Arizona Have my HIPAA rights been violated? Do I have any legal rights?

[RLynL]

Jurisdiction

Arizona

I was in an accident & had emergency surgery at one hospital & then transferred to in-patient therapy at a different hospital. The 2nd hospital failed and admitted to not obtaining a signed PHI waiver (HIPPA waiver of authorization). It is now being held up with my insurance company for an almost 6 figure amount. The hospital is scrambling & I feel like my rights may have been violated.
Rebecca

 

[justblue]

It is "HIPAA", not "HIPPA".

 

[zddoodah]

Do I have any legal rights?

This isn't a real question, right?

It is now being held up with my insurance company for an almost 6 figure amount.

"It"?

I feel like my rights may have been violated.

Which ones? Are you suggesting that the second hospital's failure to obtain a HIPAA waiver is impacting your insurance coverage? Even if that's true, as long as it eventually works out, what difference does it make? You're welcome to complain to HHS, but I don't see what value that would be to you.

 

[Zigner]

Sign a form for them now.

 

[adjusterjack]

(HIPPA waiver of authorization

Please don't malign the poor little Hippa.

 

[Tax Counsel]

I was in an accident & had emergency surgery at one hospital & then transferred to in-patient therapy at a different hospital. The 2nd hospital failed and admitted to not obtaining a signed PHI waiver (HIPPA waiver of authorization). It is now being held up with my insurance company for an almost 6 figure amount. The hospital is scrambling & I feel like my rights may have been violated.
Rebecca

HIPAA is a law that requires covered entities to keep confidential protected health information (PHI) and not disclose it to others except as permitted by the HIPAA law and the HHS regulations that implement it. One of those exceptions is when the patient authorizes the disclosure. The second hospital didn't get you to sign the authorization to get the PHI from the first hospital. But why is that a problem in getting the insurance company to pay? If the insurance company needs information from either hospital to process the claim, then all you need to do is sign an authorization allowing for them to obtain that PHI from them. So what is really causing the hold-up here? The authorization problem is easily fixed, so I'm not seeing where that is an obstacle unless you've be unwilling to sign off on it, in which case that's on you.

Where is the HIPAA violation? In other words, which hospital disclosed your PHI to someone else without meeting one of the exceptions in the HIPAA statute and regulations and how has that disclosure resulted in problems in processsing your claim? There's a disconnect here between a HIPAA violation and the insurance claim, and you'll need to explain what the violation was and what connection it has to the insurance company holding up payment for much useful comment.

What I can tell you is that you may not sue the hospital for a HIPAA violation. HIPAA only allows the U.S. Department of Health and Human Services (HHS) to enforce the law; it does not authorize lawsuits for damages by persons whose PHI was improperly disclosed. It's possible that improper disclosure might give you a claim under state law, if you end up suffering any damages from it.

 

[RLynL]

HIPAA is a law that requires covered entities to keep confidential protected health information (PHI) and not disclose it to others except as permitted by the HIPAA law and the HHS regulations that implement it. One of those exceptions is when the patient authorizes the disclosure. The second hospital didn't get you to sign the authorization to get the PHI from the first hospital. But why is that a problem in getting the insurance company to pay? If the insurance company needs information from either hospital to process the claim, then all you need to do is sign an authorization allowing for them to obtain that PHI from them. So what is really causing the hold-up here? The authorization problem is easily fixed, so I'm not seeing where that is an obstacle unless you've be unwilling to sign off on it, in which case that's on you.

Where is the HIPAA violation? In other words, which hospital disclosed your PHI to someone else without meeting one of the exceptions in the HIPAA statute and regulations and how has that disclosure resulted in problems in processsing your claim? There's a disconnect here between a HIPAA violation and the insurance claim, and you'll need to explain what the violation was and what connection it has to the insurance company holding up payment for much useful comment.

What I can tell you is that you may not sue the hospital for a HIPAA violation. HIPAA only allows the U.S. Department of Health and Human Services (HHS) to enforce the law; it does not authorize lawsuits for damages by persons whose PHI was improperly disclosed. It's possible that improper disclosure might give you a claim under state law, if you end up suffering any damages from it.

Thank you for the detailed reply. This is not my area of expertise I was just trying to obtain information to better understand everything on my side. It has been daunting trying to make sense of everything as I recover.

Forgive my erroneous error on the misspelling of HIPAA.

Thank you everyone for the feedback.