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Criminal penalties for HIPAA violations are relatively rare, although the Department of Justice does pursue criminal charges for HIPAA violations when there has been a serious violation of patient privacy, such as an impermissible disclosure of protected health information for financial gain or malicious purposes.
One such case has resulted in two criminal convictions – a violation of the Health Insurance Portability and Accountability Act and obstructing a criminal healthcare investigation.
The case relates to the DOJ investigation of the pharmaceutical firm Warner Chilcott over healthcare fraud. In 2015, Warner Chilcott plead guilty to paying kickbacks to physicians for prescribing its drugs and for manipulating prior authorizations to induce health insurance firms to pay for prescriptions. The case was settled with the DOJ for $125 million.
Last week, a Massachusetts gynecologist, Rita Luthra, M.D., 67, of Longmeadow, was convicted for violating HIPAA by providing a Warner Chilcott sales representative with access to the protected health information of patients for a period of 10 months between January 2011 and November 2011.
The access to PHI allowed patients with certain health conditions to be targeted by the firm and facilitated the receipt of prior authorizations for Warner Chilcott pharmaceutical products. When interviewed by federal agents about her relationship with Warner Chilcott, Luthra provided false information and obstructed the investigation.
Luthra had been previously charged for receiving kickbacks from Warner Chilcott in the form of fees for speaker training and speaking at educational events that did not take place. Luthra had accepted payments of approximately $23,500. The DOJ eventually dropped the charges, although the case against the physician continued to be pursued, resulting in the two convictions.
Luthra faces jail time and a substantial fine. The maximum penalty for the HIPAA violation is a custodial sentence of no more than 1 year, one year of supervised release, and a maximum fine of $50,000. The maximum penalty for obstructing a criminal health investigation is no more than 5 years in jail, three years of supervised release, and a fine of up to $250,000.