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Hipaa

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pele

Member
What is the name of your state? Hawai'i

FYI: Go to reviewjournal.com (Las Vegas newspaper), scroll down to Inside and click on Tiger attack on Roy. There is a story about a neurosurgeon who was not involved in the care of this performer, but spoke to the neurosurgeon who was, and went on to give an interview, which I saw. I wondered at the time if he was violating the HIPAA regulations. There is now an investigation about whether he violated HIPAA regulations in discussing a case he was not involved in, but discussed with the neurosurgeon who was involved and then passed information to the media. Interesting. Pele
 


ellencee

Senior Member
pele
Great minds think alike! During the discussion on this site as regards HIPAA, I started to write something about the media. How DO they get away with it? Every day I read newspaper articles about the injuries people receive in accidents, where they are hospitalized, what treatments they are receiving, and the prognosis! Mental and emotional treatments are published!

The media is apparently immune to HIPAA regulations.

The physician in the Roy scenario did state his authorization for releasing the information--well, the second one did; not the first surgeon who stated half of Roy's skull was removed (which was in error; it was 1/4 of his skull).

Before HIPAA, no one but your insurance company, your healthcare provider, and you had your information. Because of HIPAA, information on persons who are not insured is sent to the same information storehouse as is the information on persons who are insured. More information about each person's health and personal status is disclosed to these 'guardians of privacy' than has ever been shared prior to HIPAA. Anyone who chooses to believe that HIPAA safeguards privacy is mistaken. HIPAA simply interferes with family's abilities to care for each other and interferes with the providing of healthcare.

In case you can't tell, I am greatly opposed to HIPAA! And--I still want to know why the media has the right to publish information that can not be revealed to one's own children or one's own parents.

Shall we lead the revolt, pele?

EC
 

pele

Member
So, you want to fight City Hall??

You know how docs discuss cases between each other, apparently this doc wanted his 15 minutes of fame and now he and the treating surgeon are in trouble. I am pretty sure this aired on Larry King. Sad, because it is confidential information. He should have known better, with or without HIPAA. Pele
 
J

JackSchroder

Guest
I don't think anyone is in trouble about this "breach" of confidentiality. Once the story hit the press it became public information. Besides, what is so confidential about a head injury? Or an appendectomy for that matter.
Physicians want confidentiality. Patients want (and never get) privacy.
When you worry about someone telling another what a third person is in the hospital for you are worrying about matters that mean nothing. I can remember as an investigator doing what we called "a neighborhood", and I talked to maybe thousands of people about injuries and illnesses and even psychotic episodes, and because that information was "common knowledge" no privilege was attached. Those neighbors were never sued, and no one ever cared. Least of all the person in the hospital.
Once again. Doctors want confidentiality. Insdurance companies want secrecy because then no one knows anything that may result in a law suit. Patients yearn for a little privacy.
 

ellencee

Senior Member
HIPAA's roots are in the 1980s when Aids became a privacy issue. I know from working in healthcare during the process and the outcome.

Remember when some dining establishments had notices that one of their staff had the Aids virus? That effort protected the right of the person with Aids, allowing the person to be employed,and gave the consumer the opportunity to decide whether or not to risk infection through food preparation. Big business won that issue; now you don't know if the person chopping your salad ingredients has a deadly disease you could get or not.

At the same time, hospitals were dealing with privacy issues of having the diagnosis on the patients records! Can you believe that? They actually tried to keep the diagnosis off of the records. That was not a workable solution, so universal precautions were made the routine and absolute precaution--treat every patient as if they have Aids.

Then, the door tags went so visitors to the hospital wouldn't be able to read the tags and know the person was in the hospital. Nevermind that hospital workers depended and still need to depend on the doortags.

You wouldn't believe the actions that hospital workers have to take to keep prying eyes from so much as seeing part of a name.

I know, with no doubt and much proof, that these privacy techniques have increased the numbers of patient care errors that occur every day.

HIPAA is directly related to these issues, even though it does have other aspects. It is also related to insurance providers, including Medicare and Medicaid, that want to make sure no one is getting paid more than they are for a particular procedure.

By no means is it physicians or any healthcare provider, who wants the extra paperwork, increased liability, additional employees, etc. that it takes to manage the HIPAA bs.

Surely, the physicians and other healthcare workers who reveal confidentiality have erred and violated HIPAA regulations and possibly other aspects of patient confidentiality, but the media tells the whole world and remains outside of any law regarding privacy, except as pertains to the privacy of the media!

Roy could not speak for himself, but he is obviously a smart man and an astute businessman. I feel confident that he had a power of attorney that had full authorization to reveal information about him. I feel very sure that his partner, his agent, his co-workers, the hotel's staff and numerous others knew exactly what was going on with Roy's treatments and were not bound by any privacy laws such as HIPAA.

Naturally, it will be the physicians who suffer for this. Afterall, physicians are the big game of the money hunters. They are the bad guys until your heart stops beating or your child has been run over by a car; then, they are who you want to drop everything and run to save your life or the life of your child, so you can sue them later if you don't like some outcome.

As for Roy's surgeons, won't it have to be Roy that sues the surgeons or Roy's power of attorney that sues on his behalf? The public at large can't sue on Roy's behalf; neither can the media. It's just another media story at a time when there just isn't much in current events that can be sensationalized.

Jack, what you described about neighborhoods and such isn't under HIPAA, as you said. Alot of it is heresay; some of it is firsthand observation. There's no money in suing the members of neighborhoods, so no one minds sharing their opinion or receiving the opinion--but, let it be a treating medical professional or a healthcare institution and it's time to call for a lawyer!

I think HIPAA causes many problems in the safe delivery of healthcare, in cost containment of healthcare, and in providing for the patient's needs as relates to family participation/dependence for care. I mean, just think about it, in order for one to care for one's parents, an attorney must prepare a document that states the parents gave permission to reveal their healthcare needs and condition. I think that's just a little too much government interference in the private lives of families.

EC
 

cbg

I'm a Northern Girl
HIPAA applies to health care providers and to employers who learn of medical information through their group health plan. HIPAA does not apply to the media, to church prayer lists, to neighbors talking across the back fence, or to any groups other than are defined in the statute. There is a great deal of miscommunication and misinformation about HIPAA. I do not believe it was well written or well thought out, and I believe we will see case law amending it within the next couple of years. But the media reporting on the condition of an injured celebrity is in no way a HIPAA violation.
 

ellencee

Senior Member
cbg
I hope there are some case laws that bring about change. HIPAA, as it appears on paper and in theory, is far different than the total picture of impact on healthcare and families. Healthcare providers have to share in the 'blame' for creating an issue far larger than HIPAA in its purest form.
I'd love to consult on a HIPAA challenging case that involved the long, long arms of interference in healthcare and families.
EC
 

pele

Member
The violation in this specific case was not the media asking questions and getting answers. The violation was one doc sharing privileged information about a patient with another doc who then ran his mouth off to the media. Which doc is to blame? The doc who shared information with another doc not involved in the case, or the doc who then felt the need to share this with the media??
 
J

JackSchroder

Guest
A public figure is just that, a public figure. What happens to a public figure is public. No one is to blame but the person who puts his activities into the public arena. Forget this case, please. It is not important.
 

cbg

I'm a Northern Girl
Ellencee, I too would like to see changes to HIPAA as it currently stands. I think there are situations where families need more access than they are currently given. I think it is a reasonably good idea taken too far.
 
J

JackSchroder

Guest
CJG and Ellencee:

It's a great idea for the insurance industry. That's why they pushed it through
They are going to push through a $250K cap on malpractice awards and verdicts nationally too. It's coming this year.
Why not attack the insurance industry. This whole business of consents is bad. And it is the insurance industry only that wants it.
 

ellencee

Senior Member
Jack,
I am about as anti-insurance company as one can get. I very much object to insurance companies dictating healthcare to their policy holders and manipulating healthcare in general.

I very strongly object to insurance companies being notified when those persons not covered by insurance receive healthcare. Sure, it's just a demographic-type of information, but what business is it of insurance company X if Mr. or Mrs. Private Pay Public receives medical or health related care? (none in my opinion)

I very strongly object to health insurance premiums at $500 a month or more, with $2-3,000 deductible and an 80% payment of the approved charges, which may be less than half of the billable amount.

If insurance company owners and upper management didn't feed the political campaigns of just about everyone, they couldn't get away with this robbing of the American people.

If the American public had not been so greedy in seeking HUGE monetary awards for nickle and dime damages, and if certain attorneys had not inflated the amount of damages sought (for their own personal financial gain), we wouldn't have these caps that are going to hurt the ones who deserve substantial award.

That's the main reason my feathers get so ruffled over some of the rationale for suing physicians or other healthcare professionals as we see posted on this site. Most posters are seeking their monetary claim to fame over some trivial matter; others have significant damages caused by the careless and reckless delivery of healthcare. The former is at least half of the cause for the caps and the latter will be the ones to suffer because of the greed of litigants and the jurys that awarded such ludicrous damages.

As for the issue of Roy's physicians, I have no reason to doubt that whoever is Roy's spokesperson, or power of attorney, gave the physician(s) permission to talk to the media. As you said, he is a public figure.

I just want to know why the media has a right that the treating physician does not have as relates to accidental injuries or other medical treatments. (I know the media isn't bound by HIPAA.)

The treating physician can't tell the family but the media can gain this information through the 'grapevine' and through observation and publish it. Is that not ridiculous? I guess if our recent poster wants to know how to care for her parent, she should just call the local media and have them find out and tell her; HIPAA won't allow the physicians to tell her without permission from the parent and the parent can't communicate her wishes.

As a side note to all of the posters in the area of California that is currently burning due to wildfires--I hope each of you and your loved ones are safe and that your homes will not be damaged in any way. The scenes on TV and the reports in the media are shocking. I can not even imagine what it must be like to be there in the path of this destructive force.

EC
 
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pele

Member
Wow - so patient-doctor confidentiality just goes out the door if you are a celebrity? It will be of interest just to see how far this case will go. It is the first one I have heard of involving HIPAA and a breach of not only confidentiality but, to me, ethics. The public does not have the right to know what goes on between you and your physician, not one of us. Press releases should be enough to satisfy the "public's need to know".
 

cbg

I'm a Northern Girl
Doctor-patient confidentiality existed long before HIPAA was a gleam in a politician's eye. The fact that HIPAA does not apply does not make it okay to for the media to disclosed personal information that has not been okayed by the individual; it only means that HIPAA does not apply.
 

lkc15507

Member
CBG is so correct. HIPAA, even given all its flaws is a law that provides much protection. My goodness, think back 20 years ago...people felt locked into "going nowhere" jobs because of pre-existing conditions--either themselves or a covered dependant. Folks now have much more freedom to change to upward mobility positions because of HIPAA.

For a healthcare practitioner, the April 2003 changes in privacy laws (applicable only to certain groups until 2004), these privacy changes mean (should mean) virtually nil. All of this was already in practice (or certainly should have been). Confidentiality has always been a serious concern of health care practitioners. I agree, our government, in its infinite wisdom acts without thought. The new privacy regulations are a nightmare because of poor writing and even poorer interpretation. Once again, look at the interpretation of the word "REASONABLE". Good grief, very broad in itself. With the new HIPAA regs, 'reasonable' went to 'completely unreasonable' for many in an attempt to avoid possible sanction. Yet, sanction is based on a complaint by complaint basis. There are no "privacy police" out there,watching every move. Reasonable and prudent can be demonstrated in many ways with many differing protocols.

Although far from perfect, managed healthcare is what it is. Not all insurance companies want to, try to, or do direct heathcare. Most simply want to provide the proper healthcare that saves the plan AND the INSURED dollars. The networks set up at contracted rates usually provide insureds with primary, secondary, and tertiary care at designated facilities. Can anyone, physician, patient, nurse or otherwise determine that for example, Johns Hopkins would be superior in cancer treatment to MD Anderson? No. So, why not use the designated network facilities? Lastly, if a plan provides for a life-time maximum, should not that maximum be guarded judiciously? Try being a 30-year-old bone marrow transplant candidate with a lifetime maximum of $1,000,000.00. Potentially gone in no time. If the tertiary care facility recommends VAD chemotherapy that is available within the PPO, why not provide the VAD within the PPO rather than at the tertiary facility, at a greatly reduced cost? Or if a piece of DME may be provided at half the cost in network vs. out of network, why not? One needs to recognize that there is also a problem with providers. What physician wants to be questioned? None. There is (and shoud be) an inherent trust of consumers for their physicians. Yet, when it comes to money, does the physician care for any but his own pocket? Most people are concerned with the insurance company's pocket and perceive it to be very deep. May or may not be true--just like the physicians. The best is for patients to be keepers of their own asset--an insurance plan--by working and communicating with both. Just ask the parents of my 19 year old with a serious closed head injury whom no physicians thought qualified for rehab. I (insurance) fought for rehab. Now he is functioning at a very high level. Fact is, I knew what he qualified for or would qualify for medically and according to insurance. Had they waited, he would not have qualified according to insurance. His parents love me. Letting this boy languish served no one. The higher functional level he achieved the better.

Now, guess what. His dad can look for a better paying job anyway--because of HIPAA. Prior to HIPAA, forget it, end of story. By the way, his dad came to me for advice when looking for that new job--and I'm the insurance person. Evil damn thing that we are.CBG is so correct. HIPAA, even given all its flaws is a law that provides much protection. My goodness, think back 20 years ago...people felt locked into "going nowhere" jobs because of pre-existing conditions--either themselves or a covered dependant. Folks now have much more freedom to change to upward mobility positions because of HIPAA.

For a healthcare practitioner, the April 2003 changes in privacy laws (applicable only to certain groups until 2004), these privacy changes mean (should mean) virtually nil. All of this was already in practice (or certainly should have been). Confidentiality has always been a serious concern of health care practitioners. I agree, our government, in its infinite wisdom acts without thought. The new privacy regulations are a nightmare because of poor writing and even poorer interpretation. Once again, look at the interpretation of the word "REASONABLE". Good grief, very broad in itself. With the new HIPAA regs, 'reasonable' went to 'completely unreasonable' for many in an attempt to avoid possible sanction. Yet, sanction is based on a complaint by complaint basis. There are no "privacy police" out there,watching every move. Reasonable and prudent can be demonstrated in many ways with many differing protocols.

Although far from perfect, managed healthcare is what it is. Not all insurance companies want to, try to, or do direct heathcare. Most simply want to provide the proper healthcare that saves the plan AND the INSURED dollars. The networks set up at contracted rates usually provide insureds with primary, secondary, and tertiary care at designated facilities. Can anyone, physician, patient, nurse or otherwise determine that for example, Johns Hopkins would be superior in cancer treatment to MD Anderson? No. So, why not use the designated network facilities? Lastly, if a plan provides for a life-time maximum, should not that maximum be guarded judiciously? Try being a 30-year-old bone marrow transplant candidate with a lifetime maximum of $1,000,000.00. Potentially gone in no time. If the tertiary care facility recommends VAD chemotherapy that is available within the PPO, why not provide the VAD within the PPO rather than at the tertiary facility, at a greatly reduced cost? Or if a piece of DME may be provided at half the cost in network vs. out of network, why not? One needs to recognize that there is also a problem with providers. What physician wants to be questioned? None. There is (and shoud be) an inherent trust of consumers for their physicians. Yet, when it comes to money, does the physician care for any but his own pocket? Most people are concerned with the insurance company's pocket and perceive it to be very deep. May or may not be true--just like the physicians. The best is for patients to be keepers of their own asset--an insurance plan--by working and communicating with both. Just ask the parents of my 19 year old with a serious closed head injury whom no physicians thought qualified for rehab. I (insurance) fought for rehab. Now he is functioning at a very high level. Fact is, I knew what he qualified for or would qualify for medically and according to insurance. Had they waited, he would not have qualified according to insurance. His parents love me. Letting this boy languish served no one. The higher functional level he achieved the better.

Now, guess what. His dad can look for a better paying job anyway--because of HIPAA. Prior to HIPAA, forget it, end of story. By the way, his dad came to me for advice when looking for that new job--and I'm the insurance person. Evil damn things that we are.

As far as Roy is concerned? Privacy? Limited only to what his publicists allow. ANY person's confidentiality should be preserved--from the Ozark Hillbilly to the Hollywood Star. If Roy has allowed these people to speak for him, the confidentiality is out the window. Now, as a reputable medical practioner, I wouldn't give them the info in the first place................
 
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