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Health Insurance Portability and Accountability Act (HIPAA)
Discuss whether there has been a violation of Health Insurance Portability and Accountability Act (HIPAA)?
There are no court rulings that can shed light on the issue. However going by the given facts, it is as follows: "Dr. Williams shows Joan's medical records to a friend for advice. His friend tells Dr. Williams to contact his medical malpractice insurance carrier." The problem here is if the friend is also a medical practitioner, attorney or some person exempted under the act for disclosure. The issue is not clear. It is assumed that the friend is also a medical practitioner. In that case Williams can take a stand that there has been no violation of the act if the doctor passed on the information for consultation purposes, and this is very clear from section 45 CFR 160.103 according to which a business associate could be" legal; actuarial; accounting; consulting;" and so on. (U.S. Department of Health & Human Services, 2003a)
It also extends to laboratory technicians, and lawyers and insurers. The culpability comes if the information was disclosed to a third party who did not have an association with the entity- the clinic and was permitted to access the information. In such cases where the physician discloses information to another person who may be entitled to view the information then the issue of culpability does not arise. The privacy rule imposes conditions for the disclosure of medical information but it does not restrict the use of information or treatment, payment, and for public health purposes. (Chaikind, 2004)
On account of this if the information was given to the friend on a consultation basis there is no offence committed if it did not include passing...
Thus assuming that the friend was a competent medical personnel entitled to receive and advice on the issue, for example the firms lawyer, or insurance officer, Williams commits no offence. "A primary care provider may send a copy of an individual's medical record to a specialist who needs the information to treat the individual." Like wise they may also disclose health information to another covered entity or a health care provider, and in some cases for consultation. (Krause, 2012)
Except these other type of disclosures require the individual's authorization as per sec 45 CFR 164.508(a)(2) of the act. On the other hand if the friend is a stranger to the system, and the disclosure is made to him then Williams committed an offence. The rule thus is to protect the privacy of the patient as far as possible. The law however has made ample exceptions to this for operational feasibility.
2) If Dr. Williams is in violation of HIPAA, might he be subject to criminal prosecution and, if found guilty, what penalties might he face?
In 2010, the Supreme Court decision in Skilling v. United States, declared that the mail and wire fraud cases may be "premised on violations of the "intangible right to honest services," has the potential to alter the future of health care fraud litigation." (Krause, 2012) The disclosure of patient information often leads to stigma for the patients in some cases -- as in the case of patients suffering from AIDS or some form of mental problems. The problem in the issue is the kickbacks that are…
References
Chaikind, Hinda R. (2004) "The Health Insurance Portability and Accountability ACT
(Hipaa): Overview and Analyses" Nova Publishers.
Krause, Joan H. (2012) "Kickbacks, Honest Services, and Health Care Fraud after Skilling"
Annals of Health Law, vol. 21, no. 1, 2012, pp: 41-43.
Retrieved 22 November, 2012 from http://www.law.uh.edu/healthlaw/perspectives/2007/(DM)HIPAACrimCharges.pdf
Information Policy" Retrieved 22 November, 2012 from http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/businessassociates.html
Rule" Retrieved 22 November, 2012 from http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html
Payment, and Health Care Operations" Retrieved 22 November, 2012 from http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/usesanddisclosuresortpo.html
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