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TJ, Esq.
TJ, Esq., Attorney
Category: Legal
Satisfied Customers: 12396
Experience:  JD, MBA
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I live in california. My medical insurance company just sent

Resolved Question:

I live in california. My medical insurance company just sent a letter to one of my doctors (ob/gyn) regarding a presribtion for sleeping pills. My general doctor has been giving me sleeping pills for a serious back problem that makes it very difficult to sleep. The letter was advising my doctor to re-evaluate me because i have been taking the sleeping pills for over x amount of months. My questions are these. Is this legal. Can the insurance company question and make recommendations to my do tor? And my other question is they didnt even contact the doctor that prescribes the pills. They contacted a different doctor and released medical information about me to another doctor. Is that legal?
Submitted: 5 years ago.
Category: Legal
Expert:  TJ, Esq. replied 5 years ago.
Hello and thank you for allowing me the opportunity to assist you.

I'm sure if you review your insurance policy in detail, you'll see that you've consented to your insurance company discussing your medical records, etc., with your doctor. So, it would not be unlawful for your insurance company to contact your doctor about the pills. However, it may be a HIPAA violation for your insurance company to contact the wrong doctor and release medical information about you to that doctor. However, HIPAA does not provide for a private right of action. This means that you cannot win a lawsuit against the insurance company for a HIPAA violation. Instead, you can file a complaint with the Department of Health and Human Services for HIPAA violations. They will investigate, and then there could be fines, etc. You can file the complaint by CLICKING HERE.

Have I satisfactorily addressed your concerns? If not, then feel free to let me know, as I will be happy to clarify my answer or help with your follow-up questions. In the meantime, please remember to click the green accept button so that I will receive credit and compensation for my time (doing so does not end our discussion). Positive feedback is always appreciated as well. Thank you and good luck!
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