What is the Health Insurance Portability and Accountability Act?

Posted on by Paul Walker, Esq.

On a daily basis, patients provide medical professionals with a large amount of personal and sensitive information. This is because they trust the doctors who take care of them to act in their best interest, including safeguarding their privacy. It is important that once medical professionals have access to this information, they keep it confidential. It is because of this that the Health Insurance Portability and Accountability Act, commonly known as HIPAA, was put into place in 1996. 

What is HIPAA?

HIPAA was enacted in order to protect the privacy of patients’ medical records and other health information. This is done by legally barring medical professionals from sharing this confidential information about their patients with other individuals or making it public. It is important to know that even if the patient’s condition is not severe or sensitive, it is still against the law to disclose the details of the individual’s personal life and health to any third party. It is required to be kept between the medical professional and the patient.

There is a way that patients can choose who they allow their medical records to be released to. When a patient files paperwork for a medical professional, they can include any loved ones that they want to have access to their health information. This can include a spouse, parent, child, sibling, etc. Only if a medical professional has this consent are they allowed to discuss a patient’s condition with only that individual without breaking HIPAA laws.

What Happens if HIPAA is Violated?

In the event that a medical professional fails to comply with the law, they have the potential to face both civil and criminal penalties. When HIPAA is violated, it can be reported by a patient, hospital, or another medical professional. These complaints are made to the Office of Professional Medical Conduct (OPMC), where an investigation can be launched and penalties may be imposed. There are four possible violation levels depending on the offense, including:

  • If a professional did not know they were in violation, they may face a $100-$50,000 fine
  • If a professional claimed they had reasonable cause to violate HIPAA, they may face a $1,000-$50,000 fine
  • If there was willful neglect that was corrected during a certain amount of time, they may face a $10,000 and $50,000 fine
  • If there was willful neglect that was not corrected, they may face a $50,000 fine
  • If there were multiple violations in the same year, they may face a fine of $1.5 million.

Contact our Firm

When a medical professional is accused of misconduct, it is essential that they retain strong legal representation. If you require a medical law attorney for your legal matters, call Paul E. Walker, an experienced New York City OPMC & OPD Lawyer. Please contact the Walker Medical Law firm to set up a free initial consultation.