HIPAA, The Good, The Bad, and the Solution

HIPAA brings good benefits but can be a bad barrier to helping a loved one.

HIPAA is a Federal Law with the full name “The Health Insurance Portability and Accountability Act of 1996″. Although it was enacted in 1996, the Federal rules implementing this statute were not completely enacted until December 2000 with a major revision to the regulations in March 2002.

The Good!

It is law designed to keep your medical records private to you but also available to you. One of the primary purposes of HIPAA is to prevent the mega-corporations of America and healthcare providers from transmitting your private healthcare information without your knowledge.  This law prevents Google or other internet search companies from finding out about your health issues (at least from your Doctor or health insurance company because they still track your search activities) or having your health information sold to companies to market to you or discriminate against you. 

This rule covers health plans, healthcare clearing houses and more important to you, healthcare providers (your doctors and medical staff). Its requirement to keep your medical records private doesn’t really apply to people in general. More specifically it covers healthcare providers that electronically transmit health information.  In today’s world – this covers all but the rarest of rare healthcare providers.  Remember though, HIPAA does not regulate your average citizen’s use or transmission of your records and it is not as sweeping as some people believe.  The whole point of HIPAA is to accomplish two main goals, which are:
(1)    To make sure your healthcare information is available to you from your healthcare provider, and;

(2)    To make sure that the healthcare providers, insurance providers (and their backoffice information clearing houses) can not disseminate your private healthcare information without your permission.

The Bad!

As with all government regulations, HIPAA shows up in multiple places in our daily lives.  Every time you go to the doctor or other healthcare provider, they are required to provide notice to you on how they handle your private healthcare information. Each and every one of the financial institutions that handle healthcare information such as life insurance companies, health insurance companies and the like, are also required to disclose to you their HIPAA policies. So you have lots of “Notices” put in front of you everywhere you turn. This has led to HIPAA overload and a de-sensitization as to what this law is really all about.

Because there are legal barriers or protections against the transmission of your protected health information, there will be a time when you are trying to provide care for a loved one and the insurance company or other medical provider that does not want to have to answer to your advocacy will politely hold up their hand and say “I am sorry, I can not speak to you about your loved one’s private medical information”.  They will end the conversation in it’s tracks.  I have found that as a practical matter, medical providers in everyday life are willing to share information with a loved one when everyone is in agreement under some view of “implied consent” from your loved one. That changes drastically as soon as you start holding the medical provider accountable or disagree with their treatment plan.

The Solution!

The easy solution to this type of stonewalling is to have a HIPAA release drafted and signed by your loved one.  This release enables your health advocates (family or friends as you authorize) authority to get the necessary information and cut through the bureaucratic red tape that is often connected to medical records.  Visit a blog article on planning tips for a special needs child. You should ask about a HIPAA release as part of your Estate Planning documents which would include Health Care Surrogates and Living Wills.

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