant summary judgment that the risk of heat illness was open and obvious. However, the learned intermediary defense does not apply in this case.
The document is a decision by an Immigration Judge denying the respondent's motion to reopen removal proceedings. It provides background on the case, including that the respondent was ordered removed in absentia on March 7, 2011 for failing to appear at a hearing. The respondent filed a motion to reopen, arguing he did not receive notice of the hearing. The Judge denies the motion, finding the respondent's affidavit alone is insufficient to overcome the presumption of delivery of the hearing notice by regular mail, as no additional corroborating evidence was provided.
60 Minutes and New England Compounding Pharmacymzamoralaw
This order grants plaintiff Chad Green's motion to conduct an expedited inspection of defendant New England Compounding Pharmacy's (NECC) facility in Framingham, Massachusetts, subject to certain parameters. The court found good cause for early discovery through an inspection, as time is of the essence and further delay could make it difficult for Green to obtain scientifically valid information. The court also found that the proposed inspection and testing are reasonably calculated to lead to the discovery of admissible evidence. The inspection will be allowed to proceed within four days according to specified restrictions to avoid interfering with ongoing government investigations.
Chad Green adv. New England Compounding Pharmacymzamoralaw
This order grants plaintiff Chad Green's motion to conduct an expedited inspection of defendant New England Compounding Pharmacy's (NECC) facility in Framingham, Massachusetts, subject to certain parameters. The court found good cause for early discovery through an inspection, as time is of the essence and further delay could make it difficult for Green to obtain scientifically valid information. The court also found that the proposed inspection and testing are reasonably calculated to lead to the discovery of admissible evidence. The inspection will be allowed to proceed within four days according to specified restrictions to avoid interfering with ongoing government investigations.
The Supreme Court of India heard a case regarding the death of an inmate in Tihar Jail, Delhi. The Court directed the Jail Superintendent to file an affidavit by April 5th providing details about CCTV camera coverage, contraband entering the jail, and the incident. The Court also directed statements from medical officers regarding medical treatment of the inmate. The Court noted the father of the deceased has not received compensation and the government lawyer assured this would be addressed. The case will be heard again on April 8th.
The Supreme Court of Florida ruled on whether the attorney-client privilege protects a party from having to disclose that their attorney referred them to a treating physician. The court determined that such a disclosure implicates confidential communication between the attorney and client and is therefore protected by attorney-client privilege. This decision quashes the ruling of the Fifth District Court of Appeal, which had ordered the disclosure.
This document outlines the procedures and legal standards for deprivation proceedings in juvenile court in Georgia. It discusses pleading requirements, service of petitions, parties to the proceedings, appointment of guardians, the right to counsel, recordation requirements, preliminary protective custody, detention hearings, adjudicatory hearings, and the clear and convincing evidence standard required to prove deprivation.
This document is an appellant's opening brief for a case in the California Court of Appeal regarding a trust. Robert Quick (the appellant) alleges that Andrea Pearson (the respondent), as trustee, breached the trust by concealing its existence from him and failing to provide him distributions as a beneficiary. The brief argues that Quick sufficiently alleged facts to state a cause of action and overcome defenses of statute of limitations and laches. It maintains the trial court erred in sustaining Pearson's demurrer without leave to amend.
Kindred Kentucky Supreme Court 16 32-op-bel-kyZ Research
The Supreme Court denied interlocutory relief to two nursing homes seeking to compel arbitration based on arbitration agreements signed by attorneys-in-fact during admission to the nursing homes. The Court found that the power-of-attorney instruments did not grant the attorneys-in-fact authority to waive the residents' right to access the courts. Additionally, the Court reaffirmed that wrongful death beneficiaries cannot be bound by arbitration agreements signed on behalf of the deceased.
The document discusses two motions in the case of Stephen M. Gaggero v. Knapp, Petersen and Clarke, et al.
1) The court partially granted the plaintiff's motion to quash the third deposition notice but ordered that the plaintiff submit to a final deposition of no more than 10 hours on a mutually agreeable date.
2) The court denied the plaintiff's motion to quash the subpoena for production of documents from the plaintiff's previous attorney. The court found that the plaintiff waived privilege by suing both the defendant and previous attorney and putting the attorney's conduct at issue. The documents were ordered to be produced.
This document is a legal petition requesting review of a hearing officer's recommended order regarding an agency determination. It summarizes the legal issues and standards of review, arguing that genuine issues of material fact exist and summary judgment is therefore improper. It asserts the hearing officer's order lacked legal basis and the agency's interpretation was contrary to statute or an abuse of discretion. The petition aims to show material facts are in dispute and the moving party is not entitled to judgment as a matter of law.
This order declares a Georgia statute capping noneconomic damages in medical malpractice cases unconstitutional. The order discusses the facts of the case, in which a jury awarded damages to the plaintiffs that exceeded the statutory cap. The court considered motions to strike affidavits submitted by the plaintiffs and denied the motions. In a lengthy analysis, the court found that the statutory cap violates the right to a jury trial guaranteed by the Georgia constitution. The court examined the history and scope of the right to a jury trial and determined that the cap improperly infringes on this right. Therefore, the court declared the statutory cap unconstitutional.
02/09/12 GARRETSON RESOLUTION GROUP - Motion To Vacate (STAMPED)VogelDenise
The Garretson Firm Resolution Group, Inc. appears to be a FRONTING Firm for United States President Barack Obama. This is Vogel Denise Newsome's REBUTTAL to Lawsuit/Complaint filed against her for exercising her FIRST AMENDMENT RIGHTS (i.e. Freedom of Speech, etc.). Information that President Barack Obama does NOT want the PUBLIC to see!
San Diego attorney Scott McMillan sued Darren Chaker to remove public records about McMillan's being named in a child molestation investigation. The report is contained as an exhibit in San Diego Superior Court Case No. 37-2017-00036344-CU-NP-CTL and can also be seen on this profile.
Nonetheless, Scott McMillan San Diego attorney suffered a miserable loss in San Diego federal court, then appealed the loss to the Ninth Circuit. San Diego attorney Scott McMillan also filed an identical lawsuit in San Diego Superior Court, Case No. 37-2017-00036344-CU-NP-CTL. As expected, the Ninth Circuit found the lawsuit against Darren Chaker was meritless.
Now, San Diego attorney Scott McMillan is facing two anti-SLAPP motions in San Diego Superior Court and of course the inevitable embarrassment of losing his case, which is almost as bad as Scott McMillan having been sued twice recently for fraud and legal malpractice.
The claimant, Fred Doe, requests that the Appeals Council review and vacate an unfavorable ALJ decision denying disability benefits. Doe contends that remand is necessary due to issues with how the ALJ calculated Doe's RFC, improperly rejected the opinion of examining psychologist Dr. Brent Geary, and inadequately discounted Doe's credibility. Specifically, the ALJ only provided one specific but illegitimate reason for rejecting Dr. Geary's opinion, and the reasons given for discounting Doe's credibility, such as daily activities, were not clear and convincing as required. Doe argues the case should be remanded for proper consideration of this evidence.
CASE ANALYSIS 1
1. Chris Rock v. Larry the Cable Guy
The main issue in this case is whether Larry the Cable Guy should be granted the appeal on the default ruling considering his argument that he was not properly notified.
This is a motion to vacate default judgement. Rule 60(b) (1) provides grounds for relief from a final judgement stating that a judge might relieve a party from a final judgement order based on “… mistake, inadvertence, surprise or excusable neglect.”
Where default judgement is made against a defendant, there are provisions within the law that allow them to seek to vacate or set aside the decision. Rule 60 provides grounds for Relief from a judgement or order. The grounds that the petitioner makes his case are that there was a contravention of Rule 4 as it provides for in the procedure for summons notification in order to reverse the default judgement against him that was based on Rule 55 (a) as (c) states that “…(c) The court may set aside an entry of default for good cause, and it may set aside a final default judgment under Rule 60(b).”
A similar ruling was made in the case of Kirtland v. Fort Morgan Auth. Sewer Serv., Inc. The court threw out the motion to set aside the request the default judgment based on Rule 55(c) which gave it the discretion to “set aside an entry of default at any time before judgment”. As such, all other provisions withstanding, it was still the court’s discretion to allow or disallow the application as guided by the premise of the law.
As Larry had constantly received but ignored notifications of the summons, and he was well aware that in breaching the contract he stood culpable and therefore liable for legal action, his appeal should be declined and the default judgement declined. In arriving at this decision, it is important to consider that all summonses had been done in line with Rule 4 and Larry knew about them and chose to avoid them. This disqualifies him from being able to use the Rule 60 (b) (1) provision as he had no excusable neglect and there were no clerical errors. A consideration of Rule 59 (e) which provides that "A motion to alter or amend the judgment shall be served not later than 10 days after entry of the judgment" should also be made.
The default judgment should be affirmed and the appeal thrown out.
2. W.R. Reeves v. Central of Georgia Railway Company
The main issue in this case is whether admission of testimony by Reeves by the judge in light of the provisions of the Federal Employers Liability Act contributes to a reversible error.
This is a liability for negligence case whose main focus is on the possibility of legal error. The Federal Employers Liability Act provides substantial grounds for a railroader worker to be compensated should there be injuries while on the job. The Central of Georgia Railway Company had a vicarious liability to compensate Reeves.
The Federal Employers Liability Act was mainly designed to offer compensation for some of ...
This document summarizes several recent developments in employment law across various areas:
1) It discusses recent court rulings on whether law firm shareholders are considered employees under discrimination statutes, the appropriate causation standard for ADA claims, and whether the paycheck accrual rule applies to §1983 cases.
2) It also summarizes recent cases related to burden of proof standards for FMLA interference claims, the scope of bankruptcy anti-discrimination statutes, and whether a new EEOC charge is required for retaliation occurring after an initial filing.
3) Additionally, the document analyzes issues like what constitutes actionable retaliation by a lawyer, the right to a jury trial under the WARN Act, and standards for
Federal Court Denying Motion by Satish Vuppalapati, Madhavi Vuppalapati and A...mh37o
Federal court denied the motion by Satish Vuppalapati, Madhavi Vuppalapati and Anandhan Jayaraman. Court confirmed that PISL India and PISl PA are one and the same companies.
This document is a report and recommendation from a magistrate judge regarding a motion to dismiss for lack of personal jurisdiction filed by the defendant, Info Directions, Inc. The plaintiff, Transverse LLC, alleges that Info Directions interfered with its contract and misappropriated its trade secrets related to billing software. The magistrate judge provides background on the parties and claims, summarizes the legal standards for personal jurisdiction, and will make a recommendation to the district court judge on the motion to dismiss.
A judge on the United States Court of Appeals for the Second Circuit for the past 11 years, Sonia Sotomayor is now high on lists that lawyers and politicians have assembled of possible replacements for Justice David H. Souter of the Supreme Court. She has a reputation as a sharp, outspoken and fearless jurist, and many of her opinions have demonstrated a willingness to take the government to task whenever she believes the circumstances warrant it.
This document summarizes several medical device lawsuits and regulatory actions. It discusses a case where a woman sued Medtronic over injuries she claimed were caused by the off-label use of Medtronic's Infuse bone growth device. It also summarizes settlements and rulings in cases involving transvaginal mesh, breast implants, hip implants, pain pumps, surgical staplers, and vascular grafts. Commentary is provided on an FDA draft guidance defining medical device accessories and on using circumstantial evidence in product liability cases. The document provides summaries of litigation and regulatory news in the medical device field.
1 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF CA.docxjoyjonna282
1
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF CALIFORNIA
------------------------------------------------------X
DOUGLAS SMITH,
Plaintiff
Against DECISION
ON MOTION TO
DISMISS
JANE JOHNSON,
PISSEDPRODUCER.COM, INC,
Defendants
------------------------------------------------------X
Haas, J.,
Defendant Jane Johnson (“Johnson”) lives in Portland, Oregon, and operates
defendant corporation, pissedproducer.com (the “website”). The website is devoted to
allowing service providers to complain about actions of consumers. According to the
website’s terms, business owners or service providers are allowed to post feedback about
consumers “that other producers should be wary of.” The website also allows aggrieved
producers to publish the names, addresses and other personal information about
consumers, along with audio and video files that relate to the transaction.
On June 12, YR-01, Brenda James (“James”) posted a story regarding plaintiff,
Douglas Smith (“Smith”) in which she accused him of, inter alia, lying about his
conversations with her, behaving antagonistically towards her and unjustifiably
complaining about her business. She also posted information about Smith’s name,
address and license plate number and a video that showed a confrontation between her
and Smith.
Johnson knowingly allowed this information to remain on her site in spite of
Smith’s protest.
2
Smith brought the present action against Johnson and the corporation that holds
the website alleging defamation, invasion of privacy for intrusion upon seclusion,
invasion of privacy for misappropriation of name and likeness and intentional infliction
of emotional distress against all three defendants.
Subject matter jurisdiction is established under 28 U.S.C. § 1332 (diversity
jurisdiction) because plaintiff is a resident of California and defendants are residents of
Oregon and the amount in controversy is more than $75,000. This is undisputed.
Johnson and the website have moved to dismiss the complaint based on FRCP
Rule 12(b)(2), alleging that this court does not have personal jurisdiction over her and
under FRCP Rule 12(b)(6) for failure to state a claim upon which relief can be granted
with respect to each of the four counts of the complaint.
For the reasons set forth below, I deny the defendant’s motion to dismiss with
respect to each count.
Personal Jurisdiction
Defendant argues that this court lacks personal jurisdiction over Johnson and the
website because they operate exclusively in the state of Oregon and have insufficient
contacts with California to subject them to personal jurisdiction in the state of California.
Under the due process clause of the 14th amendment to the United States
Constitution, a state may exercise long arm jurisdiction over an out-of-state defendant
only if the defendant has “certain minimum contacts with it s ...
This document is a memorandum filed by federal defendants in opposition to plaintiffs' motion for a temporary restraining order and preliminary injunction. It argues that the court should deny the plaintiffs' motion because: (1) the plaintiffs have not established that the court has jurisdiction over their claims, as they have not shown a waiver of sovereign immunity; (2) even if jurisdiction exists, the plaintiffs have failed to state a claim under the First Amendment as non-resident aliens; and (3) ICE's actions regarding hunger strikes are reasonably related to legitimate interests in operating family residential facilities safely. The memorandum also provides background on the plaintiffs and legal standards regarding reinstatement and withholding-only removal proceedings.
Matt Lewis Law - Indemitty Dispute ResolutionMatt Lewis Law
Practices, Procedures & Problems Update 2009.Form DWC-45 Certify good faith effort has been made to resolve the issues identified.Sometimes requires more than a letter to the opposing party. No consistency with this requirement.
Evidentiary exchange – 14 days prior.Matt Lewis Law, P.C. is a firm serving Dallas in Administrative practice, Division of Workers' Compensation cases and Temporary income benefits cases.
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Matt Lewis Law Dallas Texas - Indemnity Dispute Resolution July 2009Matt Lewis Law
INDEMNITY DISPUTE RESOLUTION
Requesting A BRC
Form DWC-45
Certify good faith effort has been made to resolve the issues identified.
Sometimes requires more than a letter to the opposing party. No consistency with this requirement.
Evidentiary exchange – 14 days prior
......
Defense Response to Government Motion to Reconsider 2 October 2014 - al Iraqi...Thomas (Tom) Jasper
This Motion is timely filed pursuant to Rule for Military Commission (R.M.C.) 905(b) and Military Commissions Trial Judiciary Rule of Court (R. C.) 3.7.
The defense requests the Military Judge deny the Government's motion to reconsider, or in the alternative, deny the requested relief as unnecessary.
Similar to Lincare HIPAA remediated decision by administrative judge (20)
Presence Health Resolution Agreement with OCRdata brackets
This resolution agreement between the US Department of Health and Human Services (HHS) and Presence Health Network resolves HHS investigation number 14-176036 regarding Presence Health's violations of the HIPAA Breach Notification Rule. Presence Health failed to provide timely notification of a 2013 breach affecting 836 individuals to those individuals, media outlets, and HHS as required. The agreement requires Presence Health to pay $475,000 and comply with a corrective action plan, which involves revising policies and procedures around breach notification and applying sanctions to employees who fail to follow breach notification policies.
Oregon Health & Science University HIPAA Finesdata brackets
This resolution agreement is between the US Department of Health and Human Services (HHS) and Oregon Health & Science University (OHSU) to resolve HHS investigations of two data breaches at OHSU involving unsecured protected health information. OHSU agrees to pay HHS $2.7 million and comply with the terms of a corrective action plan, which requires OHSU to conduct a risk analysis, develop a risk management plan, implement encryption of mobile and network connected devices, and provide status updates to HHS. The agreement resolves alleged violations of HIPAA privacy and security rules related to the data breaches and ensures OHSU's ongoing compliance during a three year term.
Catholic Health Care Services Resolution Agreement data brackets
This resolution agreement between HHS and CHCS resolves HHS's investigation into CHCS regarding compliance with HIPAA rules. CHCS will pay HHS $650,000 and comply with a corrective action plan to address deficiencies in its risk analysis, security measures, and policies and procedures related to protecting electronic protected health information. The corrective action plan requires CHCS to conduct annual risk analyses, develop and distribute policies to its workforce, report any failures to comply with policies, and provide documentation to HHS. This agreement resolves the issues related to a breach of electronic protected health information at CHCS and its affiliated skilled nursing facilities.
This resolution agreement between the U.S. Department of Health and Human Services (HHS) and New York Presbyterian Hospital (NYP) resolves allegations that NYP impermissibly disclosed patients' protected health information during filming of a television show at the hospital. Under the agreement, NYP will pay $2.2 million and comply with a corrective action plan to strengthen its privacy policies and procedures regarding disclosures to film crews. The agreement includes a release of claims by HHS related to the covered conduct and requires NYP to implement policies addressing uses and disclosures of protected health information, safeguards, authorizations, training, and internal reporting procedures.
This resolution agreement summarizes a settlement between the US Department of Health and Human Services (HHS) and New York Presbyterian Hospital (NYP) regarding an investigation into a potential violation of patient privacy rules. Key points:
- HHS investigated NYP for impermissibly disclosing patient health information to a film crew without authorization.
- NYP agrees to pay $2.2 million and comply with a corrective action plan to resolve the matter.
- The corrective action plan requires NYP to develop comprehensive privacy policies, train staff, investigate potential violations, and report certain incidents to HHS for the next two years.
Raleigh Orthopedic RA and CAP April 2016data brackets
Raleigh Orthopedics's Resolution Agreement and CAP resulting from Raleigh Orthopedic violating the Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules
HIPAA Violation Fines: North memorial Hospistal Settlement data brackets
This resolution agreement resolves a potential violation of HIPAA rules regarding the protection of patient health information. North Memorial Health Care paid $1,550,000 to settle claims that it improperly provided a business associate, Accretive Health, access to patient information without having a signed business associate agreement in place. As part of the settlement, North Memorial agreed to comply with corrective actions to improve its privacy and security practices.
This document provides suggested documentation for exclusions from various measures related to meaningful use of electronic health records. For each measure, it lists the suggested documentation to provide in order to claim an exclusion. This includes summary reports from certified EHR systems with required details like numerators, denominators, and time periods. It also lists statements or documentation that can demonstrate why a particular exclusion or exception applies in some cases. The documentation suggested aims to prove that exclusions are correctly applied and that meaningful use requirements or objectives are not applicable.
Lincare HIPAA Notice of Proposed Determination remediateddata brackets
This document from the Department of Health and Human Services notifies Lincare, Inc. that it intends to impose a civil monetary penalty of $239,800 for violations of the HIPAA Privacy Rule. It finds that a Lincare employee impermissibly disclosed protected health information of 278 patients to an unauthorized individual by leaving the PHI in her home and vehicle without safeguards. It also finds that Lincare's policies failed to adequately protect PHI removed from its facilities. Lincare is found liable for impermissible disclosure, failure to safeguard PHI, and inadequate policies regarding off-site PHI protection. Lincare's arguments do not establish affirmative defenses to the violations.
Office of Inspector General Study on OCR's HIPAA audit programdata brackets
Office of Inspector General: OCR should strengthen its oversight of covered entities' compliance with the HIPAA privacy standards.
OIG has recently completed a study of OCR's HIPAA audit program and published the following recommendations:
(1) OCR should fully implement a permanent audit program
(2) OCR should maintain complete documentation of corrective action
(3) OCR should develop an efficient method in its case-tracking system to search for and track covered entities
(4) OCR should develop a policy requiring OCR staff to check whether covered entities have been previously investigated
(5) OCR should continue to expand outreach and education efforts to covered entities. OCR concurred with all five recommendations and described its activities to address them.
OCR's chief Jocelyn Samuels has concurred with all the recommendations of OIG.
For the complete report please visit our slideshare page:
Cancer Care Group HIPAA Settlement Agreementdata brackets
Cancer Care has taken corrective action with regard to the specific requirements of the Privacy and Security Rules that are at the core of this enforcement action, as well as actions to come into compliance with the other provisions of the HIPAA Rules. The Resolution Agreement and Corrective Action Plan (CAP) can be found on the OCR website at: http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/cancercare.html
Parkview Health System, Inc. (Parkview) has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule with the Department of Health and Human Services (HHS) Office for Civil Rights (OCR). Parkview will pay $800,000 and adopt a corrective action plan to correct deficiencies in its HIPAA compliance program.
HIPAA Settlement New York Presbyterian and Columbia Universtiydata brackets
The resolution agreement summarizes a breach incident involving New York Presbyterian Hospital (NYP) impermissibly disclosing electronic protected health information (ePHI) of 6,800 patients to Google and other internet search engines. It outlines NYP's obligations to pay $3.3 million, implement a corrective action plan, and comply with HIPAA privacy and security rules going forward. The corrective action plan requires NYP to conduct a risk analysis, develop a risk management plan, review and revise access and device policies, implement security awareness training, and report to HHS for three years.
OCR received a breach notice in February 2012 from QCA Health Plan, Inc. of Arkansas reporting that an unencrypted laptop computer containing the ePHI of 148 individuals was stolen from a workforce member’s car. While QCA encrypted their devices following discovery of the breach, OCR’s investigation revealed that QCA failed to comply with multiple requirements of the HIPAA Privacy and Security Rules, beginning from the compliance date of the Security Rule in April 2005 and ending in June 2012. QCA agreed to a $250,000 monetary settlement and is required to provide HHS with an updated risk analysis and corresponding risk management plan that includes specific security measures to reduce the risks to and vulnerabilities of its ePHI. QCA is also required to retrain its workforce and document its ongoing compliance efforts.
OCR opened a compliance review of Concentra Health Services (Concentra) upon receiving a breach report that an unencrypted laptop was stolen from one of its facilities, the Springfield Missouri Physical Therapy Center. OCR’s investigation revealed that Concentra had previously recognized in multiple risk analyses that a lack of encryption on its laptops, desktop computers, medical equipment, tablets and other devices containing electronic protected health information (ePHI) was a critical risk. While steps were taken to begin encryption, Concentra’s efforts were incomplete and inconsistent over time leaving patient PHI vulnerable throughout the organization. OCR’s investigation further found Concentra had insufficient security management processes in place to safeguard patient information. Concentra has agreed to pay OCR $1,725,220 to settle potential violations and will adopt a corrective action plan to evidence their remediation of these findings.
Skagit county- HIPAA violation settlement agreement with HHSdata brackets
Skagit County, Washington, has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules. Skagit County agreed to a $215,000 monetary settlement and to work closely with the Department of Health and Human Services (HHS) to correct deficiencies in its HIPAA compliance program. Skagit County is located in Northwest Washington, and is home to approximately 118,000 residents. The Skagit County Public Health Department provides essential services to many individuals who would otherwise not be able to afford health care.
OCR opened an investigation of Skagit County upon receiving a breach report that money receipts with electronic protected health information (ePHI) of seven individuals were accessed by unknown parties after the ePHI had been inadvertently moved to a publicly accessible server maintained by the County. OCR's investigation revealed a broader exposure of protected health information involved in the incident, which included the ePHI of 1,581 individuals. Many of the accessible files involved sensitive information, including protected health information concerning the testing and treatment of infectious diseases. OCR's investigation further uncovered general and widespread non-compliance by Skagit County with the HIPAA Privacy, Security, and Breach Notification Rules.
Skagit County continues to cooperate with OCR through a corrective action plan to ensure it has in place written policies and procedures, documentation requirements, training, and other measures to comply with the HIPAA Rules. This corrective action plan also requires Skagit County to provide regular status reports to OCR.
EHR meaningful use security risk assessment sample documentdata brackets
Under the HIPAA Privacy and Security Rule, business associates are required to perform active risk prevention and safeguarding of patient information that are very important to patient privacy. The HITECH act allows only minimum necessary to be disclosed when handling protected health information (PHI).
This security risk assessment exercise has been performed to support the requirements of the Department of Health and Human Services (HHS), Office for the Civil Rights (OCR) and other applicable state data privacy laws and regulations. Upon completion of this risk assessment, a detail risk management plan need to be developed based on the gaps identified from the risk analysis. The gaps identified and recommendations provided are based on the input provided by the staff, budget, scope and other practical considerations
Adult & Pediatric Dermatology, P.C., of Concord, Mass., has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules with the Department of Health and Human Services, agreeing to a $150,000 payment. The practice will also be required to implement a corrective action plan to correct deficiencies in its HIPAA compliance program. Adult and Pediatric Dermatology is a private practice that delivers dermatology services in four locations in Massachusetts and two in New Hampshire. This case marks the first settlement with a covered entity for not having policies and procedures in place to address the breach notification provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as part of American Recovery and Reinvestment Act of 2009 (ARRA).
The HHS Office for Civil Rights (OCR) opened an investigation of Adult and Pediatric Dermatology upon receiving a report that an unencrypted thumb drive containing the electronic protected health information (ePHI) of approximately 2,200 individuals was stolen from a vehicle of one its staff members. The thumb drive was never recovered. The investigation revealed that Adult and Pediatric Dermatology had not conducted an accurate and thorough analysis of the potential risks and vulnerabilities to the confidentiality of ePHI as part of its security management process. Further, Adult and Pediatric Dermatology did not fully comply with requirements of the Breach Notification Rule to have in place written policies and procedures and train workforce members.
In addition to a $150,000 resolution amount, the settlement includes a corrective action plan requiring Adult and Pediatric Dermatology to develop a risk analysis and risk management plan to address and mitigate any security risks and vulnerabilities, as well as to provide an implementation report to OCR.
Download the Corrective Action Plan(CAP) here >>
Tips s to providers: Almost all of the HIPAA/HITECH violations identified in the last few years is due to insufficient security risk analysis conducted by the providers or business associates.
This resolution agreement between HHS and Affinity Health Plan resolves an investigation into a breach of protected health information. Affinity will pay $1,215,780 and comply with a corrective action plan. The plan requires Affinity to retrieve photocopier hard drives containing PHI, conduct a security risk analysis, and update policies. If Affinity breaches the agreement or plan, HHS may impose civil money penalties. Both parties aim to resolve the issues without further legal action.
Test bank calculating drug dosages a patient safe approach to nursing and mat...rightmanforbloodline
Test bank calculating drug dosages a patient safe approach to nursing and math 2nd edition by castillo werner mccullough
Test bank calculating drug dosages a patient safe approach to nursing and math 2nd edition by castillo werner mccullough
Test bank calculating drug dosages a patient safe approach to nursing and math 2nd edition by castillo werner mccullough
Health Tech Market Intelligence Prelim Questions -Gokul Rangarajan
The Ultimate Guide to Setting up Market Research in Health Tech part -1
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
This lays foundation of scoping research project what are the
Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
1. Define Research Objectives and Scope
Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
5. Ethical Considerations and Compliance
Ethical Approval: Ensure compliance with ethical guidelines for research involving human subjects.
Data Privacy: Implement measures to protect participant confidentiality and adhere to data protection regulations (e.g., GDPR, HIPAA).
6. Budget and Resource Allocation
Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
The Ultimate Guide in Setting Up Market Research System in Health-TechGokul Rangarajan
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
"Market Research it too text-booky, I am in the market for a decade, I am living research book" this is what the founder I met on the event claimed, few of my colleagues rolled their eyes. Its true that one cannot over look the real life experience, but one cannot out beat structured gold mine of market research.
Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
"In fact, a survey by CB Insights found that 42% of startups fail due to no market need, which is like building a spaceship to Mars only to realise you forgot the fuel."
Sudharsan Srinivasan
Operational Partner Pitchworks VC Studio
Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
Simple Steps to Make Her Choose You Every DayLucas Smith
Simple Steps to Make Her Choose You Every Day" and unlock the secrets to building a strong, lasting relationship. This comprehensive guide takes you on a journey to self-improvement, enhancing your communication and emotional skills, ensuring that your partner chooses you without hesitation. Forget about complications and start applying easy, straightforward steps that make her see you as the ideal person she can't live without. Gain the key to her heart and enjoy a relationship filled with love and mutual respect. This isn't just a book; it's an investment in your happiness and the happiness of your partner
About CentiUP - Product Information Slide.pdfCentiUP
A heightened child formula, with the trio of Nano Calcium, HMO, and DHA mixed in the golden ratio, combined with NANO technology to help nourish the body deeply and comprehensively, helps children increase height, boost brain power, and improve the immune system and overall well-being.
Cyclothymia Test: Diagnosing, Symptoms, Treatment, and Impact | The Lifescien...The Lifesciences Magazine
The cyclothymia test is a pivotal tool in the diagnostic process. It helps clinicians assess the presence and severity of symptoms associated with cyclothymia.
About CentiUP - Introduction and Products.pdfCentiUP
A heightened child formula, with the trio of Nano Calcium, HMO, and DHA mixed in the golden ratio, combined with NANO technology to help nourish the body deeply and comprehensively, helps children increase height, boost brain power, and improve the immune system and overall well-being.
Nursing management of the patient with Tonsillitis PPTblessyjannu21
Prepared by Prof. Blessy Thomas MSc Nursing, FNCON, SPN. The tonsils are two small glands that sit on either side of the throat.
In young children, they help to fight germs and act as a barrier against infection.
Tonsils act as filters, trapping germs that could otherwise enter the airways and cause infection.
They also make antibodies to fight infection.
But sometimes, they get overwhelmed by bacteria or viruses.
This can make them swollen and inflamed.
Tonsillitis is an infection of the tonsils, two masses of tissue at the back of the throat.
Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side.
Tonsillitis is common, especially in children.
It can happen once in a while or come back again and again in a short period.Nursing management of Tonsillitis is important.
A comprehensive understanding of the operations for management of Tonsillitis and areas requiring special attention would be important.
Benefits:
Linga mudra generates excessive heat within the body and is very useful for dealing with colds.
It also helps in boosting the immune system and makes the body more resistant to colds and similar infections.
The benefits of penis posture also extend to the respiratory system and it can help loosen the phlegm accumulated from the throat.
This posture also helps in weight loss.
Discomfort experienced in an air conditioned room is relieved by this mudra.
Difficulty in breathing can be relieved by this mudra.
Congested nose can be relieved by this mudra immediately and one can get good sleep.
It controls the flow of the menstrual cycle. Performing the Linga mudra with the Sun Mudra gives better results – both 15 minutes each, one after the other.
When navel center is shifted from its original place, comes back to its place by this mudra.
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Emotional and Behavioural Problems in Children - Counselling and Family Thera...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
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Lincare HIPAA remediated decision by administrative judge
1. DEPARTMENT OF HEALTH & HUMAN SERVICES
Office of the Secretary
Departmental Appeals Board, MS 6132
Civil Remedies Division
330 lndependence Avenue. SW
Cohen Building. Room G-644
Washington. D.C. 20201
January 13,2016
Marshall S. Ney, Esq.
Friday, Eldredge & Clark, LLP
600 S. 52nd Street, Suite 200
Rogers, Arkansas 72758
and RECEIV[;:)
Roger C. Geer, Esq.
Daniel R. Wolfe, Esq. JAN ? ?016
Assistant Regional Counsels
Office of the General Counsel, Region VI
1301 Young Street, Suite 1138 By: HHS / OGe / JB
Dallas, Texas 75202
Re: Director of the Office for Civil Rights, Petitioner, v. Lincare, Inc.,
d/b/a United Medical.
Docket No. C-14-1056
Decision No. CR4505
Dear Counsel:
Enclosed is your copy of the decision of Administrative Law Judge (ALJ) Carolyn Cozad
Hughes in the above case. If you wish to appeal a decision that is adverse to you, you
must file a notice of appeal with the Appellate Division of the Departmental Appeals
Board (Board) pursuant to 45 C.F.R. Part 160, Subpart E. 45 C.F.R. § 160.548.
The appeal procedures are set out in detail in the document Guidelines -- Appellate
Review ofDecisions ofAdministrative Law Judges Relating to Imposition ofCivil Money
Penalties Based on Violations ofthe HIPAA Administrative Simplification Provisions.
This document is accessible at http://www.hhs.gov/dab/divisions/
appellate/guidelines/civilmoney.html but a copy is enclosed for your convenience.
2. 2
A notice of appeal must be filed within 30 days of the date of service of the ALl decision
unless you file a written request for an extension which the Board grants for good cause
shown. A request for an extension must be filed within the initial 30-day period and
should explain why there is good cause for the requested extension, which may not
exceed 30 days. If the ALl decision is mailed to you, an additional five days is added to
the time permitted for filing the notice of appeal. 45 C.F.R. § 160.526(c).
All submissions to the Board should be addressed to:
Department of Health and Human Services
Departmental Appeals Board, MS 6127
Appellate Division
330 Independence Ave., S.W.
Cohen Building, Room G-644
Washington, D.C. 20201
If you have any questions, please contact Appellate Division Director Carolyn Reines
Graubard at carolyn.reines-graubard@hhs.gov or at (202) 565-0116.
_~incere~_--..;~,,
~'MternDirector, Civil Remedies Division
Departmental Appeals Board
Enclosure
3. Department of Health and Human Services
DEPARTMENTAL APPEALS BOARD
Civil Remedies Division
Director of the Office for Civii Rights,
Petitioner,
v.
Lincare, Inc., d/b/a United Medical,
Respondent.
Docket No. C-14-1056
Decision No. CR4505
Date: January 13, 2016
DECISION
Respondent, Lincare, Inc., d/b/a United Medical, supplies respiratory care, infusion
therapy, and medical equipment to patients in their homes. The estranged husband of one
of its managers complained that his wife allowed him access to the "protected health
information" of Lincare patients, even though he was not authorized to see it. Following
a lengthy investigation, the Director of the Office for Civil Rights (OCR) determined that
Respondent Lincare violated the Health Insurance Portability and Accountability Act of
1996 (HIPAA) because it did not implement policies and procedures to safeguard records
containing its patients' protected health information (PHI), and it failed to protect against
disclosure to unauthorized persons the PHI of 278 of its patients. OCR proposes a civil
money penalty (CMP) of $239,800.
OCR moves for summary jUdgment, which Respondent Lincare opposes.
I agree that the undisputed evidence establishes that Lincare violated HIPAA. I therefore
grant OCR's motion and sustain the $239,800 CMP.
4. 2
Background
HlPAA, sections 1171 through .1180 of the Social Security Act (Act) (collectively
referred to as the Administrative Simplification Provisions), creates privacy rights and
protections for consumers of health services. Pursuant to its provisions, the Secretary of
Health and Human Services has implemented a "Privacy Rule," which sets standards for
protecting PHI. 45 C.F.R. Part 160 and Part 164, Subpart E; see Act § I In(d). Except
as permitted by the regulations, a "covered entity," such as Respondent Lincare (see
discussion below for definition), may not disclose PHI, a type of individually identifiable
health information (see below). 45 C.F.R. § I64.502(a). It "must reasonably safeguard"
PHI from "any intentional or unintentional use or disclosure that is in violation of the
standards, implementation specifications or other requirements" of Subpart E of the
Privacy Rule. 45 C.F.R. § 164.530(c)(2).
Here, Richard Shaw was married to Lincare Manager Faith Shaw, although their
marriage went through a rough patch. She left him and, in late 2008, Richard Shaw
complained to OCR that she left behind documents containing the PHI of Lincare
patients. The documents were in his possession even though he was not authorized to see
them. OCR Exhibit (Ex.) 1; OCR Ex. 2 at 1-2 (Montoya Dec!. 'J[ 3). OCR investigated
and determined that Respondent Lincare had violated HIPAA's Privacy Rule. In a letter
dated January 28, 2014, OCR advised Respondent Lincare that it proposed imposing a
$239,800 CMP. OCR Ex. 1.
Respondent Lincare appeals and OCR now moves for summary judgment. See 45 C.F.R.
§ 160.508(b)(13). With its motion and brief (OCR Br.), OCR submits 41 exhibits (OCR
Exs. I - 41). Respondent Lincare filed a brief opposing summary judgment (R. Br.),
along with one exhibit (R. Ex. 1). OCR filed a reply (OCR Reply) and Respondent filed
a sur-reply (R. Sur-reply).
Issues
As a threshold matter, I consider whether summary judgment is appropriate.
On the merits, the issue is whether Respondent Lincare violated HIPAA standards.
Because Respondent did not properly challenge the amount of the CMP, that issue is not
before me.
5. 3
Discussion
Summary Judgment. Summary judgment is appropriate if a case presents no genuine
issue of material fact, and the moving party is entitled to judgment as a matter of law.
Bartley Healthcare Nursing &Rehab., DAB No. 2539 at 3 (2013) (citing Celotex Corp.
v. Catrett, 477 U.S. 317, 322-25 (1986)); Ill. Knights Templar Home, DAB No. 2274 at
3-4 (2009), and cases cited therein.
The moving party may show the absence of a genuine factual dispute by presenting
evidence so one-sided that it must prevail as a matter of law or by showing that the non
moving party has presented no evidence "sufficient to establish the existence of an
element essential to [that party's] case, and on which [ihat party] will bear the burden of
proof at trial." Livingston Care Ctr. v. Dep't ofHealth &Human Servs., 388 F.3d 168,
173 (6th Cir. 2004) (quoting Celotex Corp., 477 U.S. at 323-24). To avoid summary
judgment, the non-moving party must then act affirmatively by tendering evidence of
specific facts showing that a dispute exists. Matsushita Elec. Indus. Co. v. Zenith Radio
Corp., 475 U.S. 574, 586 n.ll (1986); see also Vandalia Park, DAB No. 1939 (2004);
Lebanon Nursing & Rehab. Crr., DAB No. 1918 (2004). The non-moving party may not
simply rely on denials, but must furnish admissible evidence of a dispute concerning a
material fact. Ill. Knights Templar, DAB No. 2274 at 4; Livingston Care Ctr., DAB No.
1871 at 5 (2003).
In examining the evidence for purposes of determining the appropriateness of summary
judgment, I must draw all reasonable inferences in the light most favorable to the non
moving party. Brightview Care Ctr., DAB No. 2132 at 2, 9 (2007); Livingston Care Ctr.,
388 F.3d at 172; Guardian Health Care Clr., DAB No. 1943 at 8 (2004); but see
Brightview, DAB No. 2132 at 10 (entry of summary judgment upheld where inferences
and views of non-moving party are not reasonable). However, drawing factual inferences
in the light most favorable to the non-moving party does not require that I accept the non
moving party's legal conclusions. Cf Guardian Health Care Ctr., DAB No. 1943 at 11
("A dispute over the conclusion to be drawn from applying relevant legal criteria to
undisputed facts does not preclude summary judgmerit if the record is sufficiently
developed and there is only one reasonable conclusion that can be drawn from those
facts.").
6. 4
Admissible evidence. Respondent Lincare argues that OCR has not demonstrated that it
must prevail as a matter of law because its evidence is unreliable and inadmissible.
According to Respondent, OCR's affidavits are unreliable because they include legal
conclusions and "simple, unsworn hearsay." Without specifically challenging anyone of
the non-testimonial exhibits, Respondent characterizes them all as "un-verified pieces of
paper." R. Br. at 6.1
As a threshold matter, the Federal Rules of Civil Procedure do not even require a movant
to support its motion with affidavits. Rules 56(a) and (b) say that either party may move
for summary judgment "with or without supporting affidavits." See Celotex Corp. ,477
U.S. at 323 (finding "no express or implied requirement in Rule.56 that the moving party
support its motion with affidavits or other similar materials negating the opponent's
claim. On the contrary, Rule 56(c), which refers to 'the affidavits, ifany' (emphasis
added), suggests the absence of such a requirement."); Hartnagel v. Nonnan, 953 F.2d
394,395 (8th Cir. 1992) ("The movant is not required by the rules to support its motion
with affidavits or other similar materials negating the opponent's claim.").
Moreover, although I may apply the Federal Rules of Evidence "where appropriate," I am
not bound by them, and I have broad discretion to admit evidence. I must exclude
evidence that is irrelevant or immaterial; I may exclude relevant evidence "if its probative
value is substantially outweighed by the danger of unfair prejudice, confusion of the
issues, or by considerations of undue delay or needless presentation of cumulative
evidence." 45 C.F.R. § 160.540. Applying these criteria, OCR's exhibits are
unquestionably admissible:
• Affidavits. The affidavits include the testimony of Valerie Montoya, the OCR
investigator assigned to Mr. Shaw's complaint. OCR Ex. 3 (Montoya Dec!.). She
describes Complainant Shaw's accusations, the admissions and other statements
made to her by Lincare Center Manager (and estranged wife) Faith Shaw, and the
admissions and other statements made to her by Lincare Area Manager Darrell
Layton. Under the Federal Rules of Evidence, all of these statements would be
admissible for the fact that the individuals made them.2
Fed. R. Evid. 801(c).
1 Respondent's criticism could more easily apply to its own exhibit - the written
declaration of Lincare Corporate Compliance Officer Jenna Pederson. Without
additional foundation or explanation, she declares as true selected quotations from
statements that she and two other Lincare employees made, which Respondent cited in its
brief opposing summary judgment. R. Ex. 1.
2 Unless offered for the truth of the matter asserted, the statements would not even
qualify as hearsay. Fed. R. Evid. 801(c)(2).
7. 5
Moreover, because Lincare employees made these statements about "a matter
within the scope of [their employment) relationship ... while it existed," they are
admissiblt;: as exceptions to the hearsay rule. Rule 801(d)(2).
Respondent Lincare claims that Center Manager Shaw made her statements to
Investigator Montoya after her employment at Lincare had ended. R. Sur-reply at
6. But Respondent offers no evidence of - in fact, does not even mention - when
the employment relationship ended. In correspondence dated July 28, 2009,
Lincare told Investigator Montoya that Ms. Shaw was the Center Manager until
July 2009 and then became a patient account coordinator in Lincare's Regional
Billing and Collections office. OCR Ex. 30 at 2; see also OCR Ex. 12 at 1; OCR
Ex. 32 at 4.3
More remarkably, Respondent also claims - again without providing any support
that the statements made by Center Manager Shaw and Area Manager Layton are
outside the scope of their jobs. R. Sur-reply at 6. This cannot possibly be true.
The statements in question refer to the Lincare policies and instructions for
protecting PHI and to Manager Shaw's handling of the PHI she removed from the
office she managed. Both Manager Shaw and Area Manager Layton, who was
Manager Shaw's immediate supervisor, explained the company's policies for
maintaining PHI taken out of the office. Their jobs required them to handle, or
supervise those who handled, PHI. If protecting PHI were "outside the scope" of
their jobs, the company was gUilty of even more serious HIPAA violations than
those alleged here. But the actual uncontroverted evidence establishes that these
PHI matters were within the scope of their employment.
Investigator Montoya also authenticates some of OCR's exhibits, specifically, the
compromised documents containing PHI that Mr. Shaw turned over to OCR (see
below). OCR Ex. 3 at 2 (Montoya Dec!. 'lI 8); OCR Ex. 5; OCR Ex. 7.
3 Some evidence suggests that, by late August 2010, Manager Shaw no longer worked at
Lincare. OCR Ex. 19. In the absence of any evidence to the contrary, I could reasonably
infer that she was still an employee when she spoke to Investigator Montoya in August
2009 and even as late as June 2010. Of course, her departure from the company does not
make her subsequent statements inadmissible in these proceedings, particularly
considering that they are supported by other evidence and not specifically challenged by
Lincare. 45 C.F.R. § 160.540; see Florence Park Care Ctr., DAB No. 1931 (2004)
(holding that the moving party must submit evidence only with respect to facts that are in
dispute).
8. 6
The second affidavit was prepared by Laurie A. Rinehart-Thomas, the director of
Health Information Management and Systems at Ohio State University. Ms.
Rinehart-Thomas is certified by the American Health Information Management
Association as a registered health information administrator. OCR Ex. 4
(Rinehart-Thomas Decl.). She offers her expert opinion on Respondent Lincare's
HlPAA compliance and also describes standards in the industry against which to
measure the reasonableness of Respondent's conduct. To the extent that her
declaration asserts facts regarding industry standards and practices, those facts
would be relevant and material. While I agree that I have the ultimate authority to
decide legal questions, I do not agree that a witness's declaration is inadmissible
simply because it includes legal conclusions. Indeed, the rules say the opposite.
Rule 704 says that an opinion "is not objectionable just because it embraces the
ultimate issue." Fed. R. Evid. 704(a).4
• Other exhibits. Nor are OCR's other exhibits "unverified pieces of paper" that
would not be admissible. Not only are OCR's exhibits relevant and material and
thus admissible under 45 C.F.R. § 160.540, they would be admissible under the
Federal Rules. They include:
1. OCR's notice letter and other correspondence between OCR and
Respondent Lincare (OCR Exs. 1,29,30,31,32);
2. Complainant Shaw's written complaint (OCR Ex. 2) and other documents
from OCR's investigation (OCR Exs. 6, 10, 17, 18, 19,20);
3. The Lincare patient documents containing the PHI that is the subject of this
appeal (OCR Exs. 5, 7, 10);
4. Respondent Lincare's written policies and procedures regarding patient PHI
(OCR Exs. 8,9);
5. Email correspondence among Lincare employees regarding the missing
documents (OCR Exs. 11, 12, 13);
6. Handwritten notes of a Lincare employee, which describe employee
conversations regarding the missing documents (OCR Exs. 20-28);
7. The criminal court docket sheet for a criminal complaint the company
brought against Complainant Richard Shaw (OCR Ex. 14);
4 Ms. Rinehart-Thomas offers interesting insights into the types of practices companies
use to protect PHI. These might have been useful in a closer case. But, here, I need not
rely on her opinions in order to conclude that Lincare violated HIPAA.
9. 7
8. Correspondence between Respondent Lincare and Complainant Shaw
regarding the missing documents (OCR Exs. 15, 16);
9. Transcripts of Investigator Montoya's interviews with Lincare employees
(OCR Exs. 33, 34);
10. Research materials regarding the importance of protecting PHI (OCR
Exs. 35-38); and
11. OCR materials with instructions about protecting PHI (OCR Exs. 39-41).
Respondent Lincare has not come forward with any evidence suggesting that this
evidence is unreliable and does not even allege that it disputes the underlying facts
established by these documents. In fact, it has explicitly admitted most of them. R. Bf.
at 2-5.
OCR has thus come forward with admissible evidence, which, as the following
discussion shows, establishes that it must prevail at trial. To avoid summary judgment,
Respondent Lincare had to come forward with evidence showing a dispute of material
fact. But it has not done so, and OCR is therefore entitled to summary judgment. See
Guardian Health Care Crr., DAB No. 1943 (finding summary judgment appropriate
where the moving party identified certain facts as undisputed, and the nonmoving party
failed to identify which of those facts were in dispute, relying instead on unsubstantiated
assertions and generalizations to oppose the motion); Florence Park Care Crr., DAB No.
1931.
1. OCR is entitled to summaryjudgment because the undisputed evidence establishes
that Respondent Lincare did not reasonably safeguard the PHI ofits patients, as
required by 45 C.P.R. § 164.530(c), which allowed an unauthorized individual
access to that infonnation.5
Privacy Rule. As noted above, HIPAA creates privacy rights and protections for
consumers of health services, and, pursuant to its provisions, the Secretary has
implemented the Privacy Rule, which mandates that a covered entity reasonably
safeguard PHI from any use or disclosure that violates the rule's requirements. 45 C.F.R.
§ 164.530(c)(2).
"Disclosure" includes "the release, transfer, provision of access to, or divulging of
information outside the entity holding the information." 45 C.P.R. § 160.103.
5 My findings of fact/conclusions of law are set forth, in italics and bold, in the
discussion captions of this decision.
10. 8
The regulations define "covered entity," as I) a health plan; 2) health care clearing house;
or 3) health care provider who transmits any health information in electronic form in
connection with a transaction covered by HIPAA. Act § 1172(a); see Act § 1173(a)(I);
45 C.F.R.§§ 160.102,160.103,160.104. Employees, volunteers, trainees, and other
persons whose conduct, in performing work for a covered entity, is "under the direct
control of such covered entity" are considered the entity's "workforce." 45 C.F.R.
§ 160.103.
"Health information" means any information, whether oral or recorded in any form, that
I) is created or received by, among other entities, a health care provider; and 2) relates to
an individual's physical or mental health or condition, the provision of care to an
individual, or payment for providing health care to an individual. 45 C.F.R. § 160.103.
The regulations then define particular types of health information:
• "Individually identifiable health information" is a subset of health information,
including demographic information, that is collected from an individual. It is
created or received by a health care provider or other specified entity, and relates
to an individual's physical or mental health or condition (past, present, or future);
the provision of health care to an individual; or payment for providing health care
to an individual. The information identifies an individual or could be used to
identify an individual. 45 C.F.R. § 160.103.
• "Protected health information" (PHI) is a type of individually identifiable health
information. With limited exceptions not applicable here, it means identifiable
health information that is transmitted by electronic media, maintained in electronic
media, or transmitted or maintained in any other form or medium. 45 C.F.R.
§ 160.103.
HIPAA authorizes the Secretary to impose CMPs on those who violate its standards. It
incorporates most of the existing CMP provisions of the Act, which are found at section
1128A. Act § 1176(a)(2); 45 C.F.R. § 160.402(a). Section 1128A of the Act makes a
principal liable for the actions of its agent acting within the scope of that agency. Act
§ I128A(l); 45 c.F.R. § 160.402(c)(I).
Lincare's HIPAA violations: disclosure of PHI to an unauthorized individual. The
.material facts of this case are nQt in dispute. Respondent Lincare supplies oxygen and
other respiratory therapy equipment and services to patients in their homes or at
alternative sites. It operates more than 850 branch locations in 48 states. R. Br. at 1. The
parties agree that Lincare is a "covered entity." OCR Bf. at 4; R. Br. at 2.
11. 9
This case centers around the Lincare branch located in Wynne, Arkansas, which was
doing business as United Medical. Faith Shaw was the Wynne Center's manager from
October 2005 until July 2009 and, as such, was responsible for maintaining the PHI of its
patients. The parties agree that she was a workforce member. OCR Bf. at 4; R. Br. at 2;
OCR Ex. 19; OCR Ex. 32 at 3 (referring to Ms. Shaw as "Ms. Williams"). .
Among other materials, Ms. Shaw was responsible for:
• An "Emergency Procedures Manual," dated February 2005, which contained PHI
of 270 Lincare patients, specifically their names, addresses, telephone numbers,
and emergency contacts (OCR Br. at 4; R. Br. at 4; OCR Ex. 5); and
• Patient-specific documents dated between June 2007 and July 2008 for eight
Lincare patients. These included patient assessments and care plans, physician
prescriptions, certificates of necessity, and confirmations of orders. These
documents also contained patient names, addresses, telephone numbers, dates of
birth, medical symptoms, diagnoses, medical test results, prescriptions, names of
physicians, and names of pharmacies. OCR Br. at 4-5; R. Br. at 4; OCR Ex. 7.
The parties agree that all of these materials included PHI. OCR Br. at 4; R. Br. at 2-3.
The parties also agree that, because Lincare employees provided services away from the
company's offices, they had to remove from those offices records containing PHI. In
addition, prior to November 2008, the company instructed its center managers to
maintain copies of the procedures manual "secured" in their vehicles so that company
employees would have access to patient contact information if a center office were
destroyed or otherwise made inaccessible. OCR Ex. 18 at 1-2; OCR Ex. 33 at 30; OCR
Ex. 34 at 20-22, 26, 30, 33; R. Br. at 9.
Accordingly, Center Manager Shaw took from the office the manual and other documents
containing PHI. She told the OCR investigator that she kept the documents in her car
even though she knew that her husband had keys to the car. When she moved out of the
marital home in August 2008, she left the documents behind. She also admitted to the
OCR investigator that, when she left, she didn't even know where the car was parked.
OCR Ex. 18.
Neither Center Manager Shaw nor anyone else from Lincare realized that the documents
were missing until about November 2008, when Richard Shaw - who, everyone agrees,
was not authorized to see the PHI - reported to Lincare and then to OCR that he had
them. OCR Br. at 5;R. Br. at 3-4; OCR Ex. 3 at 2-6 (Montoya Decl. '}['}[ 7,10,11,17);
OCR Ex. 17, OCR Ex. 18; OCR Ex. 30 at I, OCR Ex. 33 at 13.
12. 10
Affirmative Defenses. HIPAA limits the affirmative defenses available to Respondent
Lincare. Act § 1176(a)(1). For violations occurring on or after February 18,2009, OCR
may not impose a CMP if: 1) the covered entity establishes that it did not know about the
violation (determined in accordance with federal common law of agency) and, by
exercising reasonable diligence, would not have known about the violation; or 2) despite
the exercise of ordinary business care and prudence, circumstances made it unreasonable
for the covered entity to comply with the violated provision; the violation was not caused
by "willful neglect"; and it was corrected within 30 days of the date the covered entity
knew or should have known about it. OCR may extend the 30-day period as it deems
appropriate, "based on the nature and extent of the failure to comply." 45 C.F.R.
§ 160.410(b).
Respondent Lincare claims that it was the victim of a theft, for which it should not be
held accountable. Without providing evidence to support its accusations, it maintains that
Complainant Shaw "stole" the manual and attempted to use it as leverage to induce his
estranged wife to return to him. R. Br. at 16. For purposes of summary judgment, I need
not accept such unsupported allegations as true. But even if I accepted the allegations,
Lincare's "defense" is just as damaging - perhaps even more damaging - than the OCR
version of events. Under HIPAA, Respondent was obliged to take reasonable steps to
protect its PHI from theft.6
It violated that obligation when Manager Shaw took
documents out of the office, left them in places (car or home) accessible to this
purportedly untrustworthy and possibly unbalanced individual, and then, apparently
without giving a thought to the security of those documents, abandoned them entirely.7
Further, as OCR correctly points out, even after it learned of the breach, Lincare took no
steps to prevent further disclosure of PHI. Indeed, managers did not seem to recognize
that they had a significant problem protecting PHI that was removed from the office.
When asked whether Lincare considered revising its policies to include specific
guidelines for safeguarding PHI taken out of its offices, Corporate Compliance Officer
6 The drafters of the regulations noted that theft "mayor may not signal a violation of
[the Privacy Rule], depending on the circumstances and whether the covered entity had
reasonable policies to protect against theft." 65 Fed. Reg. 82462, 82562 (December 28,
2000).
7 Lincare has not come forward with a shred of evidence to substantiate its defamatory
allegations against Complainant Shaw, and, in fact, all the evidence before me suggests
'
that he found the documents in the house or car that he shared with his wife. See, e.g.,
OCR Exs. 17, 18. The company filed a criminal complaint against him and had him
arrested, but the charges were dropped. OCR Ex. 14 at 2; R. Br. at 3. In any event, there
is no question that Mr. Shaw called OCR to report the unauthorized disclosure and that he
turned the documents over to that office. He may have wanted to punish his wife or to
compel her return, but his is hardly the behavior of someone intent on stealing PHI.
13. 11
Pederson replied that Lincare personnel "considered putting a policy together that said
thou shalt not let anybody steal your protected health information." OCR Ex. 33 at 29.
I do not consider this a serious response.
Thus, undisputed evidence establishes that Manager Shaw, a Lincare workforce member,
removed her patients' PHI from the company office, left it in places to which her
husband, an unauthorized person, had access, and then abandoned it altogether. Neither
she nor anyone else at Lincare even knew that the information was missing until months
later. Lincare thus failed to "reasonably safeguard" its patients' PHI and violated section
164.530(c) of the HIPAA Privacy Rule.
2. OCR is entitled to summary judgment because the undisputed evidence establishes
that, in violation of45 C.F.R. § 164.530(i), Respondent Lincare failed 'to develop or
implementpolicies andprocedures to protectfrom disclosure the PHI that staff
removedfrom branch offices.
HIPAA requirements. A covered entity must implement policies and procedures that,
with respect to PHI, comply with the "standards, implementation specifications, or other
requirements" of subparts D and E of the Privacy Rule. The policies and procedures
must be reasonably designed, taking into account the size and the type ofactivities
undertaken by the covered entity to ensure compliance. 45 C.F.R. § l64.530(i)(I). The
covered entity must maintain its policies and procedures "in written or electronic form."
45 C.F.R. §164.530U)(1)(i).
Lincare's HIPAA violation: inadequate policies and procedures for protecting PHI. As
noted above, the parties agree that, in order to perform their duties, Lincare employees
had to take out of the office documents containing PHI. OCR Br. at 5; R. Br. at 3-4. The
parties also agree that Lincare was required to develop and implement policies and
procedures reasonably designed to protect its patients' PHI while those documents were
out of the office. OCR Br. at 6; R. Br. at 6-7.
In attempting to identify a material fact in dispute, Respondent Lincare asserts that the
question of whether its policies were "reasonably designed" presents a factual dispute
requiring a hearing. R. Br. at 7. But deciding whether Lincare's policies met the
regulatory requirements that they be reasonably designed is a legal question. And, as the
undisputed evidence establishes, Lincare's policies were inadequate. In fact, no written
policy even addressed staff's protecting PHI that was removed from the offices.
At the time of the unauthorized disclosures to Complainant Shaw, Respondent Lincare
had in place a written privacy policy that addressed maintaining records within the center
offices but said nothing about removing them from those offices. Indeed, a strict reading
of the policy suggests that such documents should not leave the office, but must be kept
in areas inaccessible to all except company employees. The policy explicitly prohibits
14. 12
outsiders from areas where PHI is stored, limiting their access to the office's "front
entrance area or lobby." OCR Ex. 9 at 4 ("Access to areas containing PHI is limited to
company employees.").
The company ostensibly revised its policies in 2009, which was after it learned of the
unauthorized disclosure. Yet, the new policies and procedures provide no guidance to
employees required to remove documents from the office's secured storage space; in that
respect, its policies for protecting patient records were virtually unchanged. OCR Ex. 8
at 4. Indeed, as noted above, Lincare management did not seem to recognize any
problem and did not seriously consider amending its policies to safeguard PHI removed
from the office. OCR Ex. 33 at 29 ("We considered putting a policy together that said
thou shalt not let anybody steal your protected health information.").
According to Area Manager Layton, sometime after the breach - he could not remember
when - he instructed staff to return all patient-specific infonnation to the center on the
same day it was taken out. Area Manager Layton conceded that he had no written record
of those instructions. OCR Ex. 34 at 27; see R. Br. at 9 (affirming that staff were
instructed to return the manual to the offices at night, but not indicating when that policy
went into effect).
To establish that it had in place and implemented an adequate policy, Respondent Lincare
points to the following bullet point in the written policy:
• Information Storage - filing cabinets and medical charts are to be kept in secured
locations where they cannot be accessed by the public.
OCR Ex. 8 at 4; OCR Ex. 9 at 4; R. Br. at 7.
In context, this provision plainly addresses file storage within the office. It and other
instructions are explicitly addressed to "each location," not to the individual employees,
and it is in a list of instructions for storage of information within the office. But, even if
it applied to documents taken out of the office, the policy does not satisfy the regulation
because it provides no usable guidance to employees. Given the "type of activities"
Lincare employees engage in, i.e., providing care in patient homes and regularly taking
PHI out of the office, the bullet point does nothing to ensure compliance with the
requirements of the Privacy Rule.
Respondent Lincare suggests that its policies are deliberately broad so that the individual
centers could tailor them to meet their differing needs. R. Br. at 7. Developing such
individualized policies, which take into account an office's size and type of activities,
15. 13
would certainly be consistent with the regulations. But those policies must still be
maintained "in written or electronic form." Respondent Lincare has come forward with
no such policies for its Wynne, Arkansas (or any other) branch and does not claim that
they existed in the required format.
Instead, Respondent Lincare suggests that it satisfied HIPAA requirements because its
employees were trained in privacy policies, and "understood those policies, practices and
procedures[.]" R. Br. at 8. But even if this training were flawless (and no evidence
suggests that it was even adequate), staff training does not compensate for missing
policies.8
In addition to having policies and procedures in place, the covered entity must
train all members of its workforce. 45 C.F.R. § 164.530(b).
Finally, the company had no policies - written or otherwise - in place to monitor
documents removed from their offices and to ensure their return. This meant that PHI
could be missing for indefinite periods without the company's knowledge, as happened
with the documents Manager Shaw removed and later abandoned.
Respondent Lincare presents no evidence to establish that it maintained, in written or
electronic form, policies and procedures reasonably designed to address protecting the
PHI removed from its offices. Indeed, no evidence suggests that it implemented any
coherent policies to keep that information secure. It therefore violated section 164.530(i)
of the HIPAA Privacy Rule.
3. Respondent Lincare has waived any challenge to the amount ofthe proposed
penalty.
OCR argues that Respondent Lincare has waived any challenge to the amount of the
CMP. I agree. To preserve that issue, a party's hearing request must include "the factual
and legal basis for opposing the penalty." 45 C.F.R. § 160.504(c); OCR Ex. I at 8; OCR
Reply at 18. Here, except to challenge the HIPAA violation itself, neither Lincare's
hearing request nor its subsequent submissions challenge the amount of the penalty. It
thus waived any challenge to the amount of the penalty.
8 Respondent offers no real evidence describing the training curriculum. It relies on
selected quotes from company employees describing their training. The employee
descriptions are far from comprehensive; they do not specify what the policies were or
when they were implemented. For example, Respondent quotes Service Representative
Robert Dean Scott describing a Wynne Center policy to return the manual to the office at
night. R. Br. at 9. Neither he nor Respondent indicates when this policy went into effect.
R. Br. at 9. Based on the undisputed evidence in the record, it probably occurred
sometime after the breach. OCR Ex. 34 at 27.
16. • 14
Moreover, even if it had otherwise preserved the issue, the respondent has the burden of
going forward and the burden of persuasion with respect to aJ.!y challenge to the amount
of the proposed penalty. 45 C.F.R. § 160.534(b)(ii). Because it proffers no evidence or
argument attacking the amount of the penalty, Respondent Lincare has not met its
burden, and I must affirm the amount of the proposed penalty.
Conclusion
The undisputed evidence establishes that Lincare violated HIPAA because it failed to
safeguard the PHI of its patients; a member of its workforce disclosed patient PHI to an
unauthorized person; and it lacked policies and procedures reasonably designed to ensure
compliance with the Privacy Rule. I therefore grant OCR's motion for summary
judgment and sustain the $239,800 eMP.