Florida Appeals Court Rules HIPAA Overrides FL Nursing Home Records Law

Florida law requires that nursing homes furnish to the “spouse, guardian, surrogate, proxy, or attorney in fact” of a former resident a copy of the resident’s records which are in the possession of the facility. The federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) provides that covered entities, such as nursing homes, may only disclose medical records to a patient or his/her “personal representative”. HIPAA defines a personal representative to mean only an “executor, administrator, or other person who has authority under applicable state law to act on behalf of a deceased individual or of the individual’s estate”. Therefore, in many situations, Florida law requires nursing homes to release medical records when HIPAA prohibits it.

In a recent decision by the United States Court of Appeals for the Eleventh Circuit the court ruled that the federal HIPAA law preempted the Florida nursing home records law (Opis Management Resources, LLC v. Florida Agency for Health Care Administration). In this case Opis and several other managers and operators of Florida nursing homes refused to provide the medical records of deceased residents to their spouses and attorneys since they were not the residents’ “personal representatives” as defined by HIPAA. As a result, the Florida Agency for Health Care Administration (“AHCA”) cited the nursing homes for failing to provide the records as required by the Florida law, and the nursing home operators sought relief in federal court.

The federal district court ruled in favor of Opis and the other nursing home operators, and AHCA took an appeal to the Eleventh Circuit Court of Appeals. On appeal AHCA argued that the Florida law did not conflict with HIPAA but merely clarified who should be considered the “personal representative” of the deceased resident. The appeals court rejected AHCA’s argument and said:
The fatal flaw in the State Agency’s argument is that … the unadorned text of the state statute 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.

Full Article and Source:
Federal Appeals Court Rules HIPAA Overrides Florida Nursing Home Records Law

See Also:
Department of Health and Human Services:  Health Information Privacy

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4 Responses to “Florida Appeals Court Rules HIPAA Overrides FL Nursing Home Records Law”

  1. Anonymous Says:

    I think that a spouse has authority unless proven they don't! I think this is a huge waste of our Judicial system!

  2. StandUp Says:

    This is a major setback.

  3. Thelma Says:

    But it's a fact – federal law controls when there is a conflict with the state law or when there is no law on the subject.

  4. tvfields Says:

    Federal legislation could correct this conflict between HIPAA and state law. Such legislation would amend § 160.203 of HIPAA so as to put elder abuse on an equal footing with child abuse when it comes to enabling the states to enact laws needed to protect their citizens against abuse. This section of HIPAA currently provides the following (Source: HIPAA Administrative Simplification, page 7, http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/adminsimpregtext.pdf)A standard, requirement, or implementation specification adopted under this subchapter that is contrary to a provision of State law preempts the provision of State law. This general rule applies, except if one or more of the following conditions is met:…(c) The provision of State law, including State procedures established under such law, as applicable, provides for the reporting of disease or injury, child abuse, birth, or death, or for the conduct of public health surveillance, investigation, or intervention.The proposed amendment would merely add “elder abuse” as followsA standard, requirement, or implementation specification adopted under this subchapter that is contrary to a provision of State law preempts the provision of State law. This general rule applies, except if one or more of the following conditions is met:…(c) The provision of State law, including State procedures established under such law, as applicable, provides for the reporting of disease or injury, child abuse, adult abuse, elder abuse, birth, isolation, segregation , confinement or death, or for the conduct of public health surveillance, investigation, or intervention.This proposal could be broadened to provide more exceptions. I (tvfields@oh.rr.com) would be glad to discuss this further with anyone interested in recommending such legislation to lawmakers.

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