HIPAA Violation?

[concerned-hubby]

Kansas-
A gentleman working for an insurance company that was preparing a quote for a business policy called my wifes place of business to follow up on her about some of the information that she wrote down on the medical history section of the application. My wife was not at the office at the time this gentleman called and instead of leaving a message or calling back he decided to start asking personal medical related questions to the secretary of the work place. Now she feels self-conscious about going to work. Doesn't this blatantly violate her confidentiality that HIPAA is supposed to protect? Does she have any grounds for legal action?

[cbg]

Did the secretary give him any information? And if so, how did she get it?

HIPAA does NOT prohibit anyone from asking questions. HIPAA only limits who can provide the information. In an employment situation, if information is released, it makes ALL the difference where the person who releases the information, got it.

[concerned-hubby]

Here's a little more background on the situation...

The secretary did not give any information to the agent because she didn't know the answers. However, because of the line of questions asked by the insurance agent, the secretary and many others in the company now know my wife has an STD.

My wife recently had a biopsy done and she had put down the results of that biopsy in the medical history of the application. The insurance agent asked the secretary if the biopsy results came back as HPV (Human papillomavirus).

The biopsy was in fact done for that reason but the biopsy was successful and the margins of that biopsy came back as clear. I feel like there is no excuse for the unprofessional line of questioning to an office secretary about my wife's personal medical history from an insurance agent who should have been speaking only to my wife about this entire scenario. This happened a couple of days ago and has already gotten back to some family and friends... all because of the insurance agent. Needless to say my wife is pretty distraught. I was the only person that knew about this and she intended to keep it that way.

I am posting here looking for guidance and I appreciate your response!

[ecmst12]

What monetary damages has she suffered?

[concerned-hubby]

I'm not sure I totally understand term monetary damages. If you're asking did she lose any money, then the answer is No. Does that make it okay? What about Punitive damages. This more of an emotional blow to her character. This information was supposed to be confidential. Can anything be done to the insurance agency or agent for disclosing such personal information?

[ecmst12]

Without monetary damages, there is no lawsuit. 75% of sexually active people have HPV, it's not exactly a big deal. I'm not sure the agent is covered under HIPAA, but you can certainly make a complaint to the HIPAA board. If he's covered, they will counsel him on how to follow the law. She doesn't get any money even if there was a violation. That's not what HIPAA is for.

If she suffered tangible monetary damages, she can sue for that. That's what lawsuits are for - money. Punitive damages? You need REAL damages before you can have punitive damages, and I doubt they'd be awarded for something like this. Your wife needs to get over it.

[concerned-hubby]

Well I appreciate the feedback, but I you don't have to be such a prick about it.

"Your wife needs to get over it. "

Not a big deal? Are you saying that because this is a fairly common STD that her right to privacy no longer exists?. Would you be saying the same thing if I said she had HIV? Or would you also think that HIV is not a big deal if 75% of sexually active people had that disease too?

75% of sexually active people have HPV, it's not exactly a big deal.

I may not fully understand what HIPAA is for but I thought it was to help protect one's medical confidentiality. It sickens me that some yahoo working for an insurance agency can just spout off to anyone about my wife's personal medical information without any repercussions.

What is confidentiality then?

[ecmst12]

Like I said, she can file a complaint with the HIPAA board, and if the agent is covered by HIPAA, he will be counseled.

[lkc15507]

Jeez I love these folks. If the questions asked revealed the nature of protected health information, it is a HIPAA violation. No question. Redress? As posted, a problem. But, that does not mean that the entitiy that violated HIPAA cannot be held accountable through proper channels. Type of plan, state Dept of Ins or fed Dept of Labor. Report the violation. Forget remuneration personally IF it was on your mind in the first place. Hold the entity responsible accountable. It can be done. They can be heftily fined.

[ecmst12]

They COULD be fined, but they won't be. Fines are very rarely, if ever, levied.

[lkc15507]

I don't disagree but the main problem is that folks don't know what to do, misunderstand their options, and have a give up attitude. You don't help. I said could, not would. Why don't you encourage and educate rather than discourage? You and those like you are without a doubt the foundation of the healthcare problem. I read your posts regularly. You don't give wrong information. You usually give incomplete information which makes it bad info in the long run. You seem to enjoy the misfortune of others. Your responses are always geared that way.

[ecmst12]

Actually I told him EXACTLY what he can do (or actually, what his wife can do) and what the outcome of it will be. All you did was pipe up in a thread that was completed a week ago and echo what was already said with more sympathetic commentary. I don't tend to be very sympathetic to posters looking for a payday when they had no actual losses.

[lkc15507]

Psychic are you? You know the outcome already? A week late? These folks looking for real info come back frequently. Sometimes much more than a week later hoping that someone with a brain will post a helpful answer. Actually, it's actually your prediction of the actual answer that I was picking on. You actually made my point in that regard. Actually, you simply blasted the poster as looking for a payday. I didn't read that in the post. Your answer was to blow him off with your prediction of what may be a common outcome. That outcome is typical because of attitudes like yours. I counsel folks and help write appeals and complaints daily. I'm quite successful because I don't xxx that folks are looking for a payday. The poster didn't mention losses other than the harm done by the revelation of PHI. You mentioned monetary losses. He asked about legal action. You interpreted monetary damages. My point was to hold the responsible parties accountable. Nothing more, nothing less. I care about accuracy and you have very little of that.