HIPAA and Mandatory Reporting Hiding in Plain Sight
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- Aileen York
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1 HIPAA and Mandatory Reporting Hiding in Plain Sight Sandy Gilmore May 2016 Learning Objectives 1. Understand HIPAA basics of patient information disclosures Review a Notice of Privacy Practices 2. Understand how HIPAA affects state laws/rules on mandatory disclosures 3. Understand how documentation of disclosures of patient information is essential to medical record management May
2 HIPAA Classic Protected Health Information (PHI) Patient Rights under HIPAA Sharing PHI with other organizations Requirement to post a Notice of Privacy Practices May HIPAA Classic Protected Health Information Name Date of birth Social security Medical record # Insurance # Photo Finger prints Admission / discharge Internet / address Birth year over 89y/o Address License # Phone # Fax# Anything that identifies a person May 2016 LEGACY HEALTH 4 2
3 HIPAA Classic Patient Rights Access to medical and billing records Amendment to medical records Confidential communications To restrict disclosures of medical records Breach notification Receive a copy of Notice of Privacy Practices Accounting of Disclosures May 2016 LEGACY HEALTH 5 HIPAA Classic Sharing PHI For Treatment, Payment and Operations TPO T Other health care providers treating the patient or involved with care P Insurance companies and others involved in paying for health care O Medicare, Quality Review Organizations GAT:LS2 May 2016 LEGACY HEALTH 6 3
4 Slide 6 GAT:LS2 I would list additional operations activities here. Medicare could also be under payment so that is a bit confusing. Greer, Anne T :LSO Legal Services, 4/25/2016
5 HIPAA Classic Notice of Privacy Practices NPP All covered entities required to have an NPP Required to provide a copy to patients Required to post in prominent areas Describes how organization uses and discloses patient Protected Health Information May 2016 LEGACY HEALTH 7 Let s See Work for a hospital or hospital group Work in a health care clinic Work for an insurance company or other payer Work for an organization that supports health care entity (business associate) Student Other May 2016 LEGACY HEALTH 8 4
6 Let s See If you have read your organization NPP sit down If you have read any NPP sit down Ok you can all sit down May 2016 LEGACY HEALTH 9 Accounting of Disclosures Patient right to have a list of all the places / organizations that received PHI, including a copy of patient medical records. Currently we DO NOT have to provide a list of organizations receiving PHI for TPO purposes > TPO = Treatment, payment or operations On request, we must provide a list of all other places PHI was sent (except for authorized disclosures) > Authorized by patient vs. mandatory reporting May 2016 LEGACY HEALTH 10 5
7 Accounting of Disclosures May come as an Accounting of Disclosure request >Form May come as a verbal request > Did you send my records to May come as part of a subpoena request > With specific individuals or organizations > List of those that got records May 2016 LEGACY HEALTH 11 Authorized by the Patient Signed authorization forms Signed patient request forms Documentation of patient request for records Documentation of when and what was sent to whom May 2016 LEGACY HEALTH 12 6
8 Authorized by the Patient Records sent to: An attorney An employer Social Security Disability insurance company School May 2016 LEGACY HEALTH 13 Not Authorized by Patient but Required by Law Mandatory Reporting Long list of situations and patient conditions that health care organizations are required by law to report. Oregon Association of Hospitals and Health Systems (OAHHS) has a list of mandatory reporting required for hospitals and health care entities May 2016 LEGACY HEALTH 14 7
9 Mandatory Reporting in Oregon Obvious or Suspected abuse > child abuse or neglect > elder abuse or neglect > individuals with developmental disabilities > abuse/assault of an adult if a child is present > infant tests positive for drugs Wounds from deadly weapons Suspicious deaths death with 24 hours of admit May 2016 LEGACY HEALTH 15 Mandatory Reporting in Oregon Blood alcohol / controlled substance for driver involved in MVA in Oregon Disease reporting Dog bites Impaired driver Birth / death POLST May 2016 LEGACY HEALTH 16 8
10 Mandatory Disclosures Data reporting - Registries Immunizations Vaccine or medications adverse events Injuries from medical devices Reporting of unprofessional behavior May 2016 LEGACY HEALTH 17 Other Disclosures Disclosures to law enforcement > Must follow HIPAA requirements During an emergency or natural disaster To prevent serious and imminent threat to person(s) self or organization May 2016 LEGACY HEALTH 18 9
11 So Now What? Review department procedures > Forms for patient requests > Forms for authorized releases > Tracking what was released Written procedures for different types of releases > Patient requests > Authorizations > Subpoenas > Abuse reporting and investigations > Employee investigations by licensing boards May 2016 LEGACY HEALTH 19 So Now What? Partner with Compliance / Privacy official Meet with nursing leadership Meet with computer department to review capabilities of software > Review mandatory reporting by organization > Review documentation of reporting > Develop a game plan for managing disclosures May 2016 LEGACY HEALTH 20 10
12 So Now What? Develop inventory of mandatory reporting required by your organization Identify who in your organization reports and to whom Determine how the disclosures are documented May 2016 LEGACY HEALTH 21 So Now What? Realize that the regulations change > Active review of what Accounting of Disclosures a patient may request > Time frames may change Stay in touch with your compliance department Read your Notice of Privacy Practices May 2016 LEGACY HEALTH 22 11
13 Learning Objectives 1. Understand HIPAA basics of patient information disclosures Review a Notice of Privacy Practices 2. Understand how HIPAA affects state laws/rules on mandatory disclosures 3. Understand how documentation of disclosures of patient information is essential to medical record management May Questions????? May 2016 LEGACY HEALTH 24 12
14 Thank you! 13
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