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DPH compliance office reports increased privacy monitoring and revised audits; commissioners press for whistleblower outcomes
Summary
OCPA presented its FY2019–20 annual report covering compliance program expansion, revised behavioral‑health audits, and privacy‑incident monitoring; commissioners and a public commenter asked for more detail on whistleblower investigation outcomes and audit corrective actions.
Maggie Rykowski, director of the Department of Public Health’s Office of Compliance and Privacy Affairs, told the Public Health Commission on Sept. 1 that OCPA expanded its compliance coverage across service lines, revised behavioral‑health audit protocols to focus on fraud/waste/abuse, and increased privacy monitoring during FY2019–20.
Rykowski said the department did not pay privacy fines in FY19–20 but recorded an increase in reportable privacy incidents and continues to investigate incidents. OCPA has deployed Epic's 'Break the Glass' review tool to identify sensitive records access and found no reportable breaches in the Bridal Glass review; Rykowski said the office will keep refining criteria for appropriate access.
Garrett Chatfield described audit protocol changes and said audits will now produce corrective action plans tied to provider error rates, with re‑reviews at three‑ or six‑month intervals. He said earlier increases in disallowed behavioral‑health claims reflected documentation errors, not evidence of fraud.
A public commenter, Dr. Derek Kerr, called attention to page 16 of the annual report showing 145 whistleblower complaints and requested transparency on outcomes (how many were substantiated, partially substantiated or not substantiated). Rykowski and commissioners agreed that providing more outcome data in future reports would improve transparency.
Why it matters: Compliance and privacy monitoring are central to the department’s integrity, billing accuracy and legal exposure. Commissioners urged OCPA to publish more outcome data for whistleblower investigations and to continue tightening Epic access policies.
What’s next: OCPA will provide follow‑up information to the commission, tighten Epic criteria and include additional outcome reporting in future annual materials where appropriate.
