Health Information Portability & Accountability Act Presented by Jennifer Coughlin Eugene, Oregon April 10, 2013
TOPICS OF CONVERSATION 1. STATE LAW PREEMPTION OF HIPAA 2. PATIENTS’ RIGHTS TO REQUEST AND RECEIVE RECORDS UNDER HIPAA 3. PATIENTS’ RIGHTS TO AMEND RECORDS UNDER HIPAA 4. SPECIAL CARE OF SPECIALIZED RECORDS
State Law Preemption of HIPAA HIPAA’s Privacy Rule is preempted by state laws which are MORE stringent regarding privacy of PHI than the federal standards The federal standards of the Privacy Rule are the baseline…if Oregon requires more stringent privacy, it wins! Federal regulatory standard
PATIENT RIGHTS UNDER HIPAA Right to Receive Notice of Privacy Practices Right to Access Protected Health Information Right to Amend Protected Health Information Right to Accounting of Disclosures of Protected Health Information Right to Request A Specified Method of Communication Right to Request Restrictions on Use and Disclosure of Protected Health Information
PATIENT RIGHTS UNDER HIPAA Right to Receive Notice of Privacy Practices Right to Access Protected Health Information Right to Amend Protected Health Information Right to Accounting of Disclosures of Protected Health Information Right to Request A Specified Method of Communication Right to Request Restrictions on Use and Disclosure of Protected Health Information
PATHWAYS TO DISCLOSURE OF PROTECTED HEALTH INFORMATION Treatment Payment Operations Patient Requests
Do I Need To Comply With HIPAA? Use computers to send health information for administrative, financial purposes Ie, filing claims for insurance ORS (2)(c)
HIPAA COMPLIANT FORMS: ORS Go to for Presentation and Linkswww.brotherslaw.com/articles
Patient has right to see, get a copy of, and amend record ORS (1)(b) What is a “record”? Identifying Information Subjective Info Told to Doctor/Nurse/PA Exam/Test Results Treatment Received Medicine Prescribed Dr.’s Notations About Patient
MINORS’ RIGHTS TO RECORDS Generally speaking….Parents or guardians have right to get their child’s medical records EXCEPTIONS: Neglect, harm After 18 Married Consent Birth control, STDs
Power of Attorney * Relevance Required * Only During POA Effective Timeframe
PERSONAL REPRESENT ATIVES Court-Appointed Personal Representatives Proof of appointment and identification If not an appointed personal representative, hierarchy of others can request
HIPAA Form Specifics Dates being requested Any previous names used Date of birth Social security number Entire record, or just part? Labs, diagnostic reports or studies, discharge summary, op notes, pertinent package, physician orders, nurses notes, test results, etc. See record, or get copy of?
SUMMARIESDENIALS Fee can be charged Understand beforehand Not required Plain language Different language?? 30 days Limited circumstances In writing Right to review denial Wrong provider is requested…duty to inform of proper provider
PATIENTS’ RIGHT TO AMEND ONLY for inaccurate or missing information Oral vs. writing Denials Minors Form for requesting amendment s/admin_offices/hipaa_privacy/medical-record- amendment.pdf s/admin_offices/hipaa_privacy/medical-record- amendment.pdf MedicalRecord.pdf MedicalRecord.pdf
Allowable Charges for Records ORS $30 10 or fewer pages $.50/page $.25/page add’l pages “Bonus” charge Postage X-rays, other expensive requests Patient can’t afford…what to do?
What Would HIPAA do? * Privacy Rule allows a “reasonable fee” based upon actual costs of copying Labor, supplies Excludes search and handling fees * OCR determination of reasonableness
SPECIALIZED TOPIC RECORDS
ALCOHOL, DRUG & PSYCHIATRIC RECORDS State and Federal Law Prohibit Disclosure of Information about Alcohol, Drug & Psychiatric Cases Includes confirmation of admission/discharge Standard Answer, “We cannot, under federal or state law, comment on such a case.” ORS 426: Mental Health & Developmental Disabilities; Drug & Alcohol ORS to ORS 42 USC 290: Methods of Disclosure
RESOURCES FOR HIPAA COMPLIANCE Brothers, Hawn & Coughlin, Power Points, Outline and details of presentation 4 Steps to HIPAA Compliance This presentation & Links Oregon HIPAA Forum Oregon Health Authority UNICABLEDISEASE/LOCALHEALTHDEPARTMENTS/Pages/hipaa.a spx UNICABLEDISEASE/LOCALHEALTHDEPARTMENTS/Pages/hipaa.a spx Office for Civil Rights Dept. Health & Human Services Psychiatric, Alcohol and Drug