Has Prime Healthcare admitted to breaking confidentiality laws?
Prime Healthcare has responded, with a letter and a public statement, to my January 4 column about the flouting of patient confidentiality by its corporate office and two executives at its Shasta Regional Medical Center. In the response, Prime states for the record that it believes its disclosure of medical information about the patient, Darlene Courtois, was legal because she “voluntarily disclosed her medical records” to the investigative reporting organization California Watch. The company’s statement is here.
The column related that Shasta Regional provided Courtois’ medical chart to the Redding Record Searchlight when it asked the hospital to comment on the California Watch article. Courtois didn’t give the hospital written permission to do that.
As my column reported, state and federal regulators don’t recognize a “voluntary” waiver as valid unless the patient specifically authorizes a hospital’s disclosure in writing; that sounds like an admission by Prime that it broke the applicable laws.
Here’s how Rachel Seeger of the Office of Civil Rights of the U.S. Department of Health and Human Services responded to my question about the case prior to the column’s publication:
There is no “waiver” that would apply to the release of a chart or medial record to the media without an individual’s written authorization….
An individual may discuss their protected health information publicly in any way that they see appropriate. The HIPAA rules do not speak to the individual, but rather to the requirements of covered entities to protect their patient’s health information appropriately.
Here’s the question-and-answer exchange I had with Marta Bortner of the California HHS on the same question:
[Q:] Does the law recognize an implicit waiver of privacy by the patient in cases in which the patient chooses to discuss his or her case publicly? In other words, by granting an interview and providing otherwise private information in one forum amount to a blanket waiver of all privacy?
[A:] No.
The license and certification branch of the California Department of Public Health has already opened an investigation into the breach.
The company’s statement and letter also assert that Shasta’s disclosure of Courtois’ chart was necessary “to prevent or lessen a threat to the health and safety of the public.” This is an apparent reference to an exception in state and federal law typically invoked to address an “imminent” threat, say to the target of a violent criminal. Prime spokesman Edward Barrera refused to tell me what threat the Courtois case presented.
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