Tuesday, 30 November 2021

What is HIPAA and why is it so important? Ask the lawyer

Q: I just want my own records from a hospital, but have to submit a specific form to comply with HIPAA.  The form seems burdensome. What is HIPAA and what is the reason for it?

A.L., Long Beach

Ron Sokol 

A:  HIPAA is the federal Health Insurance Portability and Accountability Act, which was enacted in 1996. The primary purpose of HIPAA is to protect patient privacy. Hence, sensitive patient health information cannot be given to others unless authorized or consented to by the patient. Privacy of your health records is considered very important.

Note that HIPAA applies to health care providers, health plans, health care clearinghouses, and business associates engaged in such activities as claims processing, data analysis, utilization review and billing. HIPAA therefore impacts doctors, dentists, chiropractors, psychologists, nursing homes and hospitals, among others.

Q:  If there is a HIPAA violation, what should be done and is there any real consequence?

G.D., Marina Del Rey

A:  If a HIPPA breach occurs, notice must be provided to: (a) the affected individual, (b) the federal Secretary of Health and Human Resources and (c) in some instances the media.

There can be a number of remedial steps taken when HIPPA is violated. The employer could deal with it internally and someone may then lose their job. The entity itself could face sanctions by one or more professional boards.  And criminal charges can arise.

The civil penalty for violation of HIPPA ranges from $1,000 to as much as $25,000, if there are multiple violations. Criminal penalties can be severe; for example, the minimum fine for willful HIPAA violations is $50,000 with the maximum at $250,000 (restitution may also be called for) and a jail term can be set.

Ron Sokol has been a practicing attorney for over 35 years, and has also served many times as a judge pro tem, mediator, and arbitrator.  It is important to keep in mind that this column presents a summary of the law, and is not to be treated or considered legal advice, let alone a substitute for actual consultation with a qualified professional. 


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