HIPAA in Wonderland


In which a determined pharmacist battles the forces of ignorance and stupidity on behalf of his patient and his own sanity.

David Stanley“With the passage of this bill, we will enter a new era. A time when healthcare providers will encounter unnecessary obstacles when they seek information to care for their patients, when law enforcement investigations will be brought to a standstill, and when any healthcare entity can use this new law as an excuse to avoid an unwanted task. I am proud to be a part of this process that will hinder the operations of this country's already overworked and understaffed healthcare workforce.”

I am pretty sure that no politician ever said anything like that when the law we all know as HIPAA was wending its way through Congress, and I'd be willing to bet that President Clinton said no such thing when he signed it into the books 18 years ago.

I think we can all agree that no politician in his right mind would be inclined to take a position that favored blocking the delivery of healthcare. And I’m sure that the intention behind HIPAA was not to provoke conversations like the one I was having with the insurance company help desk. Yet there I was.


Stonewall the provider

“I'm sorry sir, but healthcare privacy laws prevent us from releasing that information.”

“You mean HIPAA? Is that the law we're talking about?”

“That is correct.”

“That's funny, because I have a copy of the HIPAA law right here in front of me.”

This was my second call to try to resolve my patient's issue, and I had done my homework before I dialed that second time. “And it says right here, ‘A covered entity may disclose protected health information for the treatment activities of any healthcare provider and the payment activities of another covered entity.’ I'm the treater and you're the payer, so if you'll just answer my question now …”

“Healthcare privacy laws prevent us from releasing that information.”

“Did you even hear what I just said?”

It will probably not surprise you to learn that I had to talk to a supervisor's supervisor to get my problem solved, as I'm sure you have had this type of conversation as well.


Defy the police

Nothing seems to frighten the healthcare world more than those five letters. Fear of the “H-word” all too often induces complete paralysis in certain people, as if an instant lifetime trip to a Siberian labor camp would be the fate of anyone who runs afoul of the HIPAA police.

Well, I have news for you. There are no special HIPAA agents lying in wait, watching for you to slip up. And I wasn't trying to put one over on that help desk worker. Those words were a direct quote from the actual law, as are these:

“Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes under the following circumstances ... to identify or locate a suspect, fugitive, material witness, or missing person ... in response to a law enforcement official’s request for information about a victim or suspected victim of a crime ...”

Seems pretty clear to me. Yet that didn't stop a Daytona Beach nursing home from invoking “privacy laws” to avoid giving information to police investigating a possible sexual assault on a 75-year-old Alzheimer's patient.


Imprison the next of kin

HIPAA's relationship to law enforcement, however, seems to depend a great deal on who's interpreting the law.

It was invoked to prevent police from acting in the Daytona Beach case, in Springfield, Missouri, yet it was cited as the reason hospital security went into overdrive to detain a woman who had crossed the line, in their view, by ... wait for it … taking a picture of her own son.

You can watch a video the mother made of her encounter at http://bit.ly/unlawfuldetain, and while you do, try to come up with a way that scenario can possibly square with the intention of the people who actually wrote the law.

Better yet, just go read the law yourself - something that apparently far too many people have yet to do. Anyone who actually reads the law will see that HIPAA is never to be used to hinder a patient's care, to protect rapists, or to persecute mothers taking pictures of their children.

Unless they are teaching kids some awfully funny things in law school these days, your chances of ending up in a Siberian work camp for doing your job to help patients are almost zero.

So please, Mr. Helpdesk Person, next time could you just answer my question? 

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