Transcript Health Information Portability & Accountability Act

Health Information Portability
& Accountability Act
Presented by Jennifer Coughlin
www.brotherslaw.com
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
Federal regulatory standard
 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!
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 192.556(2)(c)
HIPAA COMPLIANT FORMS:
ORS 192.566
http://smileoregon.org/wp-content/uploads/2010/06/HIPAA-FORM.pdf
http://orcr.uoregon.edu/index.cfm?action=hipaa_auth
Go to www.brotherslaw.com/articles for Presentation and Links
Patient has right to see, get a
copy of, and amend record
ORS 192.553(1)(b)
 Identifying Information
 Subjective Info Told to
Doctor/Nurse/PA
 What is a “record”?
 Exam/Test Results
 Treatment Received
 Medicine Prescribed
 Dr.’s Notations About
Patient
MINORS’ RIGHTS TO RECORDS
 EXCEPTIONS:
 Generally
speaking….Parents or
guardians have right to
get their child’s medical
records
 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?
SUMMARIES
 Fee can be charged
 Understand beforehand
 Not required
 Plain language
 Different language??
DENIALS
 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
 http://www.utsouthwestern.edu/edumedia/edufiles/about_u
s/admin_offices/hipaa_privacy/medical-recordamendment.pdf
 http://www.bmc.org/Documents/bmc-RequestCorrectionMedicalRecord.pdf
 www.brotherslaw.com/articles
Allowable
Charges for
Records
• ORS 192.563
• $30 10 or fewer
pages
• $.50/page 11-50
• $.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 192.515 to ORS 192.517
 42 USC 290: Methods of Disclosure
RESOURCES FOR HIPAA
COMPLIANCE
 Brothers, Hawn & Coughlin, www.brotherslaw.com/articles
 Power Points, Outline and details of presentation
 4 Steps to HIPAA Compliance
 This presentation & Links
 Oregon HIPAA Forum
 http://www.oregonhipaaforum.org
 Oregon Health Authority
 http://public.health.oregon.gov/DISEASESCONDITIONS/COMM
UNICABLEDISEASE/LOCALHEALTHDEPARTMENTS/Pages/hipaa.a
spx
 Office for Civil Rights
 http://www.hhs.gov/ocr/hipaa
 Dept. Health & Human Services
 http://www.hhs.gov/hipaafaq/use/index.html
 Psychiatric, Alcohol and Drug
 http://www.law.cornell.edu/uscode/text/42/290dd-2