The Health Insurance Portability and Accountability Act of 1996 preempted state law regarding the disclosure of patient records by nursing homes

By: Felipe Burgos

 

On April 9, 2013, the United States Court of Appeals for the Eleventh Circuit upheld the district court decision that the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) preempted a Florida law regarding the disclosure of patient records by nursing homes.

 

The nursing facilities were penalized by the Florida Agency for Health Care Administration (“AHCA”) for refusing to provide medical records to deceased residents’ spouse, guardian, surrogate, proxy, or attorney in fact, according with a 1987 state law allowing to provide that personal health information.

 

Florida’s nursing facilities filed the case against the AHCA in May 2012.

 

The plaintiffs argued if they followed the Florida law requiring them to provide medical records to these parties, they would violate HIPAA. Under HIPAA, nursing homes can only provide personal health information to officially designated “personal representatives”, which could include the executor, administrator or other person acting on behalf of an individual or his or her estate. Providers also may furnish medical records to deceased residents’ family members who helped pay for the resident’s care, but only if the records are pertinent to the requestor’s financial involvement.

 

The Court maintained the decision from the lower court that the Florida statute was too broad and it did not meet the stricter HIPAA definition of personal representative, but “authorizes sweeping disclosures, making a deceased resident’s protected health information available to a spouse or other enumerated party upon request, without any need for authorization, for any conceivable reason, and without regard to the authority of the individual making the request to act in a deceased resident’s stead”.

According to the Court, HIPAA and the Florida law “could not be reconciled” because the Florida law was “an obstacle to the accomplishment and execution of the full purposes and objectives of HIPAA in keeping an individual’s protected health information strictly confidential.” The court emphasized that HIPAA ensures the privacy protection of deceased individuals’ health information by generally prohibiting its use and disclosure except in certain circumstances or with authorization. In contrast, the court explained, the Florida law allowed for “sweeping disclosures, making a deceased resident’s protected health information available to a spouse or other enumerated party upon request, without any need for authorization, for any conceivable reason, and without regard to the authority of the individual making the request to act in a deceased resident’s stead.”

Based on this argument, the court concluded HIPAA preempted the Florida law.

Because HIPAA preempts any contradictory state laws, the Florida legislature must revise the statute at issue or it will not be enforceable, Judge Susan H. Black said.

 

Link: http://www.govhealthit.com/news/appeals-court-affirms-hipaa-preemption