Patient Advocates and HIPAA

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Patient Advocates and HIPAA

Lately I’ve run into questions and discussions about patient advocates or navigators and HIPAA , so it seems a good topic for today’s post. I’ll begin with a disclaimer:  there’s no one on this green planet that can give you ALL the answers as they relate to HIPAA!  No, not even the lawyers who live it every day.  It’s complex and daunting.  But there are some basics that might be useful.  Here are the basics that can be useful to advocates: 1.  It’s HIPAA, not HIPPA.  HIPAA stands for the Health Insurance Portability Accountability Act.  Notice, it doesn’t say anything about information (which is what it’s really about), nor does it say anything about patients. 2.  HIPAA was originally  intended to protect patient information from falling into the “wrong” hands electronically.  The laws were passed in the 1990s as fax machines were being used more and more and the Internet was beginning to be used to share personal information. HIPAA was intended to address any sort of electronic sharing of records. 3.  HIPAA laws and penalties apply only to “covered entities.”  Covered entities are health insurers and payers, health care providers, and organizations that transfer that information to covered entities electronically NOT included in this list is patient advocates or navigators.  Most of us are not providers – we are facilitators and supporters, but we are not providing medical advice.  Now – a disclaimer – it’s my opinion that advocates are not covered entities. (My opinion and a dollar might buy you a cuppa coffee.)  As far as I know, no one who has any legal standing has actually ever ruled on it. And if you are a physician-advocate or a nurse-advocate, you may see the HIPAA world differently. Truth is, it doesn’t matter whether advocates are covered entities or not. See below: “What is important from our advocate point of view.” 4.  There are slews of myths about HIPAA – things that everyone assumes to be true, but aren’t true.  Included are things like the notion that family members can’t get a hold of medical records.  Well – that…


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