Frank Alario is a former physician who had medical practices in New Jersey, New York, and Florida. He recently pleaded guilty to conspiring to wrongfully disclose patients’ health information in violation of HIPAA.
Health Insurance Portability and Accountability Act (HIPAA)
A person is liable for a violation of HIPAA if they knowingly:
- Use of cause to be used a unique health identifier
- Obtain individually identifiable health information relating to an individual
- Disclose individually identifiable health information to another person.
Frank Alario admitted to unlawfully disclosing information to another person. In this case, a pharmaceutical sales rep was allowed to look up patients’ information. The rep was given access to physical files and office computers to see whether patients’ insurance covered their medications. Alario also allowed the rep to fill out prescription forms that he would then authorize.
The sales rep was present in the office both during normal office hours and outside of them. They were also given access to areas of the office restricted to staff only, including the areas holding patient files and office computers.
Finally, the sales rep was permitted to help complete drug prior authorizations (PAs). PAs are required by insurance plans to help facilitate coverage when a drug is not covered under the plans regular formulary. However, access to these is permitted to just the patient, the physician and their staff, and the insurance company.
Penalty
Frank Alario faces a maximum penalty of one year in prison and a $50,000 fine. Sentencing is scheduled for Feb 2023.
You can read more about HIPAA news here.
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