Philadelphia HIPPA Compliance Lawyers
Medical professionals are bound by the provisions found in the Health Insurance Portability and Accountability Act of 1996. Commonly known as HIPPA, questions about compliance can lead to serious legal issues for doctors, nurses, and others who work in hospitals, clinics, and other medical settings. In order to understand what sort of issues can arise, it’s necessary to take a look at HIPPA and what it requires.
The Provisions Found in HIPPA
HIPPA is designed to ensure that the following is provided to patients in just about every medical setting:
- Maintaining Health Insurance: A key element in HIPPA provides individuals who lose their jobs or move to a new employer to maintain coverage. The method used may be transferring to another group plan or utilizing the provisions found in COBRA, which was passed in 1986.
- Ensure Privacy With Health Care Information: This provision helps to limit access to patient data to only those who need it to administer treatment and individuals that the patient has specifically approved for access.
- Establishment of Industry Wide Standards for Medical Billing and other Procedures: The goal is to bring uniformity to the process and ensure that the standards are in full compliance with other health care regulations and statutes.
- Reduce Health Care Fraud and Abuse: Checks and balances within the system make the process of overcharging or billing patients for procedures that were never done more difficult.
What Does HIPPA Mean for Health Care Providers?
Much of the focus on HIPPA has to do with protecting patient information and improving health care. Many of those same provisions within the Act provide protection for health care professionals as well. By complying with all regulations, a doctor, nurse, technician, and even medical institutions insulate themselves from the potential of being sued.
Penalties for Failing to Comply With HIPPA Regulations
The U.S. Department of Health and Human Services Office for Civil Rights is responsible for reviewing any allegations that a HIPPA violation has taken place. The range of penalties varies, depending on the nature of the offense and the degree of intent surrounding the events.
- When a violation is verified but classed as unknowing, a minimum penalty of $100.00 USD per violation is imposed. Maximum penalties can be as high as $50,000.00 per violation
- Violations that are deemed to occur with reasonable cause incur a minimum of $1,000.00 per event with maximum penalties of $50,000 per violation.
- Willful neglect with a correction within a reasonable time frame carries a minimum of $10,000.00 per event and a maximum of $50,000.00 per violation.
- Willful neglect that is not corrected within a reasonable amount of time carries a minimum and a maximum penalty of $50,000.00 per violation.
Annual maximums are provided for within HIPPA terms as well as maximums for each individual violation. Currently, states do have the authority to limit those annual maximums provided the figures remain within compliance with the statutes found in the Act.
Are Civil Suits Possible?
There is nothing to prevent the filing of a civil suit against a medical professional or a medical facility. This means that along with having to deal with allegations and possible fines by a government agency, the accused party also faces the possibility of being taken to court by a patient, the patient’s estate, or surviving family members of the patient.
Does Legal Representation Provide Support to the Client?
In the event that claims of HIPPA violations arise, it pays to secure legal representation as quickly as possible. The lawyer will set about reviewing all the data related to the allegations. This includes obtaining medical records and any formal reviews that have taken place. The goal is to determine if there is any basis for the allegations, and determine what type of action is needed to protect the rights of the client.
Along with determining if grounds exist, the lawyer will also seek to uncover any information that brings further light to the situation. This can often include interviewing potential witnesses who have first-hand experiences with the events in question. Citing legal precedents that are relevant to the circumstances are also likely to be part of the defense. Seeking to identify any mitigating factors that may have led to the allegation is also part of the overall investigation.
Without legal representation, the accused party stands to face substantial financial penalties, the loss of a medical license, and an inability to continue working in the profession. With the aid of a lawyer, it’s possible to ensure that all the evidence is brought forward and the potential for a fair outcome is present.