The US HIPAA law only protects the privacy of health data held by “covered entities,” which essentially means health care providers and insurance companies. If you give your heart monitoring data or DNA to your doctor, it comes under HIPAA. If you give it to Fitbit or 23andMe, it does not. Government entities are not covered by HIPAA either, a fact that Latanya Sweeney exploited to demonstrate how service dates be used to identify individuals.
Texas passed the Texas Medical Records Privacy Act (a.k.a. HB 300 or TMPRA) to close this gap. Texas has a much broader definition of covered entity. In a nutshell, Texas law defines a covered entity to include anyone “assembling, collecting, analyzing, using, evaluating, storing, or transmitting protected health information.” The full definition, available here, says
“Covered entity” means any person who:
(A) for commercial, financial, or professional gain, monetary fees, or dues, or on a cooperative, nonprofit, or pro bono basis, engages, in whole or in part, and with real or constructive knowledge, in the practice of assembling, collecting, analyzing, using, evaluating, storing, or transmitting protected health information. The term includes a business associate, health care payer, governmental unit, information or computer management entity, school, health researcher, health care facility, clinic, health care provider, or person who maintains an Internet site;
(B) comes into possession of protected health information;
(C) obtains or stores protected health information under this chapter; or
(D) is an employee, agent, or contractor of a person described by Paragraph (A), (B), or (C) insofar as the employee, agent, or contractor creates, receives, obtains, maintains, uses, or transmits protected health information.
Update: Texas has now passed the Texas Data Privacy and Security Act (TDPSA).
I am not a lawyer, and the phrase “constructive knowledge” I suspect has some leeway, but could this include a company like, say, Dropbox, if I decided to upload a copy of my {medical chart, genome, FitBit data}?