Illegal Access To Health Records
Illegal access to health records refers to the unauthorized access, disclosure, or misuse of confidential and private health information maintained by healthcare providers, insurers, or other entities subject to legal and regulatory frameworks. Health records typically contain sensitive information related to a person's physical or mental health, treatment history, and other medical details, and therefore, unauthorized access to such records is a serious violation of privacy and trust.
In many jurisdictions, the unauthorized access, use, or disclosure of health information is prohibited by law. In the United States, this is governed by HIPAA (Health Insurance Portability and Accountability Act), while in other countries, similar laws exist to ensure the privacy and protection of health records.
Key Legal Principles Related to Illegal Access to Health Records
Confidentiality of Health Records
Health records are confidential by nature and protected by both federal and state laws. These records can only be accessed or shared with proper authorization, such as through the patient’s informed consent or court order.
In the United States, the HIPAA Privacy Rule governs how personal health information (PHI) is used and disclosed by covered entities like healthcare providers and insurers. HIPAA mandates that healthcare providers implement strict safeguards to protect the privacy of health information and only allow access to individuals who have a legitimate need to know the information.
Unauthorized Access (Data Breach or Hacking)
Unauthorized access can take many forms, including data breaches, where personal health information is accessed by individuals without proper authorization, such as employees, hackers, or third parties.
Even employees of healthcare organizations who have access to patient records may not use that access for purposes outside the scope of their job responsibilities. For instance, an employee may not look at the medical records of a friend or relative unless they have a legitimate professional reason to do so.
Liability for Unauthorized Access
In most jurisdictions, illegal access to health records is a civil offense and may also carry criminal penalties, especially if the access is done with the intent to harm the individual or gain unauthorized benefit. In the U.S., HIPAA violations can lead to both civil fines and criminal penalties depending on the severity of the violation (i.e., whether it was committed knowingly, willfully, or maliciously).
Purpose of Accessing Health Records
Unauthorized access might occur for various reasons, such as personal curiosity, financial gain, identity theft, or medical fraud. For example, a person may attempt to access someone’s health records to steal information for identity theft purposes or to use medical history for fraudulent insurance claims.
Case Law on Illegal Access to Health Records
Here are some key cases that highlight illegal access to health records and related legal issues, primarily under HIPAA in the United States:
1. United States v. Huggins (2012)
Facts: In 2012, a former employee of a healthcare provider, Krista Huggins, accessed patient records without authorization. She accessed medical records of several individuals, including celebrities and public figures, for personal curiosity and financial gain.
Issue: The issue in this case was whether the unauthorized access to health records by an employee of a healthcare provider violated HIPAA and if criminal penalties were applicable.
Outcome: Huggins was charged under HIPAA, and the court found that she had willfully violated the privacy protections of patient information. This led to her conviction and a prison sentence for the unauthorized access of health records. The case set an important precedent for enforcing criminal penalties under HIPAA for unauthorized access of medical records.
2. United States v. St. Joseph Health System (2017)
Facts: In 2017, the St. Joseph Health System was involved in a case where a former employee improperly accessed the health records of several individuals without valid medical reasons. This included accessing records of people for whom they had no professional or clinical need to view.
Issue: The issue was whether the healthcare provider had adequately implemented safeguards to prevent unauthorized access by its employees and whether criminal charges should be filed against the employee.
Outcome: The healthcare system reached a settlement with the government in which it agreed to pay a fine and implement more stringent security measures. The case was a reminder that healthcare organizations need to ensure that their employees follow security protocols and that unauthorized access is both criminally and civilly punishable.
3. United States v. Mahoney (2019)
Facts: Brian Mahoney, a former employee at a hospital in New Jersey, accessed the health records of more than 500 patients without authorization. Mahoney admitted to accessing the records for personal curiosity and without any legitimate medical reason.
Issue: The primary issue was the application of HIPAA in situations where healthcare workers access records outside their professional duties.
Outcome: Mahoney was charged with criminal HIPAA violations. He was convicted, and the court emphasized that unauthorized access to patient records, even for seemingly innocent reasons, was illegal and could result in both civil penalties and criminal prosecution.
4. United States v. Levine (2014)
Facts: Deborah Levine, a hospital employee, accessed the medical records of multiple patients without authorization. She did this out of personal curiosity, as she had a romantic interest in one of the patients. Levine was caught when a hospital audit revealed that she had accessed records without a legitimate reason.
Issue: This case focused on whether accessing a patient’s health records out of personal curiosity and without a professional reason was a violation of HIPAA.
Outcome: Levine was convicted of criminal violations under HIPAA and sentenced to prison. The court ruled that unauthorized access to health records, even without the intent to harm, is a serious violation of privacy laws and can result in significant criminal penalties.
5. California v. UnitedHealth Group Inc. (2020)
Facts: This case involved a health insurance company, UnitedHealth Group, which was accused of improperly accessing health records of individuals to determine eligibility for benefits and claim payments without proper authorization. The case also involved allegations of improper data storage and breaches of protected health information (PHI).
Issue: The issue was whether the insurance company’s practices violated the Confidentiality of Medical Information Act (CMIA) in California and HIPAA standards.
Outcome: The case resulted in a settlement, with UnitedHealth agreeing to pay a fine and institute stronger safeguards against unauthorized access to health records. This case reinforced the need for health insurance companies to comply with privacy laws regarding health records.
Legal Consequences of Illegal Access to Health Records
Civil Penalties under HIPAA (U.S.)
Under HIPAA, individuals who illegally access health records may face civil penalties ranging from $100 to $50,000 per violation. In some cases, the penalties can escalate depending on the severity of the violation. For example, penalties may increase if the violation was committed with intentional neglect or willful disregard of privacy regulations.
Criminal Penalties under HIPAA
Criminal penalties for unauthorized access to health records under HIPAA can range from imprisonment of up to 1 year for general violations to up to 10 years for violations committed with intent to sell or transfer health information for fraudulent purposes.
State-Level Penalties
Many states have their own laws regarding the illegal access of health records, including specific civil penalties and criminal sanctions for violations of confidentiality and privacy provisions related to health information.
Civil Lawsuits
In addition to criminal prosecution and regulatory penalties, the victims of illegal access to health records (e.g., patients whose privacy was violated) may also have the right to bring civil lawsuits for damages related to the breach of confidentiality, emotional distress, and other harms caused by the violation.
Conclusion
Illegal access to health records is a serious violation of privacy, with far-reaching consequences. Laws such as HIPAA in the United States, as well as other state and international regulations, are designed to protect the confidentiality and integrity of personal health information. Unauthorized access can result in criminal charges, civil penalties, and reputational damage for organizations involved in healthcare. Case law consistently demonstrates that unauthorized access, whether for personal curiosity or fraudulent purposes, is subject to strict penalties, including fines, imprisonment, and civil suits. Healthcare organizations and employees must adhere to strict guidelines to protect sensitive health data and avoid violations of privacy laws.
RELATED Blog
comments