BILL NUMBER: AB 439 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MAY 18, 2011
AMENDED IN ASSEMBLY APRIL 7, 2011
INTRODUCED BY Assembly Member Skinner
FEBRUARY 14, 2011
An act to amend Section 56.36 of the Civil Code, relating to
health care information.
LEGISLATIVE COUNSEL'S DIGEST
AB 439, as amended, Skinner. Health care information.
Existing law, the Confidentiality of Medical Information Act
(CMIA), prohibits a health care provider, a contractor, or a health
care service plan from disclosing medical information, as defined,
regarding a patient of the provider or an enrollee or subscriber of
the health care service plan without first obtaining an
authorization, except as specified. In addition to other remedies
available, existing law authorizes an individual to bring an action
against any person or entity who has negligently released his or her
confidential records in violation of those provisions for nominal
damages of $1,000.
This bill would specify that nominal damages may be
awarded at the discretion of the court. specify that,
in an action brought on or after January 1, 2012, a court
may not award nominal damages if the defendant establishes specified
factors as an affirmative defense, including, but not limited to,
that it is a covered entity, as defined, and has complied with any
obligations to notify persons entitled to receive notice regarding
the release of the information. The bill would also make a technical,
nonsubstantive change.
Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 56.36 of the Civil Code is amended to read:
56.36. (a) Any violation of the provisions of this part that
results in economic loss or personal injury to a patient is
punishable as a misdemeanor.
(b) In addition to any other remedies available at law, any
individual may bring an action against any person or entity who has
negligently released confidential information or records concerning
him or her in violation of this part, for either or both of the
following:
(1) Nominal Except as provided in
subdivision (e), nominal damages of one thousand
dollars ($1,000) , which may be awarded at the discretion of
the court . In order to recover under this paragraph, it
shall not be necessary that the plaintiff suffered or was threatened
with actual damages.
(2) The amount of actual damages, if any, sustained by the
patient.
(c) (1) In addition, any person or entity that negligently
discloses medical information in violation of the provisions of this
part shall also be liable, irrespective of the amount of damages
suffered by the patient as a result of that violation, for an
administrative fine or civil penalty not to exceed two thousand five
hundred dollars ($2,500) per violation.
(2) (A) Any person or entity, other than a licensed health care
professional, who knowingly and willfully obtains, discloses, or uses
medical information in violation of this part shall be liable for an
administrative fine or civil penalty not to exceed twenty-five
thousand dollars ($25,000) per violation.
(B) Any licensed health care professional, who knowingly and
willfully obtains, discloses, or uses medical information in
violation of this part shall be liable on a first violation, for an
administrative fine or civil penalty not to exceed two thousand five
hundred dollars ($2,500) per violation, or on a second violation for
an administrative fine or civil penalty not to exceed ten thousand
dollars ($10,000) per violation, or on a third and subsequent
violation for an administrative fine or civil penalty not to exceed
twenty-five thousand dollars ($25,000) per violation. Nothing in this
subdivision shall be construed to limit the liability of a health
care service plan, a contractor, or a provider of health care that is
not a licensed health care professional for any violation of this
part.
(3) (A) Any person or entity, other than a licensed health care
professional, who knowingly or willfully obtains or uses medical
information in violation of this part for the purpose of financial
gain shall be liable for an administrative fine or civil penalty not
to exceed two hundred fifty thousand dollars ($250,000) per violation
and shall also be subject to disgorgement of any proceeds or other
consideration obtained as a result of the violation.
(B) Any licensed health care professional, who knowingly and
willfully obtains, discloses, or uses medical information in
violation of this part for financial gain shall be liable on a first
violation, for an administrative fine or civil penalty not to exceed
five thousand dollars ($5,000) per violation, or on a second
violation for an administrative fine or civil penalty not to exceed
twenty-five thousand dollars ($25,000) per violation, or on a third
and subsequent violation for an administrative fine or civil penalty
not to exceed two hundred fifty thousand dollars ($250,000) per
violation and shall also be subject to disgorgement of any proceeds
or other consideration obtained as a result of the violation. Nothing
in this subdivision shall be construed to limit the liability of a
health care service plan, a contractor, or a provider of health care
that is not a licensed health care professional for any violation of
this part.
(4) Nothing in this subdivision shall be construed as authorizing
an administrative fine or civil penalty under both paragraphs (2) and
(3) for the same violation.
(5) Any person or entity who is not permitted to receive medical
information pursuant to this part and who knowingly and willfully
obtains, discloses, or uses medical information without written
authorization from the patient shall be liable for a civil penalty
not to exceed two hundred fifty thousand dollars ($250,000) per
violation.
(d) In assessing the amount of an administrative fine or civil
penalty pursuant to subdivision (c), the Office of Health Information
Integrity, licensing agency, or certifying board or court shall
consider any one or more of the relevant circumstances presented by
any of the parties to the case including, but not limited to, the
following:
(1) Whether the defendant has made a reasonable, good faith
attempt to comply with this part.
(2) The nature and seriousness of the misconduct.
(3) The harm to the patient, enrollee, or subscriber.
(4) The number of violations.
(5) The persistence of the misconduct.
(6) The length of time over which the misconduct occurred.
(7) The willfulness of the defendant's misconduct.
(8) The defendant's assets, liabilities, and net worth.
(e) (1) In an action brought by an individual pursuant to
subdivision (b) on or after January 1, 2012, the court shall award
any actual damages and reasonable attorney's fees and costs, but may
not award nominal damages, for a violation of this part if the
defendant establishes all of the following as an affirmative defense:
(A) The defendant is a covered entity, as defined in Section
160.103 of Title 45 of the Code of Federal Regulations.
(B) The defendant has complied with any obligations to notify all
persons entitled to receive notice regarding the release of the
information or records.
(C) The release of confidential information or records was solely
to another covered entity.
(D) The defendant took appropriate preventive actions to protect
the confidential information or records against release, retention,
or use by any person or entity other than the covered entity that
received the information or records, including, but not limited to:
(i) Developing and implementing security policies and procedures.
(ii) Designating a security official who is responsible for
developing and implementing its security policies and procedures,
including educating and training the workforce.
(iii) Encrypting the information or records, and protecting
against the release or use of the encryption key and passwords.
(E) The defendant took appropriate corrective action after the
release of the confidential records or information, and the covered
entity that received the information or records immediately destroyed
or returned the information or records.
(F) The covered entity that received the confidential information
or records did not retain, use, or release the information or
records.
(G) The defendant has not previously violated this part, or, in
the court's discretion, despite the prior violation, application of
the affirmative defense is found to be compelling and consistent with
the purposes of this section to promote reasonable conduct in light
of all the facts.
(2) In an action under this subdivision, a plaintiff shall be
entitled to recover reasonable attorney's fees and costs without
regard to an award of actual or nominal damages.
(3) A defendant shall not be liable for more than one judgment on
the merits for a violation of this subdivision.
(e)
(f) (1) The civil penalty pursuant to subdivision (c)
shall be assessed and recovered in a civil action brought in the name
of the people of the State of California in any court of competent
jurisdiction by any of the following:
(A) The Attorney General.
(B) Any district attorney.
(C) Any county counsel authorized by agreement with the district
attorney in actions involving violation of a county ordinance.
(D) Any city attorney of a city.
(E) Any city attorney of a city and county having a population in
excess of 750,000, with the consent of the district attorney.
(F) A city prosecutor in any city having a full-time city
prosecutor or, with the consent of the district attorney, by a city
attorney in any city and county.
(G) The Director of the Office of Health Information Integrity may
recommend that any person described in subparagraphs (A) to (F),
inclusive, bring a civil action under this section.
(2) If the action is brought by the Attorney General, one-half of
the penalty collected shall be paid to the treasurer of the county in
which the judgment was entered, and one-half to the General Fund. If
the action is brought by a district attorney or county counsel, the
penalty collected shall be paid to the treasurer of the county in
which the judgment was entered. Except as provided in paragraph (3),
if the action is brought by a city attorney or city prosecutor,
one-half of the penalty collected shall be paid to the treasurer of
the city in which the judgment was entered and one-half to the
treasurer of the county in which the judgment was entered.
(3) If the action is brought by a city attorney of a city and
county, the entire amount of the penalty collected shall be paid to
the treasurer of the city and county in which the judgment was
entered.
(4) Nothing in this section shall be construed as authorizing both
an administrative fine and civil penalty for the same violation.
(5) Imposition of a fine or penalty provided for in this section
shall not preclude imposition of any other sanctions or remedies
authorized by law.
(6) Administrative fines or penalties issued pursuant to Section
1280.15 of the Health and Safety Code shall offset any other
administrative fine or civil penalty imposed under this section for
the same violation.
(f)
(g) For purposes of this section, "knowing" and
"willful" shall have the same meanings as in Section 7 of the Penal
Code.
(g)
(h) No person who discloses protected medical
information in accordance with the provisions of this part shall be
subject to the penalty provisions of this part.
(h) Paragraph (6) of subdivision (e) shall only become operative
if Senate Bill 541 of the 2007-08 Regular Session is enacted and
becomes effective on or before January 1, 2009.