Violation of HIPAA Privacy Rule - Disclosure as Potential Claim?

by M
(North Carolina)

In two cases, a licensed professional counselor violated HIPAA by sharing information with a third party about a client who had not given written permission to do so. Both incidents happened within the past year.

In the first case, the client knows about the disclosure.

In the second case, the client does not know about the disclosure, but could ask in the future.

Which, if either, of these scenarios would be considered a potential claim and therefore reportable to the professional liability insurance company? How would one go about reporting the violation? Can one file a claim for compensation against the counselor's insurance company for these violations? Thank you.

Visitor Question:
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ANSWER for "Violation of HIPAA Privacy Rule - Disclosure as Potential Claim?":

M (North Carolina):

HIPAA is an acronym for the Health Insurance Portability and Accountability Act of 1996. The HIPAA law governs electronic exchanges of health data. Moreover, HIPAA has an enforcement division which monitors violations. Violations of can result in fines up to $50,000.00 per violation, and up to a year in prison.

In both scenarios you present, the counselor appears to have violated confidentiality. As long as a health care provider releases private health information (PHI) without consent of the patient or legal guardian, it's a violation, whether the patient knows about it or not.

To file a complaint go to the US Health and Human Services website. Once there, click on "Health Information Privacy Complaint Form Package" on the right side. This will take you to the area where you will enter your personal contact information and details of the actions supporting your complaint.

Although HIPAA allows for federal civil and criminal penalties for violations, it does not provide a private right to sue a doctor or other healthcare provider for a violation. There have been a few successful lawsuits, but these are very rare, and you would definitely need an attorney to pursue a private cause of action.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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