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Legalease
Legalease, Lawyer
Category: Legal
Satisfied Customers: 14511
Experience:  15 years exp all aspects of general law
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I am a 20 yr, Licensed Clinical Social Worker in a small town,

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I am a 20 yr, Licensed Clinical Social Worker in a small town, and small state. I am a board member and patient of a large community health organization. Prior to and after becoming a board member, I also accepted referrals from them (mostly due to the area being quite rural). This worked well until last summer when I realized and then confirmed that my nurse practioner was no longer referring. There was no reason I knew of, but I had other sources and excellent word of mouth clients. I last saw this hcp in late December and shared with her that I was looking to leave my relationship of 15 years and that the logistics were stressful. She was very rude from the outs et and things didn't improve. I left her office puzzled and with the intention of replacing her. Over the past three months my practice has gone down abt 80%.... Three weeks ago a former client called to ask if I was ok? Apparently she had seen this same nurse practioner and mentioned she was going to stop in and make an appt. The NP then told her that I was "going through a rough time." Our patient then asked her if I was sick? The NP replied "no she's having personal problems" I reported it to the privacy officer of the company (remember I am a board member) and they are investigating. The client was willing to give a statement. I don't think I can salvage my practice, I am behind on most bills at this point and will be starting a part-time agency job next month. My questions are:
1. Is the company obligated to report this to OCR? They receive federal money.
2. Will this be a topic at board meetings, should I resign?
3. How do I get an attorney to return my calls?
Submitted: 1 year ago.
Category: Legal
Expert:  Legalease replied 1 year ago.

Hello there-

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Can you clarify for me --

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Were you seeing this NP as a patient of hers for medical issues?

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The downturn in your business as a counselor is because this NP was no longer making referrals to your practice as a counselor and social worker?

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Did any of the other medical professionals at the health organization refer cases to you in addition to this particular NP?

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Was the board and the health organization aware that the NP was making referrals to you (and if any other medical professionals made referrals to you)

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MARY

Customer: replied 1 year ago.

-Yes, she was my primary care provider, part of my commitment as a board member also (51% of the board are patients)


-In part my referral base from them was approximately 30-40%. The downturn was in part due to lack of new referrals. However, I believe that what prevented my recovery was her attempts to redirect current or past clients from returning. I know of one other who switched du


to her.


The board was very aware of this prior to my accepting a position because I raised the concern that my priorities lie with my clients, should they have an issue with their care.


 


I have referrals from a couple of employees at other sites.


 

Expert:  Legalease replied 1 year ago.

Hello again Lee --

-

I apologize for the delay in responding but I was offline until a few minutes ago. Regarding the issues presented in your question above - you have two concerns here: the first as a patient who has had HIPPA rights violated and the second is the larger loss of business volume due to the nature of her comments to your former clients and any potential clients. Under the circumstances, you have a valid complaint that you can make to the US Dept of Health and Human Services (DHHS) / OCR for the NP's violation of the HIPPA laws - and the complaint can be made against the NP personally and the facility. The thing about the HIPPA laws is this -- the only action that a victim of this can take against the parties who violated the HIPPA laws is to file a complaint with DHHS/OCR and because that federal department has been overloaded with complaints in recent years it does take them a while to review all of the complaints and adequately respond to them. The actions that DHSS can take can be as minimal as a reprimand and can go as far as pulling all or some of the federal funding received by the healthcare facility -- it all depends upon how egregious the offense in the eyes of DHHS/OCR -- but under the circumstances they will receive at least a reprimand. Finally, to answer your first direct question above -- the facility does not have to report all violations of this nature to DHHS/OCR simply because they receive federal funding --- DHHS/OCR relies upon patient complaints for the most part and they have such an overflow of complaints from patients at various healthcare facilities across the US that they would never be able to keep up if every facility receiving federal funds were required to report all violations - no matter how minimal -- to the agency (the facilities are required to self-police and keep records of any violations they uncover or any that are reported to them - whether the violation is reported to DHHS / OCR or not).

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You were correct in reporting this to the facility yourself and the privacy committee should take some action against this NP involved in your case (particularly since you have a witness willing to come forward and let them know exactly what was said regaring you, your work and your personal situation). Other steps in this case will be entirely dependant upon how far you want to pursue the matter against the NP and/or the facility. As I noted above, there is no private right of action against either the NP or the facility under the HIPPA laws (you cannot file a privacy invasion lawsuit based solely upon the violation of the federal HIPPA laws -- you can only file the complaint with DHHS/OCR). However, that restriction does not preclude you from hiring an attorney and filing a private civil lawsuit against the NP and the facility for invasion of privacy under the state laws of Rhode Island ( invasion of privacy is a very old long standing tort action (personal injury action) that developed through case law there and in all of the states). In addition to the invasion of privacy lawsuit against the NP, you can also pursue a defamation of character lawsuit against the NP -- she committed the legal tort of slander (which is spreading false and malicious gossip by word of mouth) to such a degree that it has harmed your professional reputation and has cost you income from the lost referrals and lost patients who chose not to see you after speaking with the NP. In order to pursue invasion of privacy and defamation of character lawsuits against this woman you will have to have a few witnesses that would be willing to testify to what she said to them and how that affected their desires to contact and hire you as a counselor, and this might be difficult to do if you are living in a smaller community without many healthcare facilities readily available to patients in general.

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Finally, to answer your last question about the board meetings -- any complaint filed by you should not be the topic of general board discussion at their meetings (the board should be smart/savvy enough to realize that a complaint made for violation of privacy rights and HIPPA violations should not be the topic of general everyday board discussion and if discussed at all, should be done with a small committee broken off from the larger board whose purpose it is just to discuss privacy issues and violations). While there is nothing in the law specifically preventing this from happening (such as a statute setting forth privacy rights and issues that may or may be discussed by a corporate governing board) - the board can also be subjected to being named as a defendant in an invasion of privacy lawsuit if they are not discreet in their actions regarding your complaint. If you do not want this discussed at board meetings and you are a member of the board, then it cannot hurt to make your feelings known to the other members as well.

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To find a local attorney you should contact either the county bar association or the Providence bar association and seek to use the referral service of either one of the bar associations to refer you to several attorneys in your area who specialize in invasion of privacy cases (healthcare setting / HIPPA) and/or defamation of character cases. It may take you a while to find one who is interested in pursuing these matters for you simply due to the complexity of the case and the fact that it is not a physical injury case.

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Please let me know if you have any further questions. If not, can you please press the 3rd, 4th or 5th smile face below so I will be paid for my time. I am paid NOTHING unless you press a positive rating below. Pressing the 3rd, 4th or 5th smile face below will NOT cost you any additional money -- it simply acts as a trigger to Just Answer to pay me for my time. THANK YOU VERY MUCH !!!

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MARY

Customer: replied 1 year ago.

thank you Mary... I am on the Governance committee. Our job is to insure that the Board follows proper procedure. does this change anything?

Expert:  Legalease replied 1 year ago.

Hello again Lee -

-

The fact that you are on the governance committee does not make a difference from a legal standpoint at all except that the governance committe should make sure that either the full board or a few select members of the board review your privacy complaint and take appropriate internal actions if any such actions are warranted -- and you should recuse yourself from any review of the matter and any deliberations, discussions and/or decisions that are made regarding reprimanding or taking any other action against the NP. Other than taking yourself away from your own complaint there is nothing else that you should or must do with regard to the board or the governance committee.

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MARY

-

Please let me know if you have any further questions. If not, can you please press the 3rd, 4th or 5th smile face below so I will be paid for my time. I am paid NOTHING unless you press a positive rating below. Pressing the 3rd, 4th or 5th smile face below will NOT cost you any additional money -- it simply acts as a trigger to Just Answer to pay me for my time. THANK YOU VERY MUCH !!!

-

MARY



Legalease, Lawyer
Category: Legal
Satisfied Customers: 14511
Experience: 15 years exp all aspects of general law
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