The first form of OHCA described in the definition is intended to apply to
hospitals and their medical staffs, to allow them to use a single joint
consent, referencing a single joint privacy notice, for services provided
within the context of their OHCA.  There is no specific documentation
requirement mentioned in the regulations.  However, the regulations do
require that all OHCA participants agree to abide by the terms of the joint
privacy notice.

Some argue that this is already accomplished by the medical staff by-law
provision that requires staff members to abide by all hospital policies and
procedures.  However, I recommend separate documentation specifically
referring to the joint privacy notice.  This will help protect individual
OHCA participants from accusations that they have used or disclosed PHI
without a valid consent (on the grounds that the joint OHCA consent isn't
valid unless they have specifically agreed to abide by the terms of the
joint notice.)

I also recommend documenting the reason you believe the providers and sites
you list in your joint notice fit the definition of an OHCA, and keeping
this with the rest of your HIPAA documentation.

Disclaimer:  I am not a lawyer.  You should consult your institution's
general counsel regarding your OHCA documentation policy.

Bill

William A. MacBain
Principal
MacBain & MacBain, LLC
1108 Hector St.
Ithaca, NY  14850
607-256-1522


-----Original Message-----
From: Donna Maciak [mailto:[EMAIL PROTECTED]]
Sent: Thursday, February 07, 2002 10:17 AM
To: [EMAIL PROTECTED]
Subject: HIPAA Privacy Question


Below is a HIPAA privacy question posed by the Director of Medical
Information at our institution. Could you please give us some direction and
guidance on how to proceed.


Wentworth-Douglass Hospital would like to have an joint arrangement with our
treating physicians which would allow the hospital to use one "Consent to
the Use and Disclosure of Health Information for Treatment, Payment, or
Healthcare Operations" as well as one "Notice of Health Information
Practices".

Issues:

1. Does the Privacy regulations, section 164.501, "Organized health care
arrangement allow WDH to accomplish the goal?
2. Do I need to show proof of the joint arrangement by requiring the
physician groups to sign a document agreeing to adopt the WDH consent and
notice for their WDH patients?


Thank You,

Donna Maciak
Director, Performance Improvement & Regulatory Affairs
WDH



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