HIPAA regulations and Michael Jackson

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Posted by Alia Ahmed June 30, 2009 at 8:59 p.m.

Congress initially passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996 and it includes many aspects of medical care, including coverage for pre-existing medical conditions and release of confidential medical information. The part of HIPAA that most of us are familiar with was enacted into law April 1, 2001. We are often asked to sign forms related to HIPAA at our dentist and doctor's offices. HIPAA protects patients from having their medical information released without their consent.

A nurse practitioner, Cherilyn Lee, has spoken on three different programs tonight on CNN via the telephone. She related that she initially became acquainted with Michael Jackson at the beginning of this year when she saw his three children in their home for treatment of colds. She then started providing Michael with nutritional advice to increase his level of energy and to treat insomnia. At one point, Michael asked her to prescribe/admininster a sedative, Diprivan, for him that is only administered in an inpatient setting. She reports she wasn't even aware of what the medication was and had to check with a physician. She reports she has never prescribed any medications to Michael and told him it was a very dangerous drug.

Although Michael Jackson is now dead, does he give up his right to privacy of his medical records? This nurse had a professional relationship with Michael and both he and his children were her patients. Though she may be compelled to provide information to the coroner or the police department due to their investigation (which she says she's not spoken to about this), I believe she has violated both ethical boundaries and perhaps the law by disclosing this information.

Should she be charged with violating HIPAA regulations? Should she lose her nursing license for disclosing this information? What would your reaction be if a health care provider disclosed you and your family's medical information without your consent?

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pace (anonymous) says…

The LA police are listing the things they are investigating, talking about his prescriptions and medical conditions. Did I miss something? One of them talked about how his body looked. They had no right to broadcast the information unless it was part of some charges, not some wild hair hunt.
The nurse should be charged. The police should be slapped with a civil rights suit.
July 1, 2009 at 1:30 a.m.
Music_Girl (anonymous) says…

Pace, I agree that both are in the wrong. Seriously, just because someone is a celebrity doesn't mean that every aspect of their life and death should be up for tabloids and crazed fans to know about. Let the family have time to mourn and stop trying to steal the spotlight for your 15 minutes of fame. Sick people.
July 1, 2009 at 9:17 a.m.
Valkyrie_of_Reason (Kathy Getto) says…

All good questions, Alia! A person's privacy rights are not given up upon death. HIPPA protects those rights where medical information is concerned. Of course some information can be released without permission, i.e, to a coroner or funeral home. What we don't know is what permission, if any, the executor of Michael's estate has given in regard to this information. If no permission was given, this nurse practitioner has committed a felony as recognized by federal law. Any administrative action against her license would be a separate matter.
July 1, 2009 at 9:23 a.m.
Logan72 (Alia Ahmed) says…

One of the family attorneys really called Anderson Cooper to task for airing the nurse practitioner's statement without any other corroboration so I'm guessing the family did not authorize this nurse practitioner to speak. I'm thinking she's looking for her own 15 minutes of fame. Although CNN probably wouldn't pay her for her appearance, a tabloid might pay her for her account of what happened. Not that Michael Jackson is blameless, but there seemed to very opportunist people in his life and now at the time of his death. Sad!
July 1, 2009 at 9:34 a.m.
consumer1 (anonymous) says…

Well pitch of fit about it!! don't just complain on here!! Write your congress person. File a law suit!! take action.

Oh that is right this is Lawrence Kansas, home of the Whine and Cheeze crowd. Who like to complain but never takes any action or does anything about it...
July 1, 2009 at 9:38 a.m.
Logan72 (Alia Ahmed) says…

Consumer, I see you all knowing and know whether I or the others have taken some action. Is pointing out a problem not doing something about it? I didn't think there was anything whiny about my blog. I pointed out a pattern I've seen happen when a celebrity dies and gave some history of HIPPA regulations and ask for feedback about it. To tell you the truth, the tone of your comment seems whiny, negative and not very productive.
July 1, 2009 at 9:46 a.m.
Valkyrie_of_Reason (Kathy Getto) says…

Consumer, shining a light on an issue IS taking action as Alia has done here in her blog and similarly by shining a light on your negativity. The spotlight's on you consumer, show us what you've got!!
July 1, 2009 at 9:55 a.m.
zannniee (anonymous) says…

...and you are a credible journalistic source when you spell HIPAA wrong throughout your entire article?
July 1, 2009 at 9:58 a.m.
Logan72 (Alia Ahmed) says…

zanniee, you're right. My mispelling totally invalidates my point. Are you related to consumer?
July 1, 2009 at 10:01 a.m.
Logan72 (Alia Ahmed) says…

oops, misspelling. :~)
July 1, 2009 at 10:03 a.m.
zannniee (anonymous) says…

Actually, if you were in the healthcare industry, you'd know and care. I was just surprised that it was wrong.

*shrugs*
July 1, 2009 at 10:03 a.m.
Valkyrie_of_Reason (Kathy Getto) says…

I misspelled it, too. So what? This is not just about MJ, but about being informed.
July 1, 2009 at 10:05 a.m.
jumpin_catfish (anonymous) says…

I don't think Michael cares anymore but his children and their guardians may have a case or make up one if they don't to make a few bucks off this nurse's liability insurance. I'm sure Jesse Jackson or Al Sharpton could help them for a cut of the action.
July 1, 2009 at 10:08 a.m.
Logan72 (Alia Ahmed) says…

Actually, I have a master's degree in social work, have worked previously as an EMT and have worked in the healthcare industry most of my adult life. My patients and clients have appreciated the care and services I've provided them. I've always been conscientious of protecting a patient's confidentiality. I've always thought it is passive-aggressive to point out a spelling or typographical error unless you are actually serving as someone's editor, but know some folks feel superior if they do so.
July 1, 2009 at 10:14 a.m.
grammaddy (anonymous) says…

I think it's sad that this many people are still trying to trash MJ even after his death. Show some respect. He is gone, but his family is still here to deal with this mess. Let them have their time to mourn their loved one.
July 1, 2009 at 10:20 a.m.
Logan72 (Alia Ahmed) says…

catfish,

I think you are missing the point. When Anna Nicole Smith died the paramedics spoke to the media and it has happened numerous other times recently. My point is not whether MJ's family can sue the nurse, but whether a person's right to privacy is terminated when they die and why healthcare professionals would violate the person's confidentiality for either fame or money.
July 1, 2009 at 10:20 a.m.
Logan72 (Alia Ahmed) says…

zannie, I did correct the spelling of HIPPA. Thanks for pointing it out. I wasn't reacting to you pointing out the spelling error as much as the tone of your comment. I am not a paid journalist but considered a citizen journalist. However, even paid journalists make typing and spelling errors. I"ve read textbooks and novels with spelling and typing errors and they've been often been proofread numerous times.
July 1, 2009 at 10:28 a.m.
Valkyrie_of_Reason (Kathy Getto) says…

HIPAA protects the minimal disclosure to a health oversight agency or law enforcement by a whistleblower and subsequently protects the whistleblower from retaliation.

This gal says she wanted to speak out to dispell rumors of MJ's drug abuse. I have to agree it is more than that - has to be to put one's license on the line.
July 1, 2009 at 12:47 p.m.
Logan72 (Alia Ahmed) says…

Marion,

The nurse states she never prescribed any medications to MJ. She said one of MJ's managers called her five days before his death describing some weird symptoms. She says she told them he should go the emergency room, which sounds like good advice. There are limitations to confidentiality laws. As a social worker, I am mandated to report physical abuse, sexual abuse or neglect of a child or dependent adult even if the information was provided in a therapeutic setting. Also, healthcare professionals are not liable if they disclose that a person is an imminent danger to him or her self or others. Had the nurse reported her concerns to the proper authorities (not the media) prior to his death, voicing her concerns that he was endangering himself or incapacitated due to substance abuse, she may have been acting within the framework of the law.
July 1, 2009 at 1:21 p.m.
Logan72 (Alia Ahmed) says…

Here's the link to make a report to the California Board of Registered Nursing re: illegal or unethical practice.
enforcement_brn@dca.ca.gov
July 1, 2009 at 1:25 p.m.
Valkyrie_of_Reason (Kathy Getto) says…

porch -I agree on all accounts.
July 1, 2009 at 1:44 p.m.
Logan72 (Alia Ahmed) says…

porch_person,

I'm sure they do know about it but sometimes multiple reports are more effective. I once made a report on a suspected child abuse case. I was the 16th person to make a report re: this family and the multitude of those reports did make a difference and perhaps saved the child's life.
July 1, 2009 at 1:48 p.m.
Logan72 (Alia Ahmed) says…

Here's a response I received from the nursing board in California about complaint about the nurses' breach of confidentiality.

"We are carefully evaluating this matter and appropriate action will be
taken.

Thank you for bringing this matter to our attention and the opportunity
to be of assistance.

California Board of Registered Nursing
Enforcement Division
PO Box 944210
Sacramento, CA 94244-2100"
July 1, 2009 at 3:25 p.m.
Logan72 (Alia Ahmed) says…

Marion, I'm not offended. I hope they got hundreds of thousands of emails like mine. There is power in numbers.
July 1, 2009 at 4:13 p.m.
akt2 (anonymous) says…

I don't see how speculation, opinion and heresay would be relevant. It is not information obtained from documented medical records.
July 1, 2009 at 4:17 p.m.
Logan72 (Alia Ahmed) says…

akt2, the nurse is sharing information she gained while treating initial Michael Jackson's children for cold and subsequently treating MJ for fatigue and insomnia. That is privileged information.
July 1, 2009 at 4:33 p.m.
akt2 (anonymous) says…

If there is no specific documentation of any of the events she is describing it means nothing. I hardly thnk that any of the health care she speaks of was performed in a supervised medical setting. In legitimate medical practice patients sign consents for medical treatment and privacy practice agreements. No records, no violations.
July 1, 2009 at 4:51 p.m.
Logan72 (Alia Ahmed) says…

It doesn't have to be performed in a supervised medical setting to be protected information. Why do you think this nurse doesn't keep records? Even acknowledging that someone is your patient is a violation of HIPAA regulations if you haven't obtained their written consent to do so.

If a visiting nurse makes a house call, they are still bound to maintain patient confidentiality. Many people commented on Anderson Coopers' blog today that are healthcare officials (nurses and physicians) and they share my view that this was legally and ethically wrong for this nurse to do this.

http://ac360.blogs.cnn.com/2009/06/30...
July 1, 2009 at 5:10 p.m.
Logan72 (Alia Ahmed) says…

Marion, that definitely could be the case. She wasn't very impressive to listen to on the various "news" programs last night. I wouldn't trust her skills as a nurse if she doesn't value and respect the ethical and legal rights to confidentiality of her patient(s). It would be interesting to know if there have been other complaints lodged against her prior to this incident.
July 1, 2009 at 9:24 p.m.
MarianneRN (anonymous) says…

You can also report her to U.S. Dept. of Health and Human Services http://www.hhs.gov/ocr/privacy/index..... I am a DNS. I take my license very seriously. I have been following the news coverage closely as I am one who loved Michael Jackson. I am appalled at the behavior of these so called "professionals", and have personally reported every one of them, including one physician who claims to be his friend. My heart goes out to the Jackson family and to his millions of fans. Rest in peace, Michael. Your tortured life is over. It is much better where you are. One note to the Jacksons. There are still some people in this world with integrity. Not all professionals are so eager to talk. Since I work in a small community hospital, I have access to my own family's medical records, and yet I have never even looked. If they wanted me to know their personal business, they would tell me.
July 3, 2009 at 12:36 p.m.
Logan72 (Alia Ahmed) says…

Marianne, Your professionalism is something we should be able to expect from all healthcare providers but unfortunately, either their need for fame or money or both has caused a few of them to "sell their souls". and forego their professional ethics. You sound like a dedicated healthcare professional.
July 3, 2009 at 5:11 p.m.
pace (anonymous) says…

my Dr.'s nurse told some of my friends about my pregnancy and sex of my child. When I complained she said that it was out of love. Then went on to talk about my age of pregnancy and the span between my children. I did not make charges but I changed Drs. She really believed she gossiped out of love. What bull.
July 4, 2009 at 6:21 p.m.
Logan72 (Alia Ahmed) says…

pace,

That is outrageous that your medical information was divulged. I'm glad you changed physicians!
July 6, 2009 at 12:43 p.m.
jjmom (anonymous) says…

I agree that HIPAA was violated. Not only by the nurse, but by the media outlets that reported on it. Shouldn't they abide by HIPAA also?
July 9, 2009 at 2:19 p.m.
jkealing (Jonathan Kealing) says…

jjmom--

HIPAA only pertains to health care providers. A restraint on media reporting what health care providers are saying would be a 1st Amendment violation.

Jonathan Kealing
Online editor
July 9, 2009 at 2:44 p.m.