Q. I am a covered provider under HIPAA's privacy rule and have done my
best to comply with the requirements. What are some of the potential pitfalls
associated with the privacy rule to be aware of and avoid?
A. Unfortunately, the Office of Civil Rights (OCR), which enforces
the privacy rule, provides only limited details regarding complaints. Thus,
the conclusions we can draw are not as detailed and comprehensive as we would
like. However, there are some definite pitfalls to be aware of and avoid:
Physician practices are the entities most frequently complained about,
followed by hospitals, pharmacies, outpatient facilities, and health
plans.
Fifty-seven percent of the complaints have been closed. The top reasons for
case closure are lack of OCR jurisdiction (for example, the complaint involved
a non-covered provider), there was no HIPAA violation, or the complaint was
resolved through the entity's voluntary compliance.
Finally, 125 cases have been referred to the Department of Justice for
possible criminal prosecution.
The privacy rule preempts (or takes precedence over) any contrary state
law, unless the state law is "more stringent." In terms of patient
access, more stringent is defined to include granting the patient greater
rights of access. So the privacy rule's standards (mandatory patient access)
are to be followed, unless a state law grants patients greater rights of
access.
If access is denied, the patient's notification of denial must be
accompanied by information on how to have the denial reviewed (if denied for
reviewable grounds) and how to complain to the covered provider and HHS. It is
important to remember that to the extent possible, access must be given to the
remaining protected health information, after excluding the denied
information. Also keep in mind that the patient can authorize the release of
the entire record to a third party, such as an attorney.
Participants in the Psychiatrists' Program can access more information
about the privacy rule, as well as comprehensive information about risk
management topics, in the "For Participants Only" section of<www.psychprogram.com>.
Q. I want to change to a new medical malpractice insurance carrier and
have been researching options. Several colleagues have recommended the
Psychiatrists' Program. One benefit they have cited is the
psychiatric-specific risk management services, especially the online services.
Could you tell me more more about these resources?
A.The Psychiatrists' Program's risk management department provides a
wide range of services and is staffed by experienced professionals with legal
and clinical backgrounds. This combination provides psychiatrists with
assistance from staff who have a thorough understanding of both the clinical
situation and the legal issues and their implications. The Program identifies
and implements sound risk management services to help you avoid potential
incidents and lawsuits.
The Program includes access to online risk management resources featuring
more than 100 risk management articles, multimedia presentations, and the
Rx for Risk newsletter archive dating back to 1998. There are also a
number of risk management presentations in the Online Education Center, such
as "Six Things You Can Do NOW to Avoid Being Sued Successfully
LATER."
The Program's Web site will soon feature the newly released Risk
Management Resource for Psychiatric Practice: A Comprehensive Manual for
Psychiatrists and Mental Health Professionals, developed by the Program's
risk management department. The manual helps psychiatrists develop and refine
a risk management approach that works specifically for their individual
practices.
Participants in the Psychiatrists' Program can access these risk management
resources by logging into the "For Participants Only" section at<www.psychprogram.com>.
Those who are not Program participants may call (800) 245-3333, ext. 389, or
send an e-mail to
TheProgram@prms.com
to request a complimentary CD-ROM that includes a sampling of risk management
articles and multimedia presentations.
This column is provided by PRMS, manager of the Psychiatrists'
Program, for the benefit of members. More information about the Program is
available by visiting its Web site at<www.psychprogram.com>;
calling (800) 245-3333, ext. 389; or sending an e-mail to
TheProgram@prms.com.▪