???hippa???

[chip anderson]

I just found an old Mediaid bullitin from April 2001 that states that information on HIPAA can be obtained at www.hcfa.gov and Http://aspe.os.dhhs.gov.


I assume both sites are still maintained and updated.

Chip

[Bev Heishman]

Just received a copy of the HIPAA Training Handbook for Physician Practices (Understanding the Impact of HIPAA on your Physician Practice) by Opus Communications. www.hcmarketplace.com


Good information. It was made available to us through our local hospital network. Check it out. Info is relavant to opticals, optometry and ophthalmology.

[Joann Raytar]

Johns said:
If this plays out the way they say, I don't see how you can discuss someone's Rx with them in a dispensary, unless you are alone with the patient. They say that we will have to have the file room locked, w/ locks on the cabinets, and the keys to those locked. The receptionist will not be able to view any information unless it pertains to them checking in or out. All other info. is for the doctor only, and even then, only those files that relate to the issue at hand. (???)

I went to the pharmacy to pick up a prescription this weekend and was quickly reminded about HIPPA compliance. There were bank ropes infront of the pick-up counter. The signage said that due to HIPPA compliance customers waiting in line must stand behind the white line in order to ensure that all discussions and transactions remained confidential.

Was this overkill or what must actually be done to comply?

[joy niklas]

Jo,

I wouldn't be surprised if that is the case. According to the instructor of the Hipaa class our ins. lady attended, the level is different for each specialty. At a pharmacy, the customer's would be filling Rx's for a myriad of ailments, so they probably are at a much higher level of confidentiality.

[Joann Raytar]

joy niklas said:
According to the instructor of the Hipaa class our ins. lady attended, the level is different for each specialty.

Joy,
Who offered the class? Did your insurance person find it useful?

[SuziBlueEyes]

Just wanted to let you know International Vision Expo offers 4 classes in HIPAA.

One is in the Practice Management Track, two are offered in the NAO Track and one is offered in the Clinical Optometry Track.

For more information check out the International Vision Expo website at http://www.visionexpoeast.com and click on Conference Education on the left column. I used the find option to easily find the courses on the Conference at a Glance page.

Hope this is something you will find useful.

[Joann Raytar]

SuziBlueEyes,

I have registered for the conference but have not recieved the course mailer yet. Any idea when they are due to be sent out?

[Diane]

Jo said:
SuziBlueEyes,

I have registered for the conference but have not recieved the course mailer yet. Any idea when they are do to be sent out?

Jo,

Did you register online? I think you can go online to do this. You can at least see the courses.

Diane

[SuziBlueEyes]

They should be coming to a mailbox near you soon.

You can view courses and register on-line at www.visionexpoeast.com

:cheers:

[rbaker]

I just received the following email:

The U.S. Department of Health and Human Services (HHS) will be convening four National Conferences on the HIPAA Privacy Rule. These one-day conferences will be held in San Diego, Atlanta, New York, and Chicago. The conferences are designed to provide an unprecedented opportunity to hear from and interact with officials who developed the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and will be responsible for interpreting and enforcing the rule. The HHS Office for Civil Rights (OCR) will provide an expert faculty who will answer questions from attendees during question and answer sessions following their presentations.

What you will learn:
* The principles underlying the Privacy Rule.
* How the preemption rules create a national floor of privacy protections
* Who is a covered health care provider
* The implications of being an affiliated covered entity, a hybrid, or in an organized health care arrangement
* "Business associate" issues
* What type of information is protected under the HIPAA Privacy Rule and what is meant by the terms "use", "disclosure", "minimum necessary", and "incidental disclosures"
* The Notice of Privacy Practices requirement
* When it is necessary to obtain an authorization to use or disclose PHI and what constitutes a valid authorization
* The right of patient to access, amend, and obtain an accounting of disclosures of patient health information
* When to use an authorization for research and when research may be conducted without an authorization
* How research authorizations pre-dating the compliance date are treated
* Appropriate administrative, technical and physical safeguards
* The requirements to train the workforce on covered entity policies and procedures
* The OCR compliant investigation and compliance review authority

REGISTRATION:
Information on registration, including registration fees, for the individual
conferences can be found below. Please be advised that seating is limited
and early registration is advisable. If you need reasonable accommodations because of a disability, such as conference materials in alternative formats, sign language interpreters, etc., please contact calise.munoz@hhs.gov at least 10 - 15 days before the conference.

San Diego, California - February 5, 2003
Co-sponsored with the University of California
To register online, please click on the link below:
< <http://www.cvent.com/EventManagement...=&eCode=iktlik
bilrdiieqlihiiloviikrlik&type> http://www.cvent.com/EventManagement...&eCode=iktlikb
ilrdiieqlihiiloviikrlik&type>=
Or for registration questions, contact Jill Collier at 858-822-4770 or e-mail at jcollier@ucsd.edu


Atlanta, Georgia - February 18, 2003
Co-sponsored with Emory Healthcare at Emory University and The Morehouse School of Medicine

To register online, please click on the link below: <http://www.gynob.emory.edu/rtc/conferences_hipaa.html>
http://www.gynob.emory.edu/rtc/conferences_hipaa.html

Or for registration questions, contact 404-523-1996 ext 102, or email jbsurre@emory.edu



New York, NY - March 1, 2003

(registration and location details TBA)



Chicago, Illinois - March 2, 2003

(registration and location details TBA)

[joy niklas]

Ah, yes, "business associate issues"

This means that you have to have all your labs sign a form to be kept in your office that says they are keeping all your patient info private also. Because the Rx has the patient's name on it, someone might find out what their power is! All the labs are supposed to have a compliance officer to sign this paper. The funny thing is, when I faxed one to Pride (the prison Medicaid lab) all they faxed back to me was a form I was supposed to sign and fax back to them!:hammer:
Ain't life a funny ole thing?

[gilweber]

I don't recall if this document has ever been mentioned here. If so, sorry.

But if not, here is a fantastic resource explaining everything you ever wanted to know about the HIPAA Privacy Rule. Lots of clear and easy to understand material, FAQs, etc.

It's downloadable in .pdf (adobe), .rtf (rich text format), and .wpd (word perfect).

I strongly suggest you download and read at your leisure. It's long, but very worthwhile.

Here's the link:

http://www.hhs.gov/ocr/hipaa/privacy.html

In addition, here is another link to an excellent document that let's you figure out if you are or are not a covered entity. This is extrememely important in determining HIPAA's impact on your practice.

http://www.cms.hhs.gov/hipaa/hipaa2/...rt/default.asp

Gil Weber, MBA

[dgentz]

Just wanted to delurk for a moment and tell you all that I got my HIPPA compliance information from the AOA for $15.00. It's a workbook that walks you through what your office needs to do. The emphasis on on "reasonable" and once you sit down and look at it, it's not really that unreasonable. =) A big pain, yes, but not all that scary.

BTW, it specifically says that you do not need an agreement with your labs, as they are not considered business associates.

HTH

Dawn

[Johns]

I love the "reasonable" part.

I just visited my intern for my annual physical. He relocated to a new $38M facility. It was brand new in November of 2002. They are remodeling to the tune of $8M. They must reconfigure their waiting room, to accomodate HIPPA. They must go to a numbering system because the pt. can no longer be refered to by name outside the exam room doors.

This sounds reasonable ? This sounds like too many attorneys and not enough lawsuits.

Privacy ? There's really no such thing anyway.

Johns

[paw]

Wonder if we as patients will have to wear face masks so we won't be recognized by our neighbors in the waiting room.

The point of HIPAA is "protected health information". Saying a name doesn't divulge protected health information, when there is no medical information mentioned in the same sentence as the name.

There was a first set of rules that were draconian, then they were revised in Aug 2002 and the revised rules are the ones going into effect in April. The revised rules DO NOT require that you can't use patient's name outside the exam room.

[varmint]

So under the hippa rules, who is responsible for the patients privacy when the usps delivers important medical info to the wrong suite in a plaza? Happens to me each & every day!!!

[gilweber]

Johns wrote:

"I just visited my intern for my annual physical. He relocated to a new $38M facility. It was brand new in November of 2002. They are remodeling to the tune of $8M. They must reconfigure their waiting room, to accomodate HIPPA. They must go to a numbering system because the pt. can no longer be refered to by name outside the exam room doors."

Paw replied:

"There was a first set of rules that were draconian, then they were revised in Aug 2002 and the revised rules are the ones going into effect in April. The revised rules DO NOT require that you can't use patient's name outside the exam room."

And Varmint asked:

"So under the hippa rules, who is responsible for the patients privacy when the usps delivers important medical info to the wrong suite in a plaza? Happens to me each & every day!!!"

And I reply to all three snippets....

Johns, your Internist is misinformed. That group is jumping through hoops that do not need to be negotiated. Sounds as if they're creating all sorts of unnecessary problems for themselves and spreading disinformation to you. Such disinformation only adds to the uncertainty and fear that's clearly in abundance on this discussion list.

Paw is correct. As has been stated previously in this thread, there is no restriction on calling out patient names (for example, in the waiting area).

Everyone, if you're not clear on this please refer to the URL I provided in my January 22nd posting. That document ought to make it clear what one can and cannot do vis-a-vis patient discussions and communications.

Varmint... If a package of patient information is delivered to the wrong address and is then forwarded to you **UNOPENED** you have no immediate concerns.

However, if that package of protected health information was opened by the other party and then delivered to you, there will be HIPAA issues and you must act affirmatively to preclude further similar incidents.

Check with your attorney to confirm, but I think you're probably going to have to contact each of the patients whose records were misdelivered and, possibly, inappropriately viewed to let them know. You'll need to include such notification in one of the required "logs" described in the HIPAA regs. Beyond that what do you have to do?

Certainly you should try to contact the other party and politely ask them to be a bit more cautious when opening mail that's not theirs (especially if mail often goes to the same wrong address). That they should not open your mail is obvious, but maybe you need to let them know that there are state and federal laws involved with patient records security. Maybe that will be enough to cause the other party's mail room to be a bit more careful??

Further, you should ask the other party to contact you immediately if something is misdelivered so that you can arrange for an immediate pickup in order to take possession of the misdirected PHI.

You should also contact the delivery service (in this case the postmaster at the local USPS office) to ask (complain?) about your service and to explain the problem that you say happens every day. This is a potentially serious matter. The chance of a security/confidentiality breach is significant if your mail is being misdelivered each and every day.

Good luck.
Gil Weber, MBA

[varmint]

Some of these letters have arrived in the mail already opened, and some are medical test results, etc. addressed to a doctors office in the plaza, but had an incorrect suite number listed.
I have tried to deal with our USPS delivery problem for over 2 years, speaking with postmasters, supervisors, writing letters, etc., but they refuse to consider the issue serious. The carrier is a young adult, who gets paid for a full day wages even if he finishes his route early & goes home, so he puts anyones mail into any slot, and if any suite # is missing he simply returns the mail to the sender. Our plaza has a locked cluster box. He has returned my insurance checks, some I have never been able to get reissued, and statements to vendors who have charged me for not paying on time. I've lately considered taking a po box in another station to try & avoid this situation which is the only resolution I can think of anymore.
Maybe the folks administering the hippa rules should have some type of leaflets to inform all the non medical people of the violations in privacy, so we would not have to also be held responsible & accountable for their mistakes. Just making myself in compliance takes enough of my time away from running my business. I can see how Johns dr's office felt it necessary as I have received "hippa compliance packages" from medical printers suggesting we have to purchase these items to comply. Maybe hippa should make some more regulations for these folks too, if they are trying to take advantage of medical offices who are trying to get into compliance while continuing to run a profitable business. So much information comes in that we do not have time to decipher & decide what is actually required & what rules have been changed since we last had our training.
Didn't mean to get into this discussion, but I am tired of all the regulations & rule changes while the government tries to run my business. More rules, more regulations, thats what we need to spur the American economy.

[gilweber]

[QUOTE]varmint said:
Some of these letters have arrived in the mail already opened, and some are medical test results, etc. addressed to a doctors office in the plaza, but had an incorrect suite number listed.


And I reply:
Varmint: Immediately call the offices that are misaddressing your mail! Do not wait until April. Cut this problem off now, before there's a problem. If you can document that you've taken appropriate steps to stop the problem and to get your mail correctly addressed by the sender(s) you'll have taken an important step to self-protect in the event you're caught up in a HIPAA investigation.


Varmint continued:
I have tried to deal with our USPS delivery problem for over 2 years, speaking with postmasters, supervisors, writing letters, etc., but they refuse to consider the issue serious.

(snip)

Our plaza has a locked cluster box.

(snip)

I've lately considered taking a po box in another station to try & avoid this situation which is the only resolution I can think of anymore.


And I reply again:
Yes, perhaps a good solution given that your mail carrier is a goof and the postmaster doesn't seem interested in adressing the problem. Again, if you do this you'll have taken an important step to demonstrate that you're trying to do the right thing to preclude breaches involving the protected health information. You're thinking smartly!

(remainder of Varmint's post snipped)

I finish:
Remember these watchwords for HIPAA:

1) you're held to a reasonableness standard
2) being pro-active could be crucial
3) think outside the box if faced with seemingly insurmountable hurdles

You will survive!
Gil Weber, MBA