Q: Is hospital liable for fraud that was committed?
Hospital put into condition of admission unenforceable waiver for authorization of patient's information. After discharge from hospital patient's information was disclosed to a third party that committed fraudulent referral to hospice.
Hospital disclosed to a third party patient's records, knowingly that waiver for authorization to release records was unenforceable.
Is hospital liable for hospice fraud that was committed?
A:
Under California law, a hospital could potentially be liable for fraud committed by a third party if the hospital's actions contributed to or facilitated the fraud. In the scenario you described, there are a few key points to consider:
1. Unenforceable waiver: If the hospital included an unenforceable waiver for the authorization of patient information in the admission conditions, this could be seen as a violation of the patient's rights and privacy.
2. Disclosure of patient records: If the hospital knowingly disclosed the patient's records to a third party despite being aware that the waiver was unenforceable, this could be considered a breach of the hospital's duty to protect patient privacy and confidentiality.
3. Fraudulent referral to hospice: If the third party used the patient's information obtained from the hospital to commit a fraudulent referral to hospice, and the hospital's actions (i.e., disclosing the records despite the unenforceable waiver) facilitated this fraud, the hospital might be held liable for the resulting damages.
However, establishing liability would depend on several factors, such as:
1. The specific circumstances under which the hospital disclosed the patient's records
2. The hospital's knowledge of the waiver's unenforceability and the third party's intentions
3. The causal link between the hospital's actions and the resulting fraud
To determine the hospital's liability, it would be necessary to consult with a qualified attorney who can review the details of the case and provide guidance based on applicable California laws, such as the Confidentiality of Medical Information Act (CMIA) and the Health Insurance Portability and Accountability Act (HIPAA).
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