RE: Here is a good Privacy Issue that will cause problems

[Matthew Rosenblum]

Tim,   I must respectfullly disagree with your fundamental analysis of this scenario.� Pharmacists (chemists) have, for more than 2000 years, been part of a triad (including physicians and nurses) engaged in an on-going clinical (NOT business) practice of ensuring that the correct medications and drugs are received by the correct patients.� Whenever we remove one of those clinical disciplines from the decision-making process, medication errors and mistakes are likely to increase.   It is NOT the intention of HIPAA to deter a good clinical practice.� Unfortunately, when unscupulous people get hold of blank-prescriptions, innocent people may get hurt.� Under HIPAA, our responsibility then becomes mitigation of the harm.   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   CPI Directions, Inc. 10 West 15th Street, Suite 1922 New York, NY 10011   (212) 675-6367 [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 informaci�n privilegiada, confidencial y exenta de acceso bajo la ley aplicable. Si usted ha recibido esta comunicaci�n por error, por favor no lo distribuya.� Favor notificar al remitente del E-Mail a la direcci�n mostrada y elimine el mensaje original. Gracias.   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] Sent: Thursday, January 16, 2003 6:00 PM To: WEDI SNIP Privacy Workgroup List Subject: RE: Here is a good Privacy Issue that will cause problems   In my personal opinion, this practice - violating patient privacy, in the name of detecting abuse by private businesses - which is (it appears to me) unsupported by statute (unless mandated by DEA regulation) - is contrary to both many state laws and HIPAA.  I agree the practice serves a valuable community need, as well as the needs of the abusing patient (intervention).  However, as it (as I see it) is NOT a law enforcement reporting issue, but rather a "home grown" solution, that business simply do out of common sense, the practice will either have to be suspended, with suspects reported to law enforcement - cutting out the Sherlock Holms detection engaged in by pharmacists in the process - or get a state statute passed to support and require the activity.  After all, it appears to me that what is really occurring here is abuse of privacy, and potentially serious defamation, and that a case might be made for damages if a person is placed on these distribution lists wrongly.  However, as I am not an attorney I can not pass on a formal opinion.  Just keep in mind that a person DOES NOT LOOSE ANY RIGHTS just because a pharmacist suspects abuse!!!  It is up to statutory law enforcement of investigate, and a court to determine if a crime has been committed, NOT A CE, regardless of their practices.  I am frankly amazed that we have not heard more litigation on this issue.   Regards,   Tim McGuinness, Ph.D. Consulting Specialist in Regulatory Privacy, Security, and Application Compliance HIPAA/FDA/CMS-HCFA/ICH/ADA & Section 508/DITSCAP/NIACAP/ISO17799/BS7799/NIST 800 C&A  Specialist in Local Government Compliance  www.localgovernmentcompliance.com [EMAIL PROTECTED] /  www.timmcguinness.com / www.HIPAAhelpNETWORK.com / www.McGuinnessDesigns.com Executive Co-Chairman for Privacy, HIPAA Conformance Certification Organization (HCCO) www.hcco.us __________________________________________________________________ Office: 727-787-9801 Cell: 305-753-4149 / 240-525-1149 Email: [EMAIL PROTECTED] - MSN Instant Messenger: [EMAIL PROTECTED] (do not send email to hotmail account) __________________________________________________________________   =========================================================================== IMPORTANT LEGAL NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, please notify the sender at once, and you should delete this message and are hereby notified that any disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature. HIPAA NOTICE:  It is acknowledged that HIPAA, ASCA, and other regulations and statutes are law, and that all interpretation of law should involve licensed attorneys in good standing with their local Bar Association. The forgoing is provided for educational or discussion purposes only. The author accepts no responsibility for its accuracy, review, distribution, or use in any way. You assume responsibility for understanding this material and its applicability and/or use. The above may need to be interpreted by your attorney as needed to conform with federal or state law - you’re use of this information must always be reviewed and approved by your own attorney prior to use, application, or implementation. -----Original Message----- From: Drexler, Deborah (EHS) [mailto:[EMAIL PROTECTED]] Sent: Thursday, January 16, 2003 3:16 PM To: WEDI SNIP Privacy Workgroup List Subject: RE: Here is a good Privacy Issue that will cause problems It's sounds logical that a person loses privacy rights when they break the law.  But I'm not sure the assertion is supported by the language of the rule.  Certainly, there is an exception for disclosures to law enforcement, but this exists whether or not the person broke the law.  And inmates have fewer privacy rights, but you could break the law without actually getting incarcerated.  But other than that, I think your assumption is incorrect.  Perhaps I'm missing something?         -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] Sent: Thursday, January 16, 2003 3:05 PM To: WEDI SNIP Privacy Workgroup List Subject: Re: Here is a good Privacy Issue that will cause problems Yes and no. First, they are breaking the law when they doctor-shop for narcotics. Secondly, who is responsible for report this to law enforcement? The question comes up, how did you know the individual went to different pharmacies? were you told by the same chain of pharmacies? Usually it will be tracked by the PBM when multiple pharmacies are being used. That's why our organization wants to control narcotics OTC. Oxeycontin is usually a long term medication for severe pain and should be provided mail (where there are systems in place to catch this kind of misuse). It is a red flag when narcotics are being prescribe OTC.  With regard to what should happen; the PBM should write letters to all physicians that prescribe this narcotic to the individual in question, making them aware of the manufacturers protocol and the total number of pills being prescribed -- this is done as a matter of post utilization review for OTC drugs. The question is who has the responsibility to report this to the authorities? I believe under your scenario, the individual has lost the right to privacy once they break the law. Please correct me if I am wrong in my assumptions. Thanks, Robert Robert Blinch-Edwards Executive Director Healthcare Sarasota, Inc. 1991 Main Street, Suite 148 Sarasota, FL 34236 Tel: 941-917-7995 Fax: 941-917-1930 email: [EMAIL PROTECTED] Web: www.hcsrq.com In a message dated 1/15/2003 3:43:15 PM Central Standard Time, [EMAIL PROTECTED] writes: Subj: Here is a good Privacy Issue that will cause problems Date: 1/15/2003 3:43:15 PM Central Standard Time From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent from the Internet Today, a clinic that I work with received a letter from a local pharmacy about a patient that was a "Drug Seeker" as we call them.  Over the course of 30 days he had been to several doctors and several pharmacies and received over 350 total pills all a controlled substance. What happens to the pharmacy's ability to do these types of things under Privacy?  Clearly, pharmacist were communicated information back and forth to each other and to physicians on this person.  They even sent letters to all physicians in the area. Problem? yes or no Rebekah Savoie, CCS-P Healthcare Consultant --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI 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 vendor products and services.  They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org Confidentiality Note: The information contained in this email message is legally privileged and confidential, intended only for the use of the individual or entity named above. If the reader of this email message is not the intended recipient, you are hereby notified that any dissemination, distribution, or copy of this email message is strictly prohibited. Robert Blinch-Edwards Executive Director Healthcare Sarasota, Inc. 1991 Main Street, Suite 148 Sarasota, FL 34236 Tel: 941-917-7995 Fax: 941-917-1930 email: [EMAIL PROTECTED] Web: www.hcsrq.com --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI 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 vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI 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 vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI 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 vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI 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 vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: archive@mail-archive.com To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org