Directory information except for religious

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Directory information, except for religious affiliation, may be disclosed only to other persons who ask for the individual by name . Individual may restrict or prohibit some or all uses of directory information. If all uses are prohibited, facility can neither confirm nor deny patient’s presence . Facility must have policies and procedures for this purpose, and explain them in its Notice of Privacy Practices (NPP). 44/103
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Incidental Disclosures Examples of incidental disclosures: A patient subject to observation in a waiting area; ICU monitors observed by visitors; Conversations between a doctor and a patient in a semi- private room overheard by the room’s other occupant. General rule: incidental disclosures are not HIPAA violations if the covered entity has safeguards in place and the staff observes them. Example: sign-in sheet in a waiting room is permissible, but not if it asks patient to list medical problems so that other people who sign in can see the problems of earlier arrivals. Caveat: Be careful ! What may appear to be a permissible incidental violation may still be a HIPAA violation (example: mis-addressed email containing PHI). 45/103
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Disclosures Unrelated to Treatment, Payment, and Operations (TPO) Marketing, fund raising, research HIPAA privacy rules identify these activities as significant threats to privacy. Each requires a separate “ authorization,” and you are required to follow institutional-specific policies and procedures. 46/103
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What is a HIPAA Authorization? Written permission from the patient (or the patient’s legal representative) to use or disclose PHI for specific purposes (other than TPO – i.e. marketing, fundraising, research) Can be revoked in writing at any time By regulation, must include specified elements Specific purpose of use or disclosure Specific description of persons to which disclosure is to be made Expiration date or event (“none” or “end of study” ok for certain research) Signature and date Explanation of how to revoke the authorization 47/103
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Typical Uses of HIPAA Authorization Research that includes treatment Release of psychotherapy notes (HIPAA requires special protection for psych notes) Employment-related exam (allows releasing results to employer or prospective employer) Marketing Fundraising Patient’s request to release PHI (patient can release to whomever and for whatever purpose) As a condition for enrolling in a health plan (but still does not allow release of psych notes) 48/103
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Special Rules for HIPAA Authorizations Authorization for release of psychotherapy notes cannot be combined with anything else except another authorization for use or disclosure of psychotherapy notes Authorization for research can be combined with other types of written permission for the same research (e.g., informed consent) Covered entity generally can’t withhold treatment until the patient signs an authorization, except for:
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  • Fall '11
  • Edberg
  • Health Insurance Portability and Accountability Act, Dr. Jones

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