Tag: Department of Health and Human Services

USDA’s Budget Boom

Spending at the U.S. Department of Agriculture will be an estimated inflation-adjusted 43 percent higher this year compared to just a decade ago. The following chart shows the dramatic rise in USDA spending from fiscal 1970 to the president’s projection for fiscal 2011:

Most folks probably think of farm subsidies when they think of the USDA. However, farm programs only account for 19 percent of total USDA outlays. The vast majority of USDA spending, 69 percent, goes to food subsidies: food stamps, school breakfast and lunch programs, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). In fact, spending on food stamps alone this year will account for roughly half of total USDA spending.

Why aren’t these programs housed at the Department of Health and Human Services, the government’s chief welfare bureaucracy? The answer is politics, of course. Every five years or so Congress passes a new “farm bill,” which updates or sets the agenda for USDA programs and policies. Stuffing welfare programs in with traditional farm subsidies engenders broad legislative support for the total legislative package. Including food subsidies helps secure votes from urban and suburban legislators who would otherwise have little or no incentive to vote for farm subsidies.

See here for more on downsizing the Department of Agriculture, including both farm and food subsidies.

Privacy? Nuthin’. Respect My Authoritah!

A fascinating enforcement action under the Health Insurance Portability and Accountability Act (HIPAA) shows what really matters in the world of privacy regulation.

The U.S. Department of Health and Human Services has imposed a $4.3 million civil penalty against Maryland-based Cignet Health for violations of its regulations. HHS’s Office for Civil Rights (OCR) found that Cignet violated 41 patients’ HIPAA rights by denying them access to their medical records, which they requested between September 2008 and October 2009. The penalty for these violations is $1.3 million.

But Cigna’s real crime was willful disobedience of the government. Who knows why, but according to the government:

During the investigations, Cignet refused to respond to OCR’s demands to produce the records. Additionally, Cignet failed to cooperate with OCR’s investigations of the complaints and produce the records in response to OCR’s subpoena. OCR filed a petition to enforce its subpoena in United States District Court and obtained a default judgment against Cignet on March 30, 2010. On April 7, 2010, Cignet produced the medical records to OCR, but otherwise made no efforts to resolve the complaints through informal means.

OCR also found that Cignet failed to cooperate with OCR’s investigations on a continuing daily basis from March 17, 2009, to April 7, 2010, and that the failure to cooperate was due to Cignet’s willful neglect to comply with the Privacy Rule. Covered entities are required under law to cooperate with the Department’s investigations.

The penalty for that was $3 million.

Notably, the HHS release says nothing about the condition of the aggrieved parties. How are they doing with their $31,000 a piece? Does it fully compensate for their inability to access medical records during the relevant period?

Just kidding! Nobody really cares.

This enforcement action has nothing to do with remedying a genuine breach of privacy—an annoyance and genuine paperwork problem, yes—and everything to do with sending a message: You will respect my authoritah!