## Facts

- A patient sued her treating physician, alleging he disclosed her confidential medical information without consent during a deposition in an unrelated matter.
- The complaint pleaded federal subject-matter jurisdiction solely on an alleged violation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
- After jurisdiction was challenged, the patient sought leave to amend to allege she was a New York resident to create diversity jurisdiction.
- A magistrate judge found the patient was actually a Louisiana resident; the physician was also a Louisiana resident.

## Issues

1. Whether HIPAA creates an express or implied private right of action allowing an individual to sue directly for an alleged HIPAA violation.
2. Whether the district court abused its discretion by denying leave to amend the complaint to allege diversity jurisdiction based on a changed claim of residency.

## Decision

- The court affirmed dismissal of the action.
- HIPAA does not create a private cause of action, so a claim based only on HIPAA cannot supply federal-question jurisdiction.
- The district court did not abuse its discretion in denying leave to amend because the proposed amendment was futile: complete diversity was absent given the plaintiff’s Louisiana residency.

## Legal Principles

- Private rights of action to enforce federal statutes exist only when Congress provides a private right and a private remedy; congressional intent controls.
- HIPAA provides for administrative and governmental enforcement (including civil and criminal penalties) and contains no express private enforcement mechanism.
- Absent an express grant, a plaintiff bears a heavy burden to show an implied private remedy and must overcome the presumption against implied causes of action.
- Leave to amend may be denied where amendment would be futile, including where it would not cure a jurisdictional defect such as lack of complete diversity.

## Conclusion

The Fifth Circuit affirmed dismissal because HIPAA is not privately enforceable through civil litigation and because the plaintiff’s proposed amendment to plead diversity could not establish complete diversity and therefore could not confer federal subject-matter jurisdiction.


Acara v. Banks, 470 F.3d 569 (5th Cir. 2006)