Both physicians and nurses are subject to confidentiality rules and laws concerning patient medical records. They must keep those records confidential, and failure to do so, including unnecessarily accessing a patient’s medical records for personal reasons, can lead to disciplinary proceedings against their licenses. Since the repercussions of these proceedings can be severe, contacting an experienced Texas medical and nursing license defense lawyer should be your first step if you receive notice of a complaint concerning the confidentiality of medical records against you.
HIPAA, TMRPA, and Patients’ Personal Health Information
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects patients’ personal health information (PHI). The Texas Medical Records Privacy Act (TMRPA) is the state law counterpart of HIPAA and is also designed to protect patient medical records. These laws contain enforcement mechanisms that penalize doctors, nurses, and other healthcare professionals who violate them by disclosing personal health information, including inappropriate access to medical records. Under Tex. Health and Safety Code §181.202, violations of TMRPA can result in civil penalties and revocations of professional licenses.
Doctors or nurses who access unauthorized patient information, use their personal email accounts or computers to access patient information, or otherwise communicate patient information to others violate HIPAA. As a result, they can face sanctions under HIPAA and disciplinary sanctions from their respective licensing boards.
Confidentiality of Physician-Patient Communications and Patient Records
Tex. Occ. Code §159.022 states that all communications between a physician and a patient relative to or in connection with any professional services as a physician to the patient is confidential and privileged and may not be disclosed. These communications include “a record of the identity, diagnosis, evaluation, or treatment of a patient by a physician that is created or maintained by a physician.”
However, §159.003 outlines the exceptions to the confidentiality of patient records in court and administrative proceedings. Likewise, §159.004 provides various exceptions to physician-patient privilege concerning medical records in other contexts, including disclosure to government agencies when required by law and to law enforcement personnel when there is a probability of imminent physical injury to the patient, the physician, or another person.
Physician-Patient Confidentiality
22 Tex. Admin. Code §190.8(2)((N) states that failure to maintain the confidentiality of a patient constitutes unprofessional and dishonorable conduct or conduct that is likely to deceive, defraud, or injure the public within the meaning of the Texas Medical Practice Act. A breach of confidentiality can include improperly accessing a patient’s medical records for personal use. For instance, a physician who accesses the hospital records of an acquaintance or a person whom they recently have begun dating specifically for their personal knowledge would be inappropriate and a violation of patient confidentiality.
Under 22 Tex. Admin. Code §190.14(9), a breach of confidentiality can result in a range of sanctions, depending on the severity of the breach. For a less serious breach, sanctions might include a remedial plan requiring eight hours of continuing medical education in risk management, including coverage of HIPAA requirements, and payment of a $500 administration fee. For a more severe breach, a physician may face an agreed order containing a public reprimand, continuing medical education in risk management and HIPAA requirements, payment of a $3,000 fine per incident, and completion of the jurisprudence exam.
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Nurse-Patient Confidentiality
22 Tex. Admin. Code 217.11(1)(E) requires that nurses “respect the client’s right to privacy by protecting confidential information unless required or allowed by law to disclose the information.” Confidential information includes a patient’s medical records. Therefore, if a nurse accesses a patient’s confidential medical records with no legitimate employment-related reason to do so, then that nurse is violating the law.
A nurse’s breach of confidentiality constitutes unprofessional conduct in the practice of nursing that is likely to deceive, defraud, or injure a patient or the public under Tex. Occ. Code §301.452(b)(10). Sanctions under the Texas Board of Nursing’s disciplinary matrix for a breach of confidentiality can vary according to the intent behind the breach, the number of incidents in which a breach occurred, a history of discipline, and the severity of harm. These sanctions range from remedial education and small fines to revoking a nursing license in extreme situations.
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Defend Yourself Against Disciplinary Proceedings Involving Your Medical or Nursing License
Do not allow complaints about unauthorized access to patient medical records to affect your career adversely. Losing your medical or nursing license can be highly detrimental to your livelihood. If you are facing the loss of your professional license, we can help you take the steps necessary to challenge the allegations against you in your disciplinary proceedings. Contact a medical and nursing license defense attorney at Bertolino LLP, for advice today. Make an appointment by calling (512) 515-9518 or contact us online to see how we can help.
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