RE: developing pictures

2003-04-03 Thread Darrell Rishel 
For the "non-medical" pictures, I'd suggest you invest in a digital camera
and just print them in-house. Much quicker and probably cheaper in the long
run since you don't have to buy film. You can get a pretty decent digital
camera (certainly good enough for this kind of thing) for a couple hundred
bucks at most. 

Darrell Rishel, J.D.
Director of Information Services
Arapahoe House, Inc. 
This message is not legal advice. 

-Original Message-
From: Oriol, Albert [mailto:[EMAIL PROTECTED]
Sent: Thursday, April 03, 2003 7:17 PM
To: WEDI SNIP Privacy Workgroup List
Subject: developing pictures


Here's a good one I had not heard to date.  We often take photos. Most of
the ones that are taken for medical reasons require quality developing and
thus are developed in-house or taken to a top notch shop (with whom, I'd
think if needed we could have a BA agreement in place) -- Question, what do
you all think, assuming the pictures will show identifying information? 
 
The other situation is that of pictures taken for projects for our kids, or
for some newsletter. We're a kid's hospital and for instance we might want
to have kids build something with their picture to give mom for mother's
day. These types of pictures most likely just get developed at whatever
pharmacy happens to be on the way of a nurse's or other professional's way
home.  How should we handle those?  Take all our pictures to the place(s) we
have BA's in place and only there? 
 
a.

 




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RE: business associate questions

2003-04-01 Thread Darrell Rishel 
If your law firm provides any services to any entity in healthcare, I
strongly suggest you start getting familiar with HIPAA...in a hurry. Legal
services is one of the types of messages specifically mentioned in the
section of the regulation addressing business associates. Whether a law firm
providing services to a health care entity is a Business Associate or that
health care entity will depend essentially on two things: (1) is the health
care entity a "covered entity" under HIPAA, and (2) does the law firm
receive protected health information in the course of performing those
services. If the answer to both of those questions is yes, then you need to
have a Business Associate Agreement with the health care entity.

Darrell Rishel, J.D. 
Director of Information Services 
Arapahoe House, Inc.

This message is not legal advice.


> -Original Message-
> From: Jason Cantos [mailto:[EMAIL PROTECTED]
> Sent: Tuesday, April 01, 2003 11:24 AM
> To: WEDI SNIP Privacy Workgroup List
> Subject: business associate questions
> 
> 
> I work in a small law firm.  A couple of our clients asked us to sign 
> business associate agreements.  These business associate 
> agreements require 
> the law firm to adopt HIPAA specific policies and procedures. 
>  Are there any 
> business associates (law firms specifically) that are doing this?
> 
> On an unrelated matter, the provider of our dental insurance 
> asked us to 
> sign a business associate agreement, with us as the business 
> associate--I 
> just don't see how we are a business associate in this situation.
> 
> Thanks so much for your help.
> 
> 
> 
> 
> 
> _
> 
> 
> 
> ---
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RE: I need a Heads Up on Who Is Preparing BAA's

2003-01-31 Thread Darrell Rishel 
Accreditation is one of the specific "qualifying" services listed in the
definition of Business Associate in Sec. 160.103.

Darrell Rishel, J.D.
Director of Information Services
Arapahoe House, Inc.

This message is not legal advice or a binding signature.


-Original Message-
From: Nancy Jones [mailto:[EMAIL PROTECTED]] 
Sent: Friday, January 31, 2003 9:59 AM
To: WEDI SNIP Privacy Workgroup List
Subject: I need a Heads Up on Who Is Preparing BAA's


I work for one of those hospitals that feels strongly that we will not sign
a BAA prepared by one of our business associates (except JCAHO, who is not
giving a provider much choice - Chaps my HIPAAbuttamus - I have always held
to the interpretation that accreditors are not BA's).

I continue to see warnings that BAA's will be coming our way.  We have
already received one from McKesson.  Does anyone know which companies have
sent, or are planning to send an BA agreement to providers?

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RE: Any HIPAA Humor tools out there?

2003-01-29 Thread Darrell Rishel 
Title: Message



Those who 
live in glass houses...
 
Darrell Rishel, J.D. Director of Information Services Arapahoe House, Inc. 

This message is not legal 
advice or a binding signature. 

  
  -Original Message-From: fwdanby 
  [mailto:[EMAIL PROTECTED]] Sent: Wednesday, January 29, 2003 12:10 
  PMTo: WEDI SNIP Privacy Workgroup ListCc: WEDI SNIP 
  Privacy Workgroup ListSubject: Re: Any HIPAA Humor tools out 
  there?
  Get an acronym-matching contest 
  going.
  Here's the first (and it's not original to 
  me)
   
  Healthy 
  Income 
  Protection for
  Aggressive
  Attorneys
   
  F.W. (Bill) Danby, MD, Manchester, NH, 
  USA
  
- Original Message - 
From: 
Bentz-Miller, 
Judith 
To: WEDI SNIP Privacy Workgroup 
List 
Sent: Wednesday, January 29, 2003 9:17 
AM
Subject: Any HIPAA Humor tools out 
there?
does anyone have any good HIPAA humor training tools 
that they would bewilling to share?  I am doing a presentation 
later today and I am lookingfor something different.  
 Email me directly if you wish.  Thank you for 
helping!---The WEDI SNIP listserv to which you are 
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  listserv to which you are subscribed is not moderated. The discussions on this 
  listserv therefore represent the views of the individual participants, and do 
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  SNIP. If you wish to receive an official opinion, post your question to the 
  WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs 
  should not be used for commercial marketing purposes or discussion of specific 
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  for personal disagreements or unprofessional communication at any 
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RE: Business Associate Question

2003-01-29 Thread Darrell Rishel 
In the context of using such "temp" agencies to provide fill-in staff, they
are in either case  members of the workforce.

Darrell Rishel, J.D.
Director of Information Services
Arapahoe House, Inc.

This message is not legal advice or a binding signature.


-Original Message-
From: Giesecke, Steve [mailto:[EMAIL PROTECTED]] 
Sent: Wednesday, January 29, 2003 12:42 PM
To: WEDI SNIP Privacy Workgroup List
Subject: Business Associate Question


Would appreciate responses to the following BA classification determination:
 
With respect to Nurse staffing and other medical staffing agencies,
including home health care, my assessment is that if nurses are providing
treatment services, they (generally) are not BA's and no BAA is needed (as
with a provider - provider or plan - provider relationship; "treatment
exemption" applies).  If they are providing other professional or
administrative services such as UM/QM/CM (& come into contact with PHI) then
a BAA with the agencies providing them is needed.
 
Don't want to oversimplify in terms of my assumptions, however anywhere in
HIPAA you can "simplify" is good!
 
Thank you,
 
Steve Giesecke
Independent Consultant
Subcontractor to Sierra Systems
(360) 561-3803
 
 
 
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RE: NPP and illiterate population

2003-01-26 Thread Darrell Rishel 
Although I understand your point, I'd like to think our ethics and sense of
obligation to our patients is on a little higher plane than where the banks
and credit card companies apparantly are.

Darrell Rishel, J.D. 
Director of Information Services 
Arapahoe House, Inc.

This message is not legal advice or a binding signature.


> -Original Message-
> From: William J. Kammerer [mailto:[EMAIL PROTECTED]]
> Sent: Friday, January 24, 2003 4:25 PM
> To: WEDI SNIP Privacy Workgroup List
> Subject: Re: NPP and illiterate population
> 
> 
> Why agonize over it? Do you really believe anyone is going to 
> read these
> things? I'm literate - with full command of the English language - yet
> I've never read one of those stupid GLB privacy notices from banks and
> credit card companies, and probably would not have the 
> patience to keep
> track of all the subparts and insofar as'es.  And what's with 
> that tiny
> type they always use?
> 
> William J. Kammerer
> Novannet, LLC.
> Columbus, US-OH 43221-3859
> +1 (614) 487-0320
> 
> - Original Message -
> From: "Jennifer Peters" <[EMAIL PROTECTED]>
> To: "WEDI SNIP Privacy Workgroup List" <[EMAIL PROTECTED]>
> Sent: Friday, 24 January, 2003 05:49 PM
> Subject: RE: NPP and illiterate population
> 
> 
> How is everyone handling a situation where a patient is literate, but
> unable to comprehend the NPP?
> 
> 
> -Original Message-
> From: Bentz-Miller, Judith [mailto:[EMAIL PROTECTED]]
> Sent: Friday, January 24, 2003 11:10 AM
> To: WEDI SNIP Privacy Workgroup List
> Subject: RE: NPP and illiterate population
> 
> 
> We will be RECORDING it as a voice mail message (our system
> handles over 12 minutes!) and having an extension, with access on both
> the local line and 800 line. We are also having a privacy (800
> number) hotline set up and both numbers will be listed on business
> cards.  Business cards will be located at each receptionist desk.
> 
> -Original Message-
> From: Traci Winter [mailto:[EMAIL PROTECTED]]
> Sent: Friday, January 24, 2003 10:38 AM
> To: WEDI SNIP Privacy Workgroup List
> Subject: NPP and illiterate population
> 
> 
> I know our NPP is supposed to be easy to read and
> understand, but one of our committee members brought up an interesting
> thought. What do we do with our illiterate population and our patients
> who are legally blind. In the area we service this a definite issue.
> Should we put the NPP on an audio cassette so the patients whom are
> unable to read it can listen to it?
> 
> Opinions appreciated.
> 
> Traci Winter
> Hospitals Home Health Care, Inc.
> 
> 
> ---
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RE: Conflicts between Authorizations and Restrictions

2003-01-26 Thread Darrell Rishel 
Our form explicitly states that if the patient later signs a consent or
authorization conflicting with a prior restriction, the restriction will be
ignored.

Darrell Rishel, J.D. 
Director of Information Services 
Arapahoe House, Inc. 
This message is not legal advice or a binding signature.


> -Original Message-
> From: Noel Chang [mailto:[EMAIL PROTECTED]]
> Sent: Saturday, January 25, 2003 9:22 PM
> To: WEDI SNIP Privacy Workgroup List
> Subject: Conflicts between Authorizations and Restrictions
> 
> 
> Has anyone thought about (or is there published guidance from 
> HHS or OCR on) 
> how to resolve conflicts between authorizations and 
> restrictions requested by 
> individuals?
> 
> Suppose a patient requests a restriction on the use and 
> disclosure of their 
> PHI and a provider agrees to it.  Some point down the road, the same 
> individual forgets they had requested that restriction and signs an 
> authorization that directs the provider to make a disclosure 
> that is in 
> conflict with the previously agreed to restriction.  Does a valid 
> authorization permit a provider to disclose information in 
> accordance with 
> the authorization even if it may be contradictory to a 
> documented restriction?
> 
> Obviously you would want to identify these conflicts and 
> resolve them with 
> the individual by terminating the restriction or amending the 
> authorization 
> but what if that is not easily done.  Imagine you get an 
> authorization faxed 
> to you that on its face appears valid but once again it is 
> requesting a 
> disclosure that is in conflict with an agreed to restriction. 
>  This time the 
> faxed authorization is concerning a patient you haven't seen 
> in three years 
> and no longer lives in the same state.  Again, you could 
> track the individual 
> down through whoever faxed you the authorization and try to 
> resolve the 
> conflict but you can see how that might become time consuming.
> 
> So is there a short answer?  What trumps what?  Authorizations or 
> restrictions on use and disclosure?
> 
> Noel Chang 
> 
> --
> Open WebMail Project (http://openwebmail.org)
> 
> 
> ---
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Contact Info for Legal Action Center

2003-01-24 Thread Darrell Rishel 
In order to make sure that I did not miss anyone who requested this, I am
sending the contact info to the entire list. They have several publications
available regarding the federal regs (42 C.F.R. Part 2) regarding the
confidentiality of alcohol and drug abuse patient records for sale that I
have found useful. They are also preparing a cross-walk between those regs
and the HIPAA privacy regs. My apologies to those of you who did not request
this information.

Legal Action Center
153 Waverly Place
New York, NY 10014
+1 (212) 243-1313

Darrell Rishel, J.D.
Director of Information Services
Arapahoe House, Inc.

This message is not legal advice or a binding signature.

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RE: HIPAA privacy and people - comparison to 42 C.F.R. Part 2 (Al cohol and Drug Patient Privacy)

2003-01-22 Thread Darrell Rishel 
You are absolutely correct that there is much in HIPAA than what is in 42
C.F.R. Part 2. Isn't it nice that SAMHSA et al are being so timely with
their assistance? The Legal Action Center, a well-known, well-respected
non-profit based in New York that has done a lot of work in interpreting 42
C.F.R. Part 2, is also supposed to be coming out with a "cross-walk"
supplement, but if people are not already working on this, well ... If
anyone is interested, I can give you contact information for the Legal
Action Center.

Darrell Rishel, J.D. 
Director of Information Services 
Arapahoe House, Inc. 
This message is not legal advice or a binding signature.


> -Original Message-
> From: Vicki Hohner [mailto:[EMAIL PROTECTED]]
> Sent: Wednesday, January 22, 2003 12:13 PM
> To: Darrell Rishel; [EMAIL PROTECTED]
> Subject: RE: HIPAA privacy and people - comparison to 42 C.F.R. Part 2
> (Alcohol and Drug Patient Privacy)
> 
> 
> I have been doing a lot of work with substance abuse programs 
> and HIPAA,
> and while not deeply familar with 42 CFR protections we have 
> identified
> that there are limited areas of overlap with HIPAA privacy. 
> Many subject
> to 42 CFR mistakenly believe that the fact that they comply with this
> law, which is more stringent in its use and disclosure requirements,
> means they are exempt from complying with HIPAA. However, note that
> there are only a few overlaps between the two: primarily with uses and
> disclosures/minimum necessary, authorizations, and some 
> limited parts of
> individual rights. This leaves a lot more under HIPAA that is not
> addressed in 42 CFR--all the policies and procedures, the privacy
> officer, business associate terms, the notice of privacy 
> practices, and
> accounting of disclosures, to name a few. Note also that the 
> definitions
> of what information is protected is broader under HIPAA than under 42
> CFR. 
> 
> My understanding is that the feds (SAMHSA/CSAT) are working on a
> comparison matrix between the two--no idea when that may be 
> available.  
> 
> Vicki Hohner
> FOX Systems, Inc.
> 360-970-6856
> 360-352-4584
> Information transmitted is confidential and may be proprietary to FOX
> Systems, Inc.  It is intended only for the person or entity 
> to which it
> is addressed.   Anyone else is prohibited from disclosing, copying, or
> disseminating the contents or attachments.  If you receive this in
> error, please notify sender immediately, or us at www.foxsys.com and
> delete from your system.
> >>> Darrell Rishel <[EMAIL PROTECTED]> 01/20/03 08:57 AM >>>
> Matt-
> 
> I'll take a stab at answering your question. Please remember 
> that in an
> effort to keep it relatively brief, this is a fairly simplistic,
> high-level
> overview.
> 
> Under 42 C.F.R. Part 2 (which I'll refer to as the AOD (Alcohol and
> Other
> Drugs)regs), disclosure within a "program" is allowed on a 
> need-to-know
> basis  without the consent of the patient. This "internal" 
> disclosure is
> limited to "personnel having a need for the information in connection
> with
> their duties which arise out of the provision of diagnosis, treatment,
> or
> referral for treatment." In practice, I think this is very 
> close to, if
> not
> the same as, the HIPAA "use" definition. Although the AOD regs do not
> require a formal minimum necessary analysis, the concept of only
> disclosing
> the minimum amount of information necessary to accomplish the purpose
> for
> making the disclosure is clearly embedded in the regs.
> 
> It is the disclosure to external entities where, especially with the
> adoption of the August, 2002, HIPAA changes, a wide gap 
> remains between
> the
> two sets of regs. While HIPAA allows treatment providers to 
> disclose PHI
> for
> treatment and payment (even another provider's payment) without the
> patient's written consent, the AOD regs absolutely prohibit such
> disclosures
> related to payment, and disclosures for treatment (except for medical
> emergencies) require that a written agreement be in place and that the
> services which the external provider render be something 
> different than
> what
> the primary provider is providing. This written agreement is known in
> the
> AOD regs as a Qualified Service Organization Agreement (QSOA, for
> short). A
> QSOA is akin to a BA agreement, though much shorter and less
> complicated,
> charachteristics which are, unfortunately, soon to be a thing of the
> past.
> While a QSOA can be used in limited circumstances for treatment (the
> biggest
> problem is that we cannot have one with another AOD 
> pr

RE: When to have the patient sign an authorization

2003-01-20 Thread Darrell Rishel 
I do not believe that HIPAA mandates that an authorization can only be valid
for 60 days. Such a limitation might be a part of state law, or an
organization's own standard. I think that if you can foresee the need for
the disclosure when the patient is admitted, then you can have it signed at
that time. If the need does not become apparent until later, then you have
the patient sign it then. In either case, of course, the authorization has
to meet all off the other HIPAA (and other applicable) requirements.

Darrell Rishel, J.D.
Director of Information Services
Arapahoe House, Inc.

This message is not legal advice or a binding signature.


-Original Message-
From: Klayer Geni [mailto:[EMAIL PROTECTED]] 
Sent: Monday, January 20, 2003 11:59 AM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: When to have the patient sign an authorization


As the need arises.  The authorization is only valid for 60 days.

-Original Message-
From:   [EMAIL PROTECTED] [SMTP:[EMAIL PROTECTED]]
Sent:   Monday, January 20, 2003 1:20 PM
To: WEDI SNIP Privacy Workgroup List
Subject:When to have the patient sign an authorization

How are providers in particular handling the singing of
authorizations? Are practices having patients sign it when they first come
in, for future disclosures, or as the specific situations arise (i.e., they
later decide their atty. should see the medical records and sign an
applicable authorization).

Thanks as always for your input.

Jill Rubin, Esq.
(617)388-2404
[EMAIL PROTECTED] ---
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Database at http://snip.wedi.org/tracking/.   These listservs should not be used for 
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RE: HIPAA privacy and people - comparison to 42 C.F.R. Part 2 (Al cohol and Drug Patient Privacy)

2003-01-20 Thread Darrell Rishel 
Matt-

I'll take a stab at answering your question. Please remember that in an
effort to keep it relatively brief, this is a fairly simplistic, high-level
overview.

Under 42 C.F.R. Part 2 (which I'll refer to as the AOD (Alcohol and Other
Drugs)regs), disclosure within a "program" is allowed on a need-to-know
basis  without the consent of the patient. This "internal" disclosure is
limited to "personnel having a need for the information in connection with
their duties which arise out of the provision of diagnosis, treatment, or
referral for treatment." In practice, I think this is very close to, if not
the same as, the HIPAA "use" definition. Although the AOD regs do not
require a formal minimum necessary analysis, the concept of only disclosing
the minimum amount of information necessary to accomplish the purpose for
making the disclosure is clearly embedded in the regs.

It is the disclosure to external entities where, especially with the
adoption of the August, 2002, HIPAA changes, a wide gap remains between the
two sets of regs. While HIPAA allows treatment providers to disclose PHI for
treatment and payment (even another provider's payment) without the
patient's written consent, the AOD regs absolutely prohibit such disclosures
related to payment, and disclosures for treatment (except for medical
emergencies) require that a written agreement be in place and that the
services which the external provider render be something different than what
the primary provider is providing. This written agreement is known in the
AOD regs as a Qualified Service Organization Agreement (QSOA, for short). A
QSOA is akin to a BA agreement, though much shorter and less complicated,
charachteristics which are, unfortunately, soon to be a thing of the past.
While a QSOA can be used in limited circumstances for treatment (the biggest
problem is that we cannot have one with another AOD provider), its most
common use is for operations, just as the HIPAA BA agreement will be used
(e.g., we have a QSOA with our auditor, or outside attorneys, the company
which prints and sends out our bills, the lab which analyzes the urine
specimens we collect, etc.). But, if we want to be able to bill an insurance
company or any other third party payer, we have to have the patient's
written consent (in fact, we cannot even call to get pre-authorization
without written consent; how's that for customer friendly?). If we want to
refer the patient to another health care provider, of whatever type, or
consult with another provider (like their primary care provider) who has
seen the patient, we must have the patient's written consent unless the
situation fits within the pretty narrow exception where a QSOA can be used
and we have (or can get) one in place (the logistics and pain of trying to
get a QSOA with all of those providers, which make doing so pretty
impracticle). The requirements in the AOD regs for a valid written consent
are very similar to those for a HIPAA authorization: who is disclosing the
information, to whom is the information being disclosed, what information is
being disclosed and why is it being disclosed, there must be a reasonble,
identifiable expiration date, the patient must be able to revoke the consent
at any time (one specific exception here for persons referred by an element
of the criminal justice system where treatment is a part of the
disposition), the name of the patient, the patient's signature and the date
of the signature.

The remaining situations where disclosure can be made without written
patient consent under the AOD regs are very limited. I'll list only a few of
the major differences between the HIPAA and AOD regs. There is no general
exception for "otherwise required by law." I've forgotten exactly when the
exception for allowing a child abuse report to be filed if required by state
law was added, sometime around 1990, I think, but that used to be quite a
problem and even now the exception is very limited. There are no exceptions
for reporting any other kind of abuse. The HIPAA "law enforcement"
exception. There are provisions for disclosure in response to a court order,
but it requires a very specific order after following very specific
procedures.

I hope this has been helpful. Let me know if you have any other questions.

Darrell Rishel, J.D. 
Director of Information Services 
Arapahoe House, Inc.

This message is not legal advice or a binding signature.



> -Original Message-----
> From: Matthew Rosenblum [mailto:[EMAIL PROTECTED]]
> Sent: Saturday, January 18, 2003 5:02 PM
> To: Darrell Rishel; 'WEDI SNIP Privacy Workgroup List'
> Subject: RE: HIPAA privacy and people
> 
> 
> Darrell,
> 
> Thank you for sharing your thoughts.  And now that you 
> brought it up, how
> would you compare the "42 CFR" consent with the (voluntary) 
> H

RE: HIPAA privacy and people

2003-01-18 Thread Darrell Rishel 
I really find many of these conversations entertaining (also frequently
enlightening and helpful). "Unworkable?" Hardly. Most of you appear to not
realize how lucky you are! Nor does it appear that you give yourselves much
credit for being creative and resourceful. I work for an alcohol and drug
abuse treatment provider. We in this field have successfully operated under
what is, generally, a more demanding set of patient privacy rules (42 C.F.R.
Part 2, not to mention state mental health statutes, which are also usually
very strict)than those found in HIPAA. E.g., unlike "regular" health care
providers, we have to have the patient's written authorization to talk to
another treatment provider, not to mention just about everyone else,
including payers. If we can successfully operate in our environment, you can
successfully operate in the HIPAA environment! Will you have to change some
of your current business practices? Yes. Will you frequently find the rules
to be a pain in the neck (not to mention other parts of your anatomy)?
Certainly. Is compliance an impossible task? No. Will it cost you some
money, not only to implement, but to abide by in the future? Probably. Are
all of these new rules, which are intended to benefit patients in terms of
protecting their privacy, going to be otherwise beneficial to them? No. Some
of the burden of complying with these rules is going to make it harder for
patients, too. These rules are not necessarily "customer friendly." The
patients are going to have to make some changes and part of our
responsibility will be to educate and help them. No doubt we will frequently
be blamed for the inconvenience, but what's new? As with any other set of
government statutes and regulations which I have ever read, there are
ambiguities, if not worse defects. It will take time, and perhaps additional
rule-making, to sort everything out (if we ever get to that point, which may
never happen in such a complex area with so many legitimate, competing
private and public interests). I suggest, however, that it would be more
productive to spend time looking for solutions to the challenges presented
rather than bemoaning our fate. Pin numbers? I think that may be a very
workable concept for some settings. I've been telephoning my bank for years
(mostly I do it on-line now) and putting in a pin number and my account code
to access my bank account. Let's get on with it!

Darrell Rishel, J.D. 
Director of Information Services 
Arapahoe House, Inc.

This message is not legal advice or a binding signature.
 

> -Original Message-
> From: fwdanby [mailto:[EMAIL PROTECTED]]
> Sent: Friday, January 17, 2003 5:01 PM
> To: WEDI SNIP Privacy Workgroup List
> Cc: WEDI SNIP Privacy Workgroup List
> Subject: Re: HIPAA privacy and people
> 
> 
> With the same due respect, and I, too, mean it sincerely, the word
> 'unworkable' is very tempting to apply to the whole HIPAA 
> scenario where
> there is an interface with patients.
> Take a look at what all you very bright and well-intentioned 
> folks have been
> posting over the past several months. This is a high level of 
> confusion
> among intelligent people. Now translate that to the 
> undeniable fact that
> half the people in the real world are below average 
> intelligence (IQ < 100)
> and the world we physicians live and work in is populated by 
> patients who,
> through no fault of their own, exhibit an even higher 
> percentage of room
> temperature IQs.
> Sure, we will get some of the people complying some of the 
> time, but all of
> the people all of the time is, in a word, unworkable.
> To have us exposed to legal liability in this situation is, 
> in another word,
> unfair.


> I believe we providers should demand an umbrella of some sort 
> to protect us
> from unwarranted, arbitrary, over-zealous enforcement of an 
> essentially
> unworkable set of regulations.
> I'd love to hear other opinions on this - here if you think 
> it warranted,
> privately if you think otherwise.
> FWDanby, MD [EMAIL PROTECTED]
> 
> - Original Message -
> From: "Benjamin W. Tartaglia" <[EMAIL PROTECTED]>
> To: "WEDI SNIP Privacy Workgroup List" <[EMAIL PROTECTED]>
> Sent: Friday, January 17, 2003 12:17 PM
> Subject: RE: HIPAA privacy and telephone
> 
> 
> > With all due respect, and I mean it sincerely.
> >
> > Good idea for privacy Based on my many years of management
> > engineering and the application of voice, data and image
> telecommunications
> > systems in healthcare as an employee and later as a 
> consultant I suggest
> it
> > is unworkable. (really long and ill structured sentence).
> >
> > The major premise is "When the patient

RE: More questions on Business Associate

2003-01-12 Thread Darrell Rishel 
Matt,
 
I agree that two CEs who are sharing PHI for the purposes of treattment do
not need a BA agreement, which is why I included the statement that you must
consider who is doing "what" for whom. If the "what" is treatment services,
then a BA agreement is not necessary. The specific examples which I was
addressing, however, involved a Clearinghouse providing data translation
services for a CE  who was a provider. Clearly, in that situation, a BA
agreement is required, even though both entities are CEs, unless they fell
into the exception where a CE provides a service to an Organized Health Care
Arrangement in which it participates.
 
Darrell Rishel, J.D.
Direction of Information Services
Arapahoe House, Inc.
 
This message is not legal advice.

-Original Message-
From: Matthew Rosenblum [mailto:[EMAIL PROTECTED]]
Sent: Thursday, January 09, 2003 9:50 PM
To: 'WEDI SNIP Privacy Workgroup List'; Darrell Rishel
Subject: RE: More questions on Business Associate



Darrell,

 

I respectfully disagree.

 

Under HIPAA, a BAC is NOT required between two or more health care providers
disclose PHI to each other for the purpose of treating a patient.  And while
the Privacy rules do say that a CE may act in the capacity of a BA (as in
the scenario that I described below related to a physician providing "peer
review" services), when two entities are engaged in sharing PHI (as CEs) no
BAC would be required.

 

I hope that this helps.

 

Your questions are always welcome.

 

Matt

 

Matthew Rosenblum

Chief Operations Officer

Privacy, Quality Management & Regulatory Affairs

http://www.CPIdirections.com <http://www.cpidirections.com/> 

 

CPI Directions, Inc.

10 West 15th Street, Suite 1922

New York, NY 10011

 

(212) 675-6367

[EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> 

 

CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the
individual or entity to which it is addressed and may contain information
that is privileged, confidential and exempt from disclosure under applicable
law. If you have received this communication in error, please do not
distribute it.  Please notify the sender by E-Mail at the address shown and
delete the original message. Thank you.

 

AVISO DEL CONFIDENCIALIDAD: Este email es solamente para el uso del
individuo o la entidad a la cual se dirige y puede contener información
privilegiada, confidencial y exenta de acceso bajo la ley aplicable. Si
usted ha recibido esta comunicación por error, por favor no lo distribuya.
Favor notificar al remitente del E-Mail a la dirección mostrada y elimine el
mensaje original. Gracias.

 

-Original Message-
From: Darrell Rishel [mailto:[EMAIL PROTECTED]] 
Sent: Thursday, January 09, 2003 2:21 PM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: More questions on Business Associate

 

In both cases a BA would be required. In your example, the clearinghouse is
providing "a function or activity regulated by HIPAA" (formatting the data
to be compliant with HIPAA) for both the provider and the health plan. The
regulations clearly state that the relationship between two covered entities
may require a BA. The key concept to keep in mind is not what kinds of
entities are involved, but the relationship between the entities in terms of
who is doing what for whom.

 

Darrell Rishel, J.D.

-Original Message-
From: Ken Steen [mailto:[EMAIL PROTECTED]] 
Sent: Thursday, January 09, 2003 8:28 AM
To: WEDI SNIP Privacy Workgroup List
Subject: Re: More questions on Business Associate

What about providers sending data to clearinghouses.  Or payers sending data
to clearinghouses, who reformat the data and send in a proprietary format to
the provider.  Do they require a BA contract anywhere along the line?

 

Ken Steen

Apollo

 

- Original Message - 

From: Matthew  <mailto:[EMAIL PROTECTED]> Rosenblum 

To: WEDI SNIP Privacy Workgroup  <mailto:[EMAIL PROTECTED]> List 

Sent: Wednesday, January 08, 2003 10:51 PM

Subject: RE: More questions on Business Associate

 

Andy,

 

In most instances, when PHI is shared between CEs, no BA relationship
exists, and no BA contract would be required.  For example, when a CE
(provider) discloses PHI to another provider for the purpose of treating a
patient, no BA relationship exists, and consequently, no BA contract would
be needed.  Further, when a CE (provider) discloses PHI to a health plan for
the purpose of payment activities, no BA relationship exists, and
consequently no BA contract is required.

 

Generally, BA contracts are only required by HIPAA when a CE discloses PHI
for the purpose of a 2nd entity using the PHI on behalf of the CE to help
the CE perform a payment activity or health care operation (i.e.,
non-treatment activities that include a litany of HIPAA specified functions
such as accounting, legal, consulting, etc.)  For example, if a hospital
discloses PHI to an IT vendor, a

RE: Consulting fees

2003-01-10 Thread Darrell Rishel 
If this rose to the level of working (conspiring) together to limit how much
was being paid, perhaps. Sharing some information about what you are paying,
no.

Darrell Rishel, J.D.
Director of Information Services
Arapahoe House, Inc.

This message is not legal advice or a binding signature.


-Original Message-
From: Gerald E. DeLoss [mailto:[EMAIL PROTECTED]] 
Sent: Friday, January 10, 2003 7:37 AM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: Consulting fees


I'm no antitrust expert, but there might be antitrust problems with this. If
anyone else out there has a different opinion, please let me know.

Jud DeLoss

-Original Message-
From: Debby Bartow [mailto:[EMAIL PROTECTED]]
Sent: Friday, January 10, 2003 9:35 AM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: Consulting fees


I would be very interested in the answer to this question as well.

Debby Bartow
Tobin & Associates, Inc.
www.TobinIT.com
[EMAIL PROTECTED]
585.586.2103 x3040

-Original Message-
From: Rebekah Savoie [mailto:[EMAIL PROTECTED]] 
Sent: Thursday, January 09, 2003 8:37 PM
To: WEDI SNIP Privacy Workgroup List
Subject: Consulting fees

What are HIPAA consultants charging these days

I need something to compare to

---
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You are

RE: HIPAA-related privacy question (I think)

2002-10-22 Thread Darrell Rishel 
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While an important issue, I think it is an entirely inappropriate one for
posting to this workgroup. Let's focus on privacy under HIPAA. Since this is
not a moderated listserve, it is incumbent on each of us to exercise some
restraint.

Darrell Rishel, J.D.
Director of Information Services
Arapahoe House, Inc.

-Original Message-
From: David Frenkel [mailto:gefeg@;att.net]
Sent: Tuesday, October 22, 2002 11:20 PM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: HIPAA-related privacy question (I think)


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F.W.,
You might be interested in this from Tuesdays AHA email news.

Regards,

David Frenkel
Business Development
GEFEG USA
Global Leader in Ecommerce Tools
www.gefeg.com
425-260-5030

Hospital groups launch congressional pledge campaign
Eight national hospital groups, including the AHA, today launched a
nationwide campaign to get federal legislators on record as supporting
substantial hospital payment relief and opposing adjournment of the
107th Congress until such relief is enacted. Pointing out that the
Senate and the House recessed to prepare for the Nov. 5 elections
without completing action on a hospital provider payment relief package,
even though there is significant Capitol Hill support for such action
and the House earlier passed relief legislation, the groups in a joint
Grassroots Alert called on hospital leaders to ask their senators and
representatives to sign a pledge titled "My Commitment to My Community's
Hospitals" while legislators are on the campaign trail. The pledge
states, in part, "Hospitals in my community, and hospitals all across
America, require immediate federal relief in order to continue to
provide the high-quality health care services their patients and
communities need Therefore, Congress should not vote to adjourn
until we have passed and the President has signed legislation providing
substantial Medicare and Medicaid provider payment improvements -- at
least at the level included in H.R. 4954 or S. 3018 -- for America's
hospital and the patients they serve." Included with the pledge is a
return fax number, so that the pledges can be delivered to President
Bush and House or Senate leaders. Joining in the effort are AHA, the
Association of American Medical Colleges, the Catholic Health
Association of the United States, the Federation of American Hospitals,
the National Association of Children's Hospitals, the National
Association of Public Hospitals and Health Systems, Premier and VHA.
State, regional and metropolitan hospital associations also are working
closely with the national associations on the campaign. The pledge was
provided to all hospitals in the country.


-Original Message-
From: fwdanby [mailto:fwdanby@;grolen.com] 
Sent: Tuesday, October 22, 2002 3:12 PM
To: WEDI SNIP Privacy Workgroup List
Subject: Re: HIPAA-related privacy question (I think)

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KERBER, JEFF" <[EMAIL PROTECTED]> Wrote:
> Many providers are thinking that if they go paper only, they can get
around
> HIPAA... Only problem is, the federal programs are going to require
> electronic submission. At that time, the provider either opts out of
> MediCxxx programs to avoid complying with HIPAA or face becoming
compliant.

If the current worsening trend in MediCxxx reimbursement continues, the
enforcement of electronic submission will be an added stimulus to cease
to
be a participant in these programs. Have any of you pointed this out to
AARP?
F. W. Danby, MD


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