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Understanding the HIPAA Privacy Rule

HIPAA privacy rule
The Health Insurance Portability and Accountability Act (also known as the HIPAA Privacy Rule) is a law passed in 1996 that is designed to protect an individual's health records from getting into the wrong hands (e.g., employers looking for a way to terminate employment or insurance companies trying to find a reason not to provide coverage). It's also intended to allow individuals easier access to their own health records.
However, when you're in the hospital attempting to find out what's going on with your parent who's just been admitted, it can be frustrating and even frightening to be told that the doctor can't give you any information because of privacy rules.
As a result of the law, hospitals, doctors, nurses, pharmacies, nursing homes and other healthcare providers have designed ways to make sure that whoever they are giving information to is absolutely legitimate, in an attempt to avoid litigation. Many consumers find the red tape associated with HIPAA to be more trouble than it's worth.
So let's cut through the red tape. When can family members be given information on health conditions and records? Here are examples adapted from the Patient's Guide to the HIPAA Privacy Rule.
  • In general, doctors, nurses and other healthcare providers may NOT discuss your past health history or your long-term prognosis without specific instructions from you.
  • An emergency-room doctor may discuss your treatment in front of a friend or family member you have invited into the treatment room.
  • A doctor may discuss your condition with a parent, spouse or adult child while you are recovering from surgery, emergency care or other treatment.
  • A hospital employee may discuss your bill and any questions you have about it with a family member or friend who is with you at the hospital.
  • A doctor may speak to someone who is driving you home after outpatient surgery, giving instructions you should follow on the drive and immediately following your arrival.
  • A doctor may discuss drugs prescribed for you, possible side effects to watch for, and instructions on how to take them with whomever has accompanied you during the appointment.
Providers must ask for your permission, in writing or verbally, or inform you that they are going to discuss the information about your health with a specific person - before they do so. If you do not object, or if a provider uses his professional judgment to conclude that you do not object, he may then proceed. The law does not demand that you give permission in writing, but many providers insist you do.
If you're concerned about what will happen if your parents are admitted to the hospital and you are unable to discuss their condition, the safest thing is to ask the hospital(s) where your parents will most likely be admitted. Secure a copy of their HIPAA form and have your parents sign it in advance, identifying all of those they give permission to receive information as to their health records and conditions. You should do the same for every doctor your parents see. Quite often, they will automatically be given these forms at the doctor's office.
If you live far from your parents, it's a good idea to have them sign a letter that identifies your relationship, address and phone number, and gives health care providers permission to speak to you. They could also post a copy of the letter on their refrigerator door so that paramedics called during an emergency can just grab it and give it to emergency room staff.

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