Federal Court Dismisses Negligence Per Se Claim Based on HIPAA Violation

A Texas federal district court has granted Blue Cross and Blue Shield of Texas, Inc.’s motion to dismiss the state law claims, including a negligence per se claim filed by Brandon Walters, a group health plan participant, concerning a HIPAA violation. The case is Walters v. Blue Cross Blue Shield of Tex., Inc., 2022 WL 902735 (N.D. Tex. 2022)

Blue Cross and Blue Shield received a subpoena directing it to disclose a limited number of Walters’ medical records to an assistant judge, for review, in a separate child custody case. The judge was to privately review the records before disclosing them to the attorney for Walters’ ex-spouse. Instead, the insurance company sent the records directly to the attorney instead of the judge, violating the HIPAA privacy rule on disclosing protected health information (PHI). The insurer also failed to limit the records as directed in the subpoena. 

Walters then filed various privacy-related claims against the insurer, including a state law claim based on negligence per se. Walter argued that the insurer was negligent per se in producing medical records that exceeded the scope of the subpoena in violation of HIPAA and the Texas Medical Records Privacy Act (TMRPA). 

The court explained that negligence per se is a common-law doctrine based on a statutory standard of conduct, which differs from the standard used in a pure negligence claim, which is the reasonably prudent person test. A person or entity who violates a statute may be liable for damages under a theory of negligence per se if the violation results in the type of harm that the statute was designed to prevent. HIPAA does not contain a private right of action but only a comprehensive regulatory scheme with limited private remedies. Therefore, the court reasoned, allowing Walters to pursue a negligence per se claim based on a HIPAA violation would not align with the legislative purpose of HIPAA.

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