A Better Understanding of HIPAA


The Health Insurance Portability and Accountability Act—commonly known as HIPAA—is designed to protect patient privacy. But as reported in The New York Times, HIPAA is not well understood and is often misapplied.

The Times reported several striking examples of the misapplication of HIPAA:

  • A woman, sitting in a hospital café discussing her terminally ill husband’s inadequate treatment for pain, was chastised for  discussing his treatment and warned it constituted a HIPAA violation;
  • A woman noticed an elderly friend did not show up for their regular swim session; she also was not at her apartment. Had she gone to the hospital? Calling the hospital was pointless; the staff, citing HIPAA, refused to provide any information;
  • A daughter, who was out of town on a business trip, repeatedly phoned the hospital to provide crucial information—including medication allergies—regarding her 85-year-old mother, who was recently admitted to the hospital and suffered from an impaired memory. The daughter finally found a nurse who was willing to listen, but not before her mother had been prescribed a drug to which she was allergic. Fortunately, the drug had not yet been administered.

These above incidents highlight the ways in which HIPAA is routinely misapplied. To clarify the law, The Times outlined HIPAA’s actual provisions:

  • HIPAA applies only to health care providers, health insurers, clearinghouses that manage and store health data, and their business associates. As a result, nothing in the law would preclude a spouse from sharing health information with a friend.
  • Family members can provide information to health care providers, as the daughter did with regard to her mother. As noted in the Times, a patient’s confidential information is not threatened when a family member provides information to a health care provider.
  • HIPAA does not prohibit health care providers from sharing information with family, friends or caregivers unless the patient specifically objects. And HIPAA actually gives providers flexibility: even when a patient is incapacitated or not present, providers are allowed to exercise professional judgment about disclosing information to a friend or family member if it’s in the best interest of the patient.

Pacific ADR’s neutrals have extensive health care law experience and stand ready to assist in the resolution of your dispute. Please contact us at (206) 624-3388.

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