[ Thursday, October 07, 2010 ]


Texas Case Alleges HIPAA Violation as Basis for RICO Claim: A group of Texas retail pharmacies have sued CVS, alleging it uses PHI it obtains from its Caremark pharmacy benefits management business to help CVS steal customers from other retail pharmacies (Caremark and CVS merged in 2007). They claim that the combined entity uses PHI in a manner that violates HIPAA, which allows the RICO (Racketeer Influenced and Corrupt Organizations) Act. (via BNA, subscription required)

As fellow HIPAAcrat Kirk Nahra notes, this is an uphill battle for the plaintiffs. First, it's hard to say that the way the PHI was used actually violates HIPAA (there seems to be a good "healthcare operations" justification there). Secondly, the criminal law the plaintiff's lawyers use to tie in RICO might not be a correct fit. However, the case will be interesting because it touches on several issues directly dealt with in HITECH, including sales of PHI and use of PHI for marketing purposes.

Jeff [10:54 AM]

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