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Legal Aspects of Healthcare


HIPAA or Health Insurance Portability Act cushions the US citizens against any discriminatory insurance activities. Also this Act establishes how diverse medical experts share any form of information concerning their clients (patients). It is broadly known that the groups that are expected to adhere to HIPAA mandates covers doctors as well as other medical professionals, specialists in addition to medical data experts and organizers. Equally, this Act puts a number of restrictions on insurance firms that deny insurance coverage on the ground of preexisting medical circumstances. Also HIPAA stops employers from showing favoritism by denying medical insurance.

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Therefore, concerning Dr.William case it would be paramount to understand that insurance firms as well as other medical experts are not allowed to release or disclose client’s medical records. This illustrates the medical experts or insurance firms can only do so if it is extremely imperative and be in the innate interest of the client’s health or treatment. The only people perhaps with rightful consent to access the medical records are family members and this is well defined by HIPAA. Equally law enforcement agencies are in some instances allowed to access client medical information. Therefore, in such a situation, I am of the opinion that Dr.William did not act in accordance with the stipulations conferred under HIPAA. The underlying facts show that he disclosed Joan’s medical information to a third party.

Though, Joan had suffered injuries as a consequence of Dr. William’s error, as a doctor he was entitled to protect and provide the best medical care to his client. Therefore, the apparent issues here can be correlated to medical negligence and violation of client’s privacy. These two features are not allowed by the HIPAA Act. Concerning the scope of medical malpractice Joan can sue Dr.William and establish that the doctor owed him a duty of care, which the doctor failed to conform to the apposite standard of care, the violation caused bodily injuries, and she incurred damages.


Therefore, in this case Dr.William if found guilty under HIPAA Act could face penalties which could entail: criminal, civil, financial or imprisonment. Also under wrongful disclosure of personal exclusive health information, section 1177 asserts that an individual who willingly and knowingly:

  • utilizes or causes to be used as an exceptional health identifier;
  • obtains individually particular fitness information relating to an person;
  • discloses independently restricted health information to someone,

The reason such charges can be sustained is due to the fact that Dr.William failed to comply with the established legal and ethical tenets of HIPAA act. Therefore, the manner the doctor handles the whole issue it is imperative to argue there was a violation of HIPAA. It should be realized that Joan has constitutional rights to seek redress. Basically, violation of client’s privacy is disastrous. The doctor was in no obligation compelled to disclose the information to a third party. Though, the general publics as well as the health care personnel are confusion in regard to penalties, individual rights as well as investigations pertaining to HIPAA violations. The act offers federal protection of individual medical information and this offers the concerned patients to have diverse rights in regard to their health information. Therefore, the privacy rule is basically not limiting but it allows in some instances the disclosure of client’s information where necessary. Examining the scope of Dr. William he willingly violated these provisions and more so it was as a consequence of medical malpractice which falls under the scope of negligence. Under HIPAA the doctor has a case to answer. This can be correlated to the fact that he had injured one of her client and caused bodily harm and more so he went ahead to breach the trust the client had on him by discussing her previous medical records. Though it is not established whether the third party was an insurance firm, a relative or a fellow medical practitioner, the act itself is not therefore justified. Typically, the friend’s advice could sustain his defense but considering that he had violated the privacy concept, Joan could therefore challenge doctor’s decisions successfully.

Criminal prosecution

Basically, under HIPAA act the federal government endows the individual rights in regard to their personal information. This includes who can receive or access individual information. Therefore, under the scope of privacy rule this concerns personal information which is protected, whether written, electronic or oral. The security rule, which is a federal edict that safeguards this data in electronic nature, necessitates entities cushioned by HIPAA to guarantee that this information is secure.

HIPAA doesn’t create or permit individuals to bring any legal engagement against a cushioned entity. However, if an individual feels that his or her right to privacy including privacy to health information under HIPAA has been contravened, they have an obligation to file a complaint with the US Human Services Office for Civil Rights. This is the organ that enforces privacy as well as security rules. Therefore, Dr. William can be said to have gone against the fundamental aspects of his provision. Personal information is comprehensively safeguarded by the government and it is the duty of the concerned entity to adhere to the established tenets of privacy and confidentiality (Black, 1990; Walker, 1980).

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Therefore, in regard to the aspects of privacy as stipulated within the HIPAA it is imperative to realize that Dr. William’s behaviors are contrary to the law. This is well established by the ethical and professional provisions under HIPAA act. Thus, as is evident the behaviors carry criminal prosecution which can result in jail or monetary penalties. This can be correlated to the fact that the act has well established and articulated procedures which all professionals must observe and adhere to (Papachristou, 1999).

The reason why Joan’s case could lead to the prosecution of Dr.William rests in the fact that organizations, agencies and individual that are seen to meet the concepts covered and defined under HIPAA ought to comply with the acts aspects as to guard the privacy as well as security of individual medical information. However, if an individual is not covered, one is exempted from the aspects of complying with both features of privacy rule as well as security rule. However, Dr.William as a health care provider is covered as is with such entities as health plan experts, as well as healthcare information analysts. Therefore, being linked to HIPAA the doctor was expected in his capacity to protect the privacy of his client. It should be noted that he shared the information with a third party without the consent of his client.


The violation of Health Insurance Portability Act is a serious crime under the federal law. It is therefore essential to understand that Dr William in this regard is subject to a criminal prosecution which goes concurrently with imprisonment penalty. Though, there are instances where the culprits are only penalized financially. It is ethically wrong to expose a client’s information without any due consent (Pozgar, 2007). The reason behind this rationale is to protect the client from any form of discrimination or defamation in the greater society. In order to reinforce the HIPAA act and ascertain the concerned organizations safeguard the information entrusted with them, that is why financial or penal penalties are justified.

Thus looking at the entire procedure and requirements of HIPAA Dr. William violated the privacy rule and this is translated as a breach of trust and confidentiality. Under the federal law he is responsible for any mistake be professional or ethical. Therefore, in this regard he can be accused of professional negligence as well as the breach of client’s privacy right by exposing the clients information to a third party. According to the department of health and human services, in such a scenario he is liable to pay a fine of more than $50,000 for a single violation. However, this coupled with medical negligence can result in criminal prosecution leading to imprisonment. The reason the doctor could therefore be prosecuted lies in that he failed to request the consent of the patient when disclosing his medical information (Glenn, 2000). Therefore, such a scenario can only be avoided where the apposite procedures are followed and more so to avoid future harm to his clients it is advisable for the doctor to be more responsible while executing his professional obligations.


Black, H. (1990). Black’s dictionary. St. Paul: West Publishing

Glenn, H. Patrick (2000). Legal Traditions of the World. Oxford: Oxford University Press

Papachristou, T.K. (1999).The Sociological Approach of Law. Athens: A.N. Sakkoulas.

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Pozgar, G. (2007). Legal aspects of health care administration. Sudbury: Jones.

Walker, D. (1980). Oxford companion to law. Oxford: Oxford University Press

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