By Jerri Lynn Ward with Commentary by Hugh Barton
Posted April 18, 2003
It’s April 14 and I had been tearing my hair out over my tax return, so I decided to take a break and go visit Fred Quinn in the hospital and my grandparents at the Serendipity Village Rest Home. I cleaned up and got in my car and headed over to the hospital.
Fred Quinn is our little town’s florist. He’s in the hospital for surgery on those pesky hemorrhoids he’s had trouble with for years. I knew about them because I was in Dr. Eberhardt’s office when Rowena, Dr. Eberhardt’s receptionist and office manager announced it to everyone in the office one day.
The moment I entered the hospital, I knew something was up. People seemed to be running all over the place holding pieces of paper in their hands.
I walked into Fred’s room and it was full of people. Rowena from Dr. Eberhardt’s office, LuAnne, Dale Nichols’ pharmacy assistant, and Harvey Hampton the hospital administrator were all standing around Fred’s bed. Rowena was sticking a piece of paper in Fred’s bewildered face. Fred was a little loopy due to pain medication.
“Rowena, I can’t see the print. I don’t know where my glasses are,” slurred Fred.
Not to be deterred, Rowena started reading from the piece of paper which ended up being named something like Notice of Privacy Rights.
“You have the right to request a restriction on certain uses and disclosures of your health information, however, Dr. Eberhardt is not required to approve your request,” intoned Rowena.
“Huh?” replied Fred.
“You have a right to request that Dr. Eberhardt notify you about your health information in a way or at a location that will keep your health information confidential…
It was obvious that I wasn’t going to get to visit with Fred for a while, so I decided to go visit my Grandparents at the Serendipity Village Rest Home. As I walked in the door, I happened upon a scene very similar to the one in the hospital. Mr. Hershey, the administrator was surrounded by employees from health providers all over the county.
“Who is going to sign these Notices of Privacy Rights?” Asked Arlene, the contract dietician.
Sam Hershey looked over at me and rolled his eyes. I continued into the living room of the facility and saw my Grandparents in front of the big screen TV. donated by Mr. Heligenthal. They were trying to watch Oprah, but Saul Herrera, a technician with the town radiologist was standing over them with papers.
“Please read these and sign them,” Saul begged.
“Oprah is about to interview Trista from the Bachelorette and I’m not going to miss that for your silly papers,” replied my Grandmommy Audrey. “And, I wish all these people would stop making all this noise and leave!”
The noise from front had been getting louder. Suddenly, the noise stopped. I looked over and saw, to my surprise, that our local Congressman had entered the Serendipity. He had that smile of expectation that politicians get when they visit people in their districts and expect the people to fawn over them. The smile disappeared as the Congressman looked into the faces of a bunch of frustrated and put upon people.
“Hey you!!!” my Granddaddy Harold yelled at the Congressman, “Is this your doing?”
Suddenly, a surge of angry health providers swarmed around the Congressman and…
As you have probably noticed, Congress likes to pass laws about people’s rights, and then to make the rest of us responsible for making sure that all the people know about their rights. After all, if THEY were the ones responsible, we might have fewer laws. For now, we are stuck with telling our residents and patients about the rights that Congress has granted them in HIPAA.
Two questions arise from the above scenarios. One, do all these providers need to have patients sign Notice of Privacy Rights. Two, how can this process be streamlined.
Hugh Barton is here to answer those questions. Hugh is the co-founder and Editor in Chief of the Texas Medical-Legal Report, and a frequent speaker on HIPAA.
Hugh: “The HIPAA Privacy Rule requires most health care professionals, institutions and insurance companies(known as “Covered Entities”) to issue a “Notice of Privacy Practices” which describes the uses they can make of a person’s medical information. The rule allows them to use medical information for “treatment, payment and health care operations” without patient’s specific written authorization. Most other “uses and disclosures” – except for a defined set of public health activities, child abuse reporting and others – require a signed authorization.
In the hospital example, it should not be necessary for everyone who sees the patient to rush forward with a Notice. A hospital can decide that it, along with its medical staff is an “organized health care arrangement” and put forth a “joint notice of privacy practices.”
And at Serendipity Village Rest Home, it should not be necessary for the staff to force all the residents to sign their Notices. All that is required is that a Covered Entity make a “good faith effort” to get a written acknowledgment of receipt, or document the reason why not. While this is all certainly new, it is not quite the “Chicken Little” situation that some imagine – or fear.
Nevertheless, the HIPAA Privacy Rule does impose significant new procedural rules on health care providers for use and disclosure of medical information. Patients now have far broader legal rights than they did before: the right to request restrictions on use, the right to inspect their records, the right to amend or correct their records, the right to receive an accounting of disclosures, and the right to complain to the federal government if they don’t think a provider is handling their medical information properly.
If they have not already done so, health care professionals and institutions should immediately learn whether or not they are covered under HIPAA, and if so, what they have to do to get into compliance. Patients will be aware of their new rights, and welcome in demanding them.”
Jerri: “Hugh also has an online training for HIPAA at http://www.txmlr.com/hipaa/. I highly recommend Hugh’s course. I took the course and benefited greatly from it. You can go at your own pace and there is a test at the end. Taking the test was valuable as a learning tool. Also, you get a certificate documenting that you have gone through the training which is valuable to show that you have been trained in HIPAA.” http://state.courseinsite.com/.
For the rest of the day, the Congressman was forced to go everywhere with the health providers as they sought out patients for signatures on the Notice of Privacy Rights papers. He was forced to explain repeatedly why he voted for the bill and what the bill means. I hear that there are plans to force him to participate in paintball shootouts to determine whether State or Federal law preempts-but that’s another story.
To be continued…
All information in this article is informational only and is not legal advice. Should you have any questions or a situation requiring advice, please contact an attorney.
Copyright 2004 by Garlo Ward, P.C., all rights reserved
505 East Huntland Drive, Suite 335
Austin, Texas 78752-3714 USA