Personal privacy is a legal matter that has received a great deal of focus in recent years. This is particularly the case with medical privacy, which can impact the quality of care a person receives. Because certain illnesses and conditions are perceived to carry a stigma, those afflicted may avoid seeking medical care at all for fear that the condition will become known. Even those who do see a doctor may hold back relevant information that they do not want to become known outside the medical context. Because failing to secure personal medical information can have dire effects on a patient’s life, it is essential that it be held confidential. Therefore, the federal government has laws in place to ensure that medical information is not shared without the patient’s express permission.

In this technological age, much medical information is recorded, stored, and transferred electronically, making it more vulnerable to exposure than is usually the case with paper records, necessitating additional safeguards.

HIPAA: Health Insurance Portability and Accountability Act

The Health Insurance Portability and Accountability Act or HIPAA contains provisions to safeguard medical privacy. Since 1996 when the legislation was passed, HIPAA regulates the use of patient information, including how, to whom, and under what circumstances it can be disclosed. The Act protects information pertaining to an individual’s health and medical conditions as well as their health insurance payments. HIPAA mandates that health insurance plans and healthcare providers give a patient written notice of how their protected health information will be used and under what circumstances they may be disclosed.

Who is Regulated by HIPAA?

HIPAA covers the following:

  • Physicians and other healthcare providers and their staff
  • Hospitals, clinics, and other healthcare facilities
  • Health plans provided by employers
  • Healthcare clearing houses
  • Independent contractors employed by any of the above

When Can Information Be Disclosed?

Information protected by HIPAA can be disclosed for these reasons:

  • If the patient requests it (limited to 30 days)
  • If the law requires it (for example if there is suspicion of child abuse)
  • If sharing of information is necessary for proper the treatment or payment of treatment (for example, providing information to a health insurance company for payment)

Penalties for Violating HIPAA Privacy Regulations

Any entity that wrongly discloses private medical information in violation of HIPAA may be subject to civil and/or criminal penalties, including fines and jail time:

  • Civil fines ranging from $100 up to $25,000 per year per violation
  • Criminal penalties from $250,000 in fines up to 10 years in prison for a deliberate attempt to use the private medical information for monetary gain or to intentionally cause harm to the patient.

If Your Privacy Rights under HIPAA Have Been Violated

If you have reason to believe that your doctor, insurer, or other entity with access to your medical records has wrongly disclosed your private health information, you can file a complaint with the United States Department of Health and Human Services’ Office for Civil Rights (OCR) for investigation. If it is a criminal matter, it will be handled by the federal Department of Justice. Consider hiring an attorney to assist.

Should I Hire a Lawyer for a HIPAA Complaint?

It is a good idea to first consult an attorney with experience in the area of medical privacy issues to learn more about your rights and help you draft and file your complaint when you suspect your privacy rights have been violated. HIPAA regulations are complex and encompass both civil and criminal charges, so having a legal expertise on your side can expedite the process and improve the outcome.

How Can an Entity Covered by HIPAA Avoid Violations?

If you are a healthcare provider, insurance company, or related contractor, you need to be thoroughly informed on the requirements of HIPAA and how to train your staff to safeguard protected confidential information. An attorney experienced in healthcare law can advise you on your responsibilities and how to establish appropriate procedures to avoid HIPAA violations.

Legal Advice for HIPAA-related Matters in New Jersey

If you are an individual and feel that your right to medical privacy has been violated, or if you are a healthcare provider, insurer, or contractor with access to protected medical information that you need to secure, the firm of Barnes Law Group, LLC can assist you in matters pertaining to the HIPAA law. Medical privacy is an essential right, and it is the law. Our attorneys are deeply committed to safeguarding this important legal right by working with individuals whose rights have been breached and with companies in possession of protected information to avoid security lapses that could result in severe legal penalties. We know the law, and we have extensive experience in implementing it. Call us today for a free, no-obligation consultation to learn how we can help. We serve Cape May and Atlantic Counties and have offices conveniently located in North Wildwood and Egg Harbor Township.

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