Article Summary

HIPAA has created a strict set of regulations that impact employer training and employee activities in the healthcare workplace. Employees who insist on adherence to the rules are at risk for whistleblower retaliation, but may be protected under whistleblower laws such as the False Claims Act.

This article by TELG managing principal R. Scott Oswald and former principal David L. Scher was published by Bloomberg BNA Health Care Fraud Report on June 11, 2014. The full article is .

Excerpted from:

Bloomberg BNA Health Care Fraud Report

Workforce Whistleblowing at the Intersection of HIPAA and the False Claims Act

The Health Insurance Portability and Accountability Act (HIPAA) is an ever-present concern for healthcare providers and their workforce members. Health-care providers, health plans, and health-care clearinghouses train their staff ad nausea about the Privacy Rule and what it means to the entity.

In fact, HIPAA regulations require them to do so. 45 C.F.R. § 164.530(b)(1). But the goal of protecting patient information and rooting out fraud can come at cross purposes when an entity is defrauding government programs like Medicare and Medicaid. Most entity-administered trainings gloss—or skip—over the instances where workforce members can disclose patient information.