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OCR Director Roger Severino Concludes His Appointment

Roger Severino left his position as Director of the HHS Office for Civil Rights effective January 15, 2021. Severino has served as OCR Director since March 2017, when he was first appointed to serve in his HHS OCR leadership post. 

To his OCR colleagues, Severino said, “It has been a privilege, honor, and a pleasure to work with such a talented and dedicated group of colleagues who care deeply about protecting the civil rights, conscience and religious freedom, and health information privacy rights of all Americans.  We have made incredible strides and I want to thank each and every one of you for your contributions.  I will remember my time at OCR fondly.”

Severino has been the longest serving OCR Director in the past three decades.  Under his leadership, OCR attained national and international recognition for its work in civil rights, conscience and religious freedom, and health information privacy and security.  During his tenure, OCR issued an unprecedented number of policy documents, including regulations and guidance, implemented a number of enforcement initiatives resulting in OCR addressing major issues facing the Nation, and conducted outreach to an expansive network of stakeholders.

OCR Accomplishments March 2017 – January 2021

Between March 2017 and January 2021, OCR issued an unprecedented number of policy documents, including regulations and guidance, implemented a number of enforcement initiatives resulting in OCR addressing major issues facing the Nation, and conducted outreach to an expansive network of stakeholders. Under Severino’s leadership, OCR:

  • made critical contributions to the HHS COVID-19 response
  • helped to work towards ending the Opioid crisis
  • protected religious liberty and conscience
  • achieved the highest number of HIPAA enforcement actions
  • enhanced patient access to and control of their health information
  • combatted sex discrimination
  • enhanced equal access by persons with limited English proficiency and disabilities  
  • promoted regulatory reform and coordinated care, and
  • resulted in helping the American people

 
OCR’s major accomplishments during this time include:

Critical Contributions to the HHS COVID-19 Response:  OCR recognized from the inception of COVID-19 that its efforts were essential to support the overall HHS response.  As soon as the Secretary declared a public health emergency at the end of January 2020, OCR immediately issued a Bulletin on HIPAA Privacy and the Novel Coronavirus to inform the public on how HIPAA permits protected health information (PHI) to be disclosed during an emergency.  Subsequent proactive actions targeted key pandemic response actions to ensure that HIPAA supported telehealth, the sharing of health data with public health agencies, COVID-19 testing, and scheduling vaccination appointments.  It also issued timely guidance on telehealth, disclosures to first responders, media access to PHI, how health care entities can notify former patients about plasma donation opportunities, and Health Information Exchanges and Disclosures of PHI for Public Health Purposes.  Similarly, OCR led the federal government’s civil rights response beginning with issuing the first statement in March that civil rights protections apply during the pandemic outlined in a joint civil rights/HIPAA Informational Bulletin.  Based on a series of complaints against states for their discriminatory triaging policies, OCR became the national leader in developing model practices that protect civil rights, including resolving eight complaints at the fastest rate in OCR’s history, which changed discriminatory practices of categorically excluding individuals because of their disability or age and also led to model policies by the Health Care Resilience Taskforce for hospitals and long-term care facilities and guidance by a coalition led by the National Academy of Medicine and nine additional health care organizations.  In addition, OCR worked with hospitals in light of visitation restrictions to ensure support persons are available as a reasonable modification for patients with disabilities and worked in concert with CMS to provide technical assistance so that patients can receive safe religious hospital visitations.  OCR also facilitated the resolution of a complaint against a university hospital to provide accommodation to the religious exercise of a medical student to keep a beard according to his faith while using personal protective equipment. 

Ending the Opioid Crisis: OCR made significant contributions to this Secretarial priority by conducting a nationwide comprehensive civil rights and HIPAA public education campaign, which included an opioid website with a public service video announcement narrated by the OCR Director.  OCR also collaborated with SAMHSA and ACF to develop an on-line training program and toolkit on “Opioids and Child Welfare.” OCR’s civil rights enforcement actions in this area have become national models, including a statewide settlement with West Virginia to ensure non-discrimination in adoption.  In addition, OCR promoted public awareness of how the Privacy Rule permits disclosures of PHI that can help address the opioid crisis at outreach presentations across the county, including high visibility webinars that have provided critical information to providers.  OCR’s December 2020 NPRM on Modifications to the HIPAA Privacy Rule is the first major proposed changes to the HIPAA Rules in seven years, and addresses needed information sharing to address the opioid crisis, such as increasing the ability of covered entities to disclose PHI to family members, caregivers, and friends; and disclosures to prevent or lessen serious threats to health and safety. 

Protecting Religious Liberty and Conscience:  In January of 2018, OCR created a Conscience and Religious Freedom Division (CRFD) as a new component of OCR Headquarters’ operations, dedicated exclusively to enforcing laws that protect conscience and religious exercise and that prohibit coercion and religious discrimination in health care and human services.  OCR progressively built the new division’s capacity to handle internal compliance, outreach and education, policymaking, case processing, and investigations by hiring career staff with the appropriate skills and experience and by establishing the appropriate leadership and management structures.  OCR has undertaken major policy changes, including the release of a regulation, currently vacated by Federal courts and under appeal, Protecting Statutory Conscience Rights in Health Care; Delegations of Authority, that protects individuals and health care entities from discrimination on the basis of their exercise of religious belief or moral conviction in HHS-funded programs.  OCR made videos, both in English and Spanish, to inform the public about the work of OCR and highlighting the work of CRFD.

Promoting a Culture of Tolerance and Diversity:  Conscience and religious freedom issues in health and human services are not easily understood and are frequently misrepresented in public discourse.  Through extensive outreach, OCR facilitated voluntary compliance by raising awareness of CRFD’s formation and the laws under its jurisdiction.  OCR’s education and outreach efforts communicated the principle that it is fundamentally unfair to coerce, treat differently, persecute, or penalize an individual or organization for acting in accord with its religious or moral beliefs when those actions constitute protected conduct under Federal law.  This outreach included working across the Department and with other federal agencies to ensure violations of federal conscience laws are treated on par with violations of other federal law and to promote compliance with the Religious Freedom Restoration Act (“RFRA”).  OCR provided subject-matter expertise on RFRA, which resulted in a religious organization being able to continue partnering with HHS to provide foster care services.

  • Resolutions of National Significance:  In addition to handling complaints impacted by the COVID-19 pandemic, OCR favorably resolved high-profile matters of national significance, resulting in the enforcement of laws passed by Congress, the protection of the conscience rights of American citizens, and a heightened public awareness of CRFD and the law it enforces.
  • Protecting pregnancy resource centers:  In January 2019, OCR found the State of California in violation of the Weldon and Coats-Snowe Amendments because of its statute (currently enjoined), which subjected certain pregnancy resource centers to potential fines if they refused to provide certain notices that refer for or make arrangements for abortion.  In March 2019, OCR favorably resolved two complaints with the State of Hawaii when the Hawaii Attorney General agreed not to enforce provisions of a Hawaii law against any limited service pregnancy resource center that declined to disseminate a government-scripted notice that promotes abortion. 
  • Enforcing Individual and Institutional Conscience-Based Violations: In August 2019, OCR issued a notice of violation to a major medical center in Vermont because it coerced a nurse to assist in an elective abortion over the nurse’s repeated conscience-based objections.  When the medical center was unwilling to change its policies to prevent future coercion, HHS referred the matter to the U.S. Department of Justice for enforcement, which filed a lawsuit against the Center. In January of 2020, HHS issued an historic notice that California violated the Weldon Amendment by requiring health care plans to offer coverage for elective abortion in every plan.  In December 2020, HHS announced that it would be disallowing $200 million in federal Medicaid funds going to California in the upcoming quarter due to the state illegally mandating that all health care plans subject to regulation by the California Department of Managed Health Care cover abortion without exclusion or limitation.  In January 2021, CMS sent a letter of disallowance to California in the amount of $200 million in Federal financial participation due to California’s violation of the Weldon Amendment.

Highest Number of HIPAA Enforcement Actions:  OCR’s settlements and penalties create specific and general deterrents to HIPAA violations for the specific entities investigated, as well as the entire regulated industry.  From March 2017 through January 2021, OCR set new enforcement records in this area, by completing 48 enforcement actions requiring covered entities and business associates to implement corrective actions, or the imposition of civil money penalties, including a record 19 enforcement actions in 2020.  During this period, OCR obtained over $67.6 million in settlements, judgements, and collections on privacy and security issues ranging from lack of access to patient records to massive breaches of electronic protected health information.  The cases included the biggest U.S. health care data breach in history which resulted in OCR securing the largest settlement in OCR history with the $16 million settlement with Anthem, Inc.   

Enhancing Patient Access to and Control of their Health Information:  In 2019, OCR launched the HIPAA Right of Access Initiative to ensure individuals can get timely access to their health records, for a reasonable, cost-based fee.  To date, OCR has completed 14 enforcement actions with settlements requiring the covered entities to provide the individuals with their records, and highlighting the need for the industry to comply with this right.  Informed patients make better health care decisions and feel empowered to pay for value, which leads to improved health outcomes and these enforcement actions send a strong message to the regulated industry.  As part of this initiative, OCR’s 2020 NPRM on Modifications to the HIPAA Privacy Rule proposes to facilitate the transition to value-based health care by improving individuals’ access to their PHI, permitting more information sharing for care coordination and removing administrative burdens that do not meaningfully contribute to the protection of the privacy of individuals’ PHI. 

Combatting Sex Discrimination:  OCR launched a National Initiative, in collaboration with NIH, to enforce Title IX and Section 1557 to protect students and patients from sex discrimination (including sexual assault, abuse, and harassment), to ensure the integrity of HHS’ more than $32 billion annual funding to higher education.  As part of the Initiative, OCR is reviewing ten institutions to ensure that their policies and procedures are legally sufficient and provide strong foundations to prevent and address sex discrimination.  As part of the initiative, OCR published guidance on Effective Practices for Preventing Sexual Harassment that includes examples of sexual harassment, provides specific actions that HHS-funded programs, universities and university health and medical offices can take to reduce or prevent occurrences of sexual harassment, and identifies protective protocols that can be implemented by university health and medical professionals to protect students, employees, patients and others from sexual harassment.

Enhancing Equal Access by Persons with Limited English Proficiency:

  • Ensuring equal access to services:  OCR issued guidance to help ensure appropriate sharing of health information as well as equal access to emergency services for LEP persons and individuals with disabilities.   
  • Increasing Accessibility to OCR’s complaint portal and website: OCR made significant enhancements to its website to provide greater accessibility for persons with limited English proficiency.  A graphic titled “Other Languages” is now displayed prominently at the top of OCR’s homepage and each of its sub-homepages for Civil Rights, Conscience and Religious Freedom, and HIPAA.  The tile lists the 16 languages most frequently spoken in limited English proficient households in the U.S. based on data from the most recent U.S. Census Bureau’s American Community Survey and languages most frequently encountered by OCR.
  • Enforcing Title VI Language Access Requirements:  OCR entered into settlements with Arizona and Alabama to ensure LEP individuals are provided meaningful access to human services programs and activities, including family reunification services.   

Enhancing Equal Access by Persons with Disabilities:

Promoting Regulatory Reform and Coordinated Care:  OCR published a new Section 1557 regulation under the ACA that removes unnecessarily burdensome procedural requirements that will save the health care industry $3.6 billion over five years that can instead be used to provide essential health services.  As part of the HHS’s “Regulatory Sprint to Coordinated Care,” OCR published a proposed HIPAA regulation to enhance care coordination and case management. The estimated total cost saving from this proposed regulatory reform is $3.2 billion over five years

Helping the American People:  Over the last four years, OCR fielded 91,000 phone calls, resolved over 137,000 complaints, and maintained a quality rate in excess of 95% as measured by reconsideration requests and Congressional inquiries.

Content created by Office for Civil Rights (OCR)
Content last reviewed on January 19, 2021