Radiologist Revises Process for Workers Compensation Disclosures
Radiologist Revises Process for Workers Compensation Disclosures
Covered Entity: Health Care Provider
Issue: Impermissible Uses and Disclosures
A radiology practice that interpreted a hospital patient’s imaging
tests submitted a worker’s compensation claim to the patient’s employer.
The claim included the patient’s test results. However, the patient
was not covered by worker’s compensation and had not identified worker’s
compensation as responsible for payment. OCR’s investigation revealed
that the radiology practice had relied upon incorrect billing
information from the treating hospital in submitting the claim. Among
other corrective actions to resolve the specific issues in the case, the
practice apologized to the patient and sanctioned the employee
responsible for the incident; trained all billing and coding staff on
appropriate insurance claims submission; and revised its policies and
procedures to require a specific request from worker’s compensation
carriers before submitting test results to them.
| Mental Health Center Provides Access after Denial Covered Entity: Mental Health Center Issue: Access, Authorization The complainant alleged that a mental health center (the "Center") improperly provided her records to her auto insurance company and refused to provide her with a copy of her medical records. The Center provided OCR with a valid authorization, signed by the complainant, permitting the release of information to the auto insurance company. OCR also determined that the Center denied the complainant's request for access because her therapists believed providing the records to her would likely cause her substantial harm. The Center did not, ...read more |
| Private Practice Ceases Conditioning of Compliance with the Privacy Rule Covered Entity: Private Practice Issue: Conditioning Compliance with the Privacy Rule A physician practice requested that patients sign an agreement entitled “Consent and Mutual Agreement to Maintain Privacy.” The agreement prohibited the patient from directly or indirectly publishing or airing commentary about the physician, his expertise, and/or treatment in exchange for the physician’s compliance with the Privacy Rule. A patient’s rights under the Privacy Rule are not contingent on the patient’s agreement with a covered entity. A covered entity’s obligation to comply with all requirements of the Privacy Rule ...read more |
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| Can a covered entity refuse to disclose ePHI to an app chosen by an individual because of concerns about how the app will use or disclose the ePHI it receives? No. The HIPAA Privacy Rule generally prohibits a covered entity from refusing to disclose ePHI to a third-party app designated by the individual if the ePHI is readily producible in the form and format used by the app. See 45 CFR 164.524(a)(1), (c)(2)(ii), (c)(3)(ii). The HIPAA Rules do not impose any restrictions on how an individual or the individual’s designee, such as an app, may use the health information ...read more |
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