Quick Guide to HIPAA Practices for DME



Quick Guide to HIPAA Practices for DME

Patient have a number of options regarding their PHI which include:

Right to Inspect and Copy

Patients have a right to inspect and copy medical information that is in their patient record. A request to inspect and copy can be denied in certain circumstances[1]. If denied access to medical information, the patient may request that the denial be reviewed.

Right to Amend

If the patient feels that medical information is incorrect or incomplete, they may ask us to amend the information. In addition, the patient must provide a reason that supports the request. The supplier may deny the request for an amendment if it does not include a reason to support the request. In addition, the supplier may deny the request if the amended information is inaccurate and incomplete.

Right to an Accounting of Disclosures

The patient has the right to request an "accounting of disclosures." This is a list of the disclosures the supplier made of the patient’s PHI. The request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. The first request within a 12-month period is generally at no charge to the patient[2]. For additional lists, the supplier may charge for the costs of providing the list. The supplier will notify the patient of the cost involved and they may choose to withdraw or modify the request at that time before any costs are incurred.

Right to Request Restrictions

The patient has the right to request a restriction or limitation on the PHI used or disclosed for services, equipment, payment or operations. The patient also has the right to request a limit on the medical information disclosed to someone who is involved in the patient’s care or the payment for care, such as a family member or friend. For example, a patient could ask the supplier to not use or disclose information about the medical necessity for the equipment they had.

Right to Request Confidential Communications

The patient has the right to request that the supplier communicates with them about medical matters in a certain way or at a certain location. For example, a patient can ask that the supplier only contact them at work or by mail. The supplier cannot not ask the patient for the reason of the request, and will accommodate all reasonable requests. The request must specify how or where they wish to be contacted.

Right to a Paper Copy of The Notice

The patient can receive notices electronically and if they wish to have a paper copy they can request a copy of this notice. If the patient agreed to receive this notice electronically, they are still entitled to a paper copy of this notice upon request.

Complaints

If the patient believes their privacy rights have been violated, they may file a complaint with the supplier or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. The patient will not be penalized for filing a complaint.

Disclosing PHI Upon Request from Third Parties

As Required By Law

The supplier must disclose PHI when required to do so by federal, state or local law under the following circumstances.

To Avert a Serious Threat to Health or Safety

The supplier may use and disclose PHI when necessary to prevent a serious threat to the patient’s health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.

Workers' Compensation

The supplier may release PHI for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Risks

The supplier may disclose PHI for public health activities.

Health Oversight Activities

The supplier may disclose PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes

If the patient is involved in a lawsuit or a dispute, the supplier may disclose PHI in response to a court or administrative order. The supplier may also disclose PHI in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell the patient about the request or to obtain an order protecting the information requested.

Law Enforcement

The supplier may release PHI if asked to do so by law enforcement official.

National Security and Intelligence Activities

The supplier may release PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective Services for the President and Others

The supplier may disclose PHI to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

For all other entities

PHI can be released to other entities, such as a law office, only with the patient’s written consent. The consent does not have to be in the supplier’s format but must contain the following elements:

Patient Name

Patient’s signature

Date

For what reason the PHI will be used

The document should specifically name the supplier as to whom the permission was given

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[1] The format of the request is up to the supplier, such as a hard copy or electronic format. It is helpful if the supplier determines the format in a policy and provides format examples for employees and patients to follow. This prompts consistency in the process flow and minimizes the risk of a PHI related legal action.

[2] Many states have laws, which provide the patient with a no-charge copy of their files. Agencies requesting documents on the patient’s behalf generally can be charges a fee for copying, mailing and employee time.

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