r?m?a 5 DEPAR HE sanvl OFF 3 3 Voice 555-1340, (sou) 353.1019. run (511) 555- 1343, (son) 531?759? FAX my O?'lce Rights, Region I an JFK Federal Building, Room 1er - Boston. MA mos-coo: FEB 2 7 2014 Director, Privacy 8.: Civil Liberties Of?ce TRICARE Management Activi 7700 Arlington Blvd., Suite Falls Church, VA 22042 Re: New . Tricare OCR Transaction Number: - 01-13-153657 Deal- On December 10, 2012, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), Region I received a complaint alleging that Tricare has violated the Federal Standards for Privacy of Individually Identi?able Health Information (45 C.F.R. Parts 160 and 164, Subparts A and E, the Privacy Rule). Speci?cally, the complainant alleges that on several occasions between 2009 and 2010, the US. Naval Hospital in Yokosulca, Japan sent invoices for medical treatment to at the wrong address. This allegation could re?ect a violation of 45 C.F.R. 164.502(a) and OCR enforces the Privacy, Security, and Breach Noti?cation Rules, and also enforces Federal civil rights laws which prohibit discrimination in the delivery of health and human services because of race, color, national origin, disability, age, and under certain circumstances, sex and religion. Generally, the Privacy Rule permits a covered entity to make disclosures of protected health information (PHI) for a permitted purpose like payment, through a variety of means, such as by mail or facsimile machine, as long as the covered entity, when doing so, uses reasonable and appropriate administrative, technical, and physical safeguards to protect the privacy of the PHI. See 45 C.F.R. These safeguards may vary depending on the mode of conununicatien used. For example, when faxing PHI to a telephone number that is not used regularly, a reasonable safeguard may involve a covered entity ?rst con?rming the fax number with the intended recipient of the fax. In this matter, the complainant alleges that PHI was impermissiny disclosed either through the mail or by fax. Pursuant to its authority under 45 C.F.R. 160.304(a) and OCR has determined to resolve this matter informally through the provision of technical assistance to Tricare. To that end, OCR has enclosed a checklist of reminders on how to safely use the mail or fax machines when sending PHI. You are encouraged to review these materials closely and to share them with your staff as part of the Health Insurance Portability and Accountability Act (HIPAA) training you provide to your Transaction 01-13-153657 workforce. You are also encouraged to assess and determine whether there may have been an incident of noncompliance as alleged by the complainant in this matter, and, if so, to take the steps necessary to ensure such noncompliance does not occur in the future. Please contact OCR if you need ftu'ther information regarding the allegations in this matter. Should OCR receive a similar allegation of noncompliance against Tricare in the future, OCR may initiate a formal investigation of that matter. Based on the foregoing, OCR is closing this case without further action, effective the date of this letter. determination as stated in this letter applies only to the allegations in this complaint that were reviewed by OCR. Under the Freedom of Information Act, we may be required to release this letter and other information about this case upon request by the public. In the event OCR receives such a request, we will make every effort, as permitted by law, to protect information that identi?es individuals or that, if released, could constitute a clearly unwarranted invasion of personal privacy. If you have any questions regarding this matter, please contact Monika Rushford, Investigator, at (617) 565-1345 (Voice) or (617) 565-1343 (TDD). Sincerely, Susan M. Pezzullo Rhodes Acting Regional Manager Enclosure: Checklist with. .- i WEEKWCES OFFICE 0FW 5 Voice (617) 565-1340, {300) 368-1019, TDD (617') 565- 1343, (800} FAX [617) 565-3309, Office for Civil I JFK Federal Building, Room 1375 Government Center FEB 2 7 21m 5 ?m Re: ?(61 v. Tricare OCR Transaction Number: - 01-13-153657 Dear (melon?) On December 10, 2012, the US. Department of Health and Human Services (HHS), Of?ce for Civil Rights (OCR), Region I received your complaint alleging that Tricare has violated the Federal Standards for Privacy of Individually Identi?able Health Information (45 C.F.R. Parts 160 and 164, Subparts A and E, the Privacy Rule). Speci?cally, you allege that on several occasions between 2009 and 2010, the US. Naval Hospital in Yokosuka, Japan sent your spouse invoices for medical treatment at the wrong address. This allegation could re?ect a violation of 45 C.F.R. 164.502(a) and Thank you for bringing this matter to attention. Your complaint plays an integral part in enforcement efforts. OCR enforces the Privacy, Security, and Breach Noti?cation Rules, and also enforces Federal civil rights laws which prohibit discrimination in the delivery of health and human services because of race, color, national origin, disability, age, and under certain circumstances, sex and religion. The Privacy Rule allows health care providers and health plans to share protected health information (PHI) for permitted purposes using the mail or fax, as long as they use reasonable and appropriate administrative, technical, and physical safeguards to protect the privacy of the PHI. See 45 C.F.R These safeguards may vary depending on the mode of communication used. For example, when faxing PHI to a telephone number that is not used regularly, a reasonable safeguard may involve a covered entity first continuing the fax number with the intended recipient of the fax. We have carefully reviewed your complaint against Tricare and have determined to resolve this matter informally through the provision of technical assistance to Tricare. Should OCR receive a similar allegation of noncompliance against Tricare in the future, OCR may initiate a formal investigation of that matter. OCR Transaction Number: - 01-13-153657 Based on the foregoing, OCR is closing this case without further action, effective the date of this letter. determination as stated in this letter applies only to the allegations in this complaint that were reviewed by OCR Under the Freedom of Information Act, we may be required to release this letter and other information about this case upon request by the public. In the event OCR receives such a request, we will make every effort, as permitted by law, to protect information that identi?es individuals or that, if released, could constitute a clearlyr unwarranted invasion of personal privacy. If you have any questions regarding this matter, please contact Monika Rushford, Investigator, at (617) 565-1345 (Voice) or (617) 565-1343 (TDD). Sincerely, ?aw Susan M. Pezzullo Rhodes Acting Regional Manager