I believe that leaving the "message" (in your scenario, below) would be a 
HIPAA-sanctioned disclosure if the nurse has evidence that the spouse is:

The Personal Representative of the subject of the PHI, or
Participating in the patient's treatment

Otherwise, probably not.  Further, a CE may not "opt-out" of HIPAA by announcing in 
the NPP that it will "on occasion" engage in disclosures precluded by HIPAA.
I hope that this helps.
Your questions are always welcome.
Matthew Rosenblum
Chief Operations Officer
Privacy, Quality Management & Regulatory Affairs
CPI Directions, Inc.
10 West 15th Street, Suite 1922
New York, NY 10011
(212) 675-6367
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-----Original Message-----
Sent: Thursday, January 16, 2003 5:04 PM
To: WEDI SNIP Privacy Workgroup List
Subject: HIPAA privacy and telephone

I would like the lists opinion on this topic.

Patient comes to the office to have their potassium checked because they are on a 
diuretic.  Later, the physician's nurse calls the patient at home with results but the 
patient is not home.  Spouse answers the phone.  Can you tell the spouse that the 
potassium was fine and that he/she should tell the spouse to continue the same dose of 
diuretic and potassium supplement?  If you say "no, this type of disclosure is not 
allowed", would it matter that we put a statment in our Notice of Privacy Practices 
that stated  (in the section on Payment, treatment and  health care operations) "On 
occasion, we call test results to your home and leave the results with a family member 
if you are not present".  Now, obviously, we would not do this with a HIV result but 
it seems like such a waste of everyone's time to play phone tag to accommodate the one 
patient in a million that is actually upset because you told the spouse what the 
potassium result was.  Thank you.

Rich Fairley, 
Dubuque, IA




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