HIPAA wavier question.

[bg_daddy]

My wife had an eye exam for contacts earlier this year. She needs to order new contacts and contacted Americas Best to get her prescription information. The first time she called they told her that they would not give her that information. After I told her about HIPAA, she called back. This time they told her that as she did not come back in for a 45 day evaluation exam that they did not have to give her the information. I called back to talk to them about this and was told that she signed a wavier that gave them ownership of the prescription.

Is that possible that they could have customers waive their HIPAA rights in regards to who has ownership of the information?

Not sure if this is relevant, but we live in Indianapolis, IN.

 

[justalayman]

IC 16-39-1-1
Right of access; written requests; effective duration
Sec. 1. (a) This section applies to all health records except mental health records, which are governed by IC 16-39-2, IC 16-39-3, and IC 16-39-4.
(b) This article applies to all health records, except:
(1) records regarding communicable diseases, which are governed by IC 16-41-8-1; or
(2) records regarding alcohol and other drug abuse patient records, which are governed by 42 CFR, Part 2.
(c) On written request and reasonable notice, a provider shall supply to a patient the health records possessed by the provider concerning the patient. Subject to 15 U.S.C. 7601 et seq. and 16 CFR Part 315, information regarding contact lenses must be given using the following guidelines:
(1) After the release of a patient from an initial fitting and follow-up period of not more than six (6) months, the contact lens prescription must be released to the patient at the patient's request.
(2) A prescription released under subdivision (1) must contain all information required to properly duplicate the contact lenses.
(3) A contact lens prescription must include the following:
(A) An expiration date of one (1) year.
(B) The number of refills permitted.
(4) Instructions for use must be consistent with:
(A) recommendations of the contact lens manufacturer;
(B) clinical practice guidelines; and
(C) the professional judgment of the prescribing optometrist or physician licensed under IC 25-22.5.
After the release of a contact lens prescription under this subsection, liability for future fittings or dispensing of contact lenses under the original prescription lies with the dispensing company or practitioner.
(d) On a patient's written request and reasonable notice, a provider shall furnish to the patient or the patient's designee the following:
(1) A copy of the patient's health record used in assessing the patient's health condition.
(2) At the option of the patient, the pertinent part of the patient's health record relating to a specific condition, as requested by the patient.
(e) A request made under this section is valid for sixty (60) days after the date the request is made.
As added by P.L.2-1993, SEC.22. Amended by P.L.40-1994, SEC.66; P.L.102-1994, SEC.1; P.L.2-1995, SEC.72; P.L.108-1996, SEC.4; P.L.157-2006, SEC.4.

how I read that is they can restrict the information for up to 6 months. After that period, they must release it upon a proper written request.

 

[ecmst12]

I think you're reading it wrong. They have to release the prescription only if requested WITHIN 6 months.

 

[justalayman]

I think you're reading it wrong. They have to release the prescription only if requested WITHIN 6 months.

(1) After the release of a patient from an initial fitting and follow-up period of not more than six (6) months, the contact lens prescription must be released to the patient at the patient's request.

while I see it as not very clear, I still read it as the release is required after the initial fitting and a follow up period of not more than 6 months. That means both events must have taken place. Beyond that, prescriptions are automatically terminated by law so limiting it to a 6 month period wouldn't make any sense. You are arguing the doctor does not have to provide a scrip, even if it is still valid, if it has been more than 6 months time.


but why quibble when federal rules require the optometrist to provide the patient with a prescription as soon as the fitting is complete. It is not optional.


http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&tpl=/ecfrbrowse/Title16/16cfr315_main_02.tpl

 

[ecmst12]

It could also mean that the patient must complete a follow up exam within 6 months before a script must be released to them - and that is kind of what America's Best said too (except they wanted her to come back for follow up within 45 days).

Or my brain could just be mush and I don't have a clue what it means I should go to bed!

 

[justalayman]

It could also mean that the patient must complete a follow up exam within 6 months before a script must be released to them - and that is kind of what America's Best said too (except they wanted her to come back for follow up within 45 days).

Or my brain could just be mush and I don't have a clue what it means I should go to bed!

not totally disagreeing with you. It is poorly written IMO. That is why we should just go to the federal rules that says, without exception, once a person has been fitted (as in lenses have been or could be dispensed), the prescribing doctor shall provide a copy of the prescription complete enough so that any provider of lenses could fill it. It does not allow for a follow up requirement to delay the release of the scrip.

§ 315.3 Availability of contact lens prescriptions to patients.
(a) In general. When a prescriber completes a contact lens fitting, the prescriber:

(1) Whether or not requested by the patient, shall provide to the patient a copy of the contact lens prescription;

from: http://business.ftc.gov/documents/bus63-complying-contact-lens-rule

What if my patient asks for a copy of the contact lens prescription before the lens fitting is complete?
The Act and the Rule do not require that you provide the contact lens prescription to the patient before the fitting is complete. If you are prepared to sell your patients contact lenses, however, you cannot refuse to give them a copy of their prescription on the grounds that their fitting isn’t complete. If you’re willing to sell them the lenses, that means their fitting is complete, and you must give them a copy of the prescription.

 

[gracenotes]

Am not familiar with America's Best, but I have never had any problems getting paper copies of Rx's for glasses and contact lenses either (a) from an optometrist at Kaiser,or, (2) from an optometrist who practiced in a Costco store. In fact, in the last case, I misplaced the Rx during a move and the office was kind enough to send me an email attachment of the prescription that I used to order contact lenses online. I believe the glasses Rx is good for 3 or 4 years, the contact lenses Rx is good for 2 years (in California). There has never been a question of anyone else 'owning' my prescription.

 

[ecmst12]

I HAVE had an issue with a doctor refusing to give me a copy of my contact lens prescription, and he gave me some line about liability that I totally bought at the time. This was MANY years ago though.