HIPAA LAWS: WHAT THEY DO AND WHAT THEY DON’T

BY SNN.BZ STAFF

The term “HIPAA laws” is often thrown around in conversations about medical privacy, but many people misunderstand its true scope and limitations. The Health Insurance Portability and Accountability Act (HIPAA) is designed to safeguard an individual’s protected health information, such as medical records and diagnoses, held by healthcare providers and other covered entities.

While some believe HIPAA shields all medical information from public disclosure—and ideally, it might—its protections are not absolute. For instance, if a person experiences a psychiatric episode on their front lawn in full view of neighbors and people passing by, HIPAA does not prevent those witnesses from discussing what they saw and it doesn’t prohibit them from discussing it with local newscasters. This is because there is no expectation of privacy in public spaces, highlighting a critical distinction in how HIPAA applies to private versus public settings.

HIPAA (Health Insurance Portability and Accountability Act) laws are designed to protect the privacy and security of an individual’s protected health information (PHI), such as medical records, diagnoses, or treatment details held by covered entities like healthcare providers, hospitals, or insurance companies. These laws ensure that sensitive health information is not disclosed without the individual’s consent, except in specific circumstances allowed by law.

HIPPA however, does not protect or shield a person from their relatives, co-workers or friends discussing an individual’s medical information if they are aware of it. For instance, a person feeling agrieved cannot sue a friend, neighbor or even a relative for discussing that individual’s medical condition with another person (if they know of it).

HIPAA applies only to covered entities and their business associates, not to private individuals like neighbors or passersby who witness a public event. For instance, when a bi-polar patient experiences an episode at a beach, a shopping mall or a supermarket, or on the street, or in a way that is visible or audible to others (e.g., through open windows or even hallways), that type of event does not fall under HIPAA’s protections. And here’s why:

Public Nature of the Incident: Once an episode occurs in a public or semi-public setting, like a street or in view of neighbors, it is no longer private. An episode may begin in the interior of a house or apartment but once the police handcuff and take the individual to the hospital, that event is no longer private. It was only private until the person reached the door. Once the patient was taken to a medical facility, the view of being brought out of a private space, once in public – remains forever public. HIPAA does not regulate what private citizens see, hear, or discuss about events they witness in public. For example, neighbors or passersby who see the police or medical personnel responding to your friend’s episode are not bound by HIPAA, as they are not healthcare providers or entities handling the patient’s information.
No Expectation of Privacy in Public: Legally, individuals do not have a reasonable expectation of privacy for actions that occur in public spaces. Meghan Markle herself will tell you that she had to call the press to come photograph her because no one paid attention. She actually called the press to where she was (as the Kardashians have done for years) to witness Markle’s entrances and exits. Courts have consistently ruled that events visible or audible to the public—such as a mental health crisis requiring police or medical intervention—are not protected under privacy laws like HIPAA. This means that neighbors or others who witness these events are free to discuss what they saw, as they are not disclosing protected health information obtained from a covered entity. They are discussing “a public” event that they witnessed.
HIPAA’s Scope: HIPAA only governs the disclosure of health information by specific entities, such as doctors, nurses, or hospitals. For instance, if a healthcare provider were to share details of your friend’s bipolar diagnosis or treatment without her consent, that could be a HIPAA violation. But neighbors talking about what they saw during a public episode is not a HIPAA issue, as they are not accessing or sharing private health information from a covered entity.
Police and Emergency Response: When police or emergency medical services respond to a crisis, their actions (such as restraining or sedating someone) are not covered by HIPAA in the context of public intervention. While first responders are trained to handle such situations with care, their primary focus is safety, not privacy, especially in a public setting.

HIPAA protects a patient’s medical records and private communications with healthcare providers, it cannot however control what people see or hear during a public episode. The law doesn’t apply to private citizens who witness events in public spaces, and there’s no legal mechanism to prevent neighbors or passersby from discussing what they’ve seen.

HIPAA also does not apply to relatives of patients suffering from mental illness. The patient is often under the impression that no one is aware of their condition. The case is more often than not, that all the members of a family are fully aware aware of when their relative “acts up” and they have usually known about it since the patient was a very young person. These conditions rarely just “pop up” one day.

We absolutely empathize with the feelings of embarrassment or exposure that a person that suffers a manic episode in public experiences. We sugest strategies to manage the condition in a more private setting, if possible, such as working with the patient’s healthcare team to adjust their treatment plan.

Working directly with one’s healthcare aide is also helpful so that a patient can work out a plan to launch in place during crises events to minimize public escalation. Encourage patients to discuss these concerns with their trusted mental health professionals who can offer guidance on managing episodes and their impact on their lives.

Some famous individuals who have publicly discussed their bipolar disorder include Carrie Fisher, Demi Lovato, Mariah Carey, Catherine Zeta-Jones, and Kanye West.

Isaac Newton, known for his work in physics and mathematics, and potentially Ludwig Boltzmann, a physicist who struggled with mental health issues. Politicians include Winston Churchill, the former British Prime Minister, and Abraham Lincoln, the 16th U.S. President, both of whom exhibited symptoms suggestive of bipolar disorder. Among corporate leaders, Andy Behrman, author and mental health advocate, and Brian Dunn, former CEO of Bonobos, have publicly discussed their bipolar disorder diagnoses.

So for those of you suffering from bi-polar disorder – you’re actually in great company!