Cecily Zamora
While patients cannot sue for a direct HIPAA violation, they can take legal action against healthcare providers and obtain damages for violations of state laws. In some states, it is possible to file a lawsuit against a HIPAA-covered entity on the grounds of negligence or for a breach of an implied contract, such as a failure to protect medical records. If a patient's protected health information (PHI) has been exposed or stolen, they may be able to take legal action against the breached entity to recover damages for any harm or losses suffered. The first step is to submit a complaint about the violation to the HHS' Office for Civil Rights (OCR). In New Jersey, HIPAA release forms are required under certain circumstances, and organizations that experience a breach must report the incident.
| Characteristics | Values |
|---|---|
| Can patients sue for a HIPAA violation? | Yes, but not under the provisions of HIPAA laws. |
| What can patients sue for? | Harmful violation of their medical history or medical privacy. |
| What type of claims can patients make? | Negligence claims or breach of contract claims. |
| What is PHI? | Personal health information, including a patient's Social Security number, date of birth, and other identifiers. |
| What is the first step to take legal action? | Submit a complaint about the violation to the HHS' Office for Civil Rights (OCR). |
| How can a complaint be filed? | In writing or via the OCR website. |
| What happens after a complaint is filed? | The OCR can investigate complaints against covered entities and their business associates. |
| What is a covered entity? | Health plans, health care clearinghouses, or health care providers that conduct certain transactions electronically. |
| What is the time limit for filing a claim? | 180 days from the day the situation occurs. |
| What is the New Jersey data breach notification law? | Organizations that are breached and compromise personal information must report the incident. |
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What You'll Learn
Patients can't sue for HIPAA violations
Patients cannot sue for HIPAA violations under HIPAA laws, as there is no private cause of action in HIPAA. This means that patients cannot directly sue for a HIPAA violation under HIPAA, even if their healthcare provider has violated HIPAA rules and caused them harm.
However, patients can take legal action and sue for violations of state laws, such as negligence or breach of contract claims, which may involve a harmful violation of their medical history or medical privacy. These lawsuits can be expensive and challenging, as patients must prove that harm or damage occurred due to negligence or the theft of unsecured personal information.
If patients believe their PHI, or personal health information, has been exposed or stolen, they can take several steps to seek justice. Firstly, they can submit a complaint to the HHS' Office for Civil Rights (OCR), which enforces the protections of HIPAA. Secondly, they can contact an attorney to take legal action against a HIPAA-covered entity, such as a healthcare provider or business associate, although this may be difficult without evidence of actual harm.
While patients cannot directly sue for HIPAA violations, they can take alternative courses of action, such as filing complaints with the federal government or seeking free credit monitoring services to protect themselves from fraud and theft.
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Patients can sue for state law violations
State laws in New Jersey offer patients additional protections and rights regarding their health information. The New Jersey Confidentiality of Medical Information Act (CMIA) and the New Jersey Consumer Fraud Act (NJCFA) are two critical pieces of legislation that patients can turn to if their health information has been improperly handled or disclosed.
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Patients must prove harm or damage
While patients can sue healthcare providers or specific healthcare professionals for violating state laws involving HIPAA, they cannot sue for a HIPAA violation under HIPAA. Even if HIPAA rules have been violated and harm has been suffered as a direct result, patients cannot seek damages for the violation of HIPAA laws.
However, patients can take legal action and sue for damages for violations of state laws. For example, in some states, it is possible to file a lawsuit against a HIPAA-covered entity on the grounds of negligence or for a breach of an implied contract. In such cases, it is necessary to prove that damage or harm has been caused as a result of negligence or the theft of unsecured personal information. This can be challenging, as it is not enough to say that a covered entity disclosed the information without consent. The patient must show that it affected their life or job.
If a patient believes that their protected health information (PHI) has been exposed or stolen as a result of a healthcare data breach, they may be able to take legal action against the breached entity to recover damages for any harm or losses suffered as a result of the breach. The first step is to submit a complaint about the violation to the Department of Health and Human Services' (HHS) Office for Civil Rights (OCR). This can be done in writing or via the OCR website. If the violation involves criminal activity, the OCR may refer the complaint to the Department of Justice (DOJ) for investigation.
State Attorneys General can also impose financial penalties on HIPAA-covered entities and business associates for violations of HIPAA rules. Financial penalties can also be imposed if a breach of electronic PHI violates state laws. Some states, such as New Jersey, are active enforcers of HIPAA compliance. When state laws are violated, individuals whose electronic PHI has been compromised may be able to take legal action against the breached entity if it can be proven that they have suffered harm due to the negligence of a covered entity or business associate.
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Patients must submit a complaint first
If a patient believes their health information privacy rights have been violated, they must first submit a complaint to the Office for Civil Rights (OCR) within the Department of Health and Human Services (HHS). The OCR can investigate complaints against covered entities, such as health plans, healthcare clearinghouses, or healthcare providers that conduct certain transactions electronically, as well as their business associates. The complaint must be filed within 180 days of the patient becoming aware of the violation, although this deadline may be extended if "good cause" is shown.
The OCR Complaint Portal allows for the electronic submission of complaints, and the OCR website provides information on what is needed to submit a complaint. The patient must name the covered entity or business associate involved and describe the acts or omissions that violated the Privacy, Security, or Breach Notification Rules. The patient must also electronically sign the complaint and complete a consent form.
After submitting a complaint to the OCR, patients can then pursue legal action against the covered entity or business associate. While patients cannot directly sue for a HIPAA violation, they can take legal action for violations of state laws, such as negligence or breach of contract. To successfully sue for a HIPAA violation, patients must prove that damage or harm was caused by the breach of their protected health information.
It is important to note that taking legal action can be expensive and may not always be successful. Patients should carefully consider their aims and alternatives before pursuing a lawsuit. Consulting with an attorney who specializes in HIPAA regulations can help patients understand their options and the likelihood of success.
In summary, patients must first submit a complaint to the OCR before taking legal action for a HIPAA violation. This process allows for the investigation of the alleged violation and provides patients with the opportunity to seek justice while also protecting their rights and privacy.
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Entities must notify patients of breaches
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a federal law that sets data privacy and security standards for individuals' identifiable health information. Personal health information (PHI) includes a patient's Social Security number, date of birth, and other identifiers.
HIPAA's Breach Notification Rule requires covered entities to notify patients when their unsecured PHI is impermissibly used or disclosed—or "breached"—in a way that compromises its privacy and security. Covered entities include health plans, healthcare clearinghouses, or healthcare providers that conduct certain transactions electronically.
If a breach involves the unsecured PHI of more than 500 individuals, covered entities must notify a prominent media outlet serving the state or jurisdiction in which the breach occurred, in addition to notifying the Secretary of the breach and the U.S. Department of Health and Human Services (HHS) without unreasonable delay and no later than 60 calendar days from the discovery of the breach. The notification must include a brief description of the breach, a description of the types of information involved, the steps affected individuals should take to protect themselves, and a description of what the covered entity is doing to investigate, mitigate harm, and prevent further breaches.
For breaches involving fewer than 500 individuals, covered entities are permitted to maintain a log of the relevant information and notify HHS within 60 days after the end of the calendar year. Covered entities must also notify affected individuals following the discovery of a breach of unsecured PHI. These individual notifications must be provided without unreasonable delay and no later than 60 days following the discovery of a breach.
If a patient believes that their PHI has been exposed or stolen as a result of a healthcare data breach, they may be able to take legal action against the breached entity to recover damages for any harm or losses suffered. However, it should be noted that a patient cannot directly sue for a HIPAA violation under HIPAA provisions. Instead, patients can take legal action against healthcare providers for violations of state laws involving HIPAA, such as negligence or breach of contract claims.
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Frequently asked questions
No, a patient cannot sue anyone directly for a HIPAA breach. However, patients can sue healthcare providers or healthcare professionals for violating state laws involving HIPAA.
If you believe your health information privacy rights have been violated in New Jersey, you can file a complaint with the Office for Civil Rights (OCR). The OCR can investigate complaints against covered entities and their business associates.
A HIPAA breach occurs when there is a violation of the Privacy, Security, or Breach Notification Rules. For example, when a covered entity discloses patient records or other sensitive information without consent.
To file a HIPAA complaint in New Jersey, you must first submit a complaint to the OCR within 180 days of the incident. The OCR will then investigate the complaint and determine if there has been a violation of the Privacy or Security Rules. If there has been a violation, the OCR will take action against the covered entity.
