In the three years since Americans gained federal protection for their private medical information, the Bush administration has received thousands of complaints alleging violations but has not imposed a single civil fine and has prosecuted just two criminal cases, according an Associated Press story June 4.

Of the 19,420 grievances lodged so far, the most common allegations have been that personal medical details were wrongly revealed, information was poorly protected, more details were disclosed than necessary, proper authorization was not obtained or patients were frustrated getting their own records, the AP reported.

The government has "closed" more than 73 percent of the cases -- more than 14,000 -- either ruling that there was no violation, or allowing health plans, hospitals, doctors' offices or other entities simply to promise to fix whatever they had done wrong, escaping any penalty the article states.

Citing an Office of Civil Rights spokesperson, AP reported that the enforcement agency charged with the enforcement of the law is primarily concerned with working with hospitals and physicians to help them achieve complaince. While praised by hospitals, insurance plans and doctors, the approach has drawn strong criticism from privacy advocates and some health industry analysts. They say the administration's decision not to enforce the law more aggressively has failed to safeguard sensitive medical records and made providers and insurers complacent about complying.

The debate has intensified amid a government push to computerize medical records to improve the efficiency and quality of health care. Privacy advocates say large centralized electronic databases will be especially vulnerable to invasions, making it even more crucial that existing safeguards be enforced, according to CMS.

About 5,000 cases remain open, and some still could result in fines, and the OCR has reportedly referred at least 309 possible criminal violations to the Justice Department. Officials there would not comment on the status of those cases other than to say they would have been sent to U.S. attorney or FBI offices around the country for investigation, the AP article reports.