Jim, The part of the rule you quoted comes from section 164.510(a) and concerns disclosures for facility directories.
Look at section 164.510(b), specifically, sub-paragraph 164.510(b)(1)(i). It says you may disclose "the protected health information directly relevant to such person's involvement with the individual's care or payment related to the individual's health care". So if John Smith's grandson is involved in helping his grandfather take his meds, then I interpret the rule to say you can tell the grandson what meds he is supposed to be taking. While I'm at it though, I would like to correct an error I did make in my previous response. Dave Ermer correctly pointed out to me that the rule says the individual only has to identify "other individuals" involved in their care, and not family members. In other words, according to the rule the individual has to specify if their next door neighbor (who is not related to them) is involved in their care, but they do not have to specify which family members are involved. The provider is authorized to make disclosures to ANY family member that is involved in the individual's care. Although I may have misrepresented what the rule says, as I wrote to Dave, I stand by my earlier recommendation that you ask the individual to identify which family members are involved in their care. Even though it is not required by the law I think it is prudent. Keep in mind that these disclosures to family members are specifically exempt from the requirement to verify identity under section 164.514(h). That means you are permitted to disclose the relevant PHI to anyone who calls a doctor and CLAIMS to be a family member involved in a patient's care. Furthermore, I am not aware of a definition in the rule for the term "family member". Are cousins, uncles, aunts, second cousins, in-laws, included? I think there is too much potential to make a disclosure that will wind up getting you in trouble. As long as you have to ask the individual if they agree or object to these types of disclosures, you might as well ask them to identify exactly which family members they want to include. Thanks, Noel -- Open WebMail Project (http://openwebmail.org) ---------- Original Message ----------- From: "James Kelly" <[EMAIL PROTECTED]> To: "WEDI SNIP Privacy Workgroup List" <[EMAIL PROTECTED]> Sent: Wed, 19 Feb 2003 22:26:04 -0500 Subject: RE: "family" phone calls > Noel, > > I must respectfully disagree with what you said: > > "So if someone calls, claiming to be John Smith's grandson and > wanting to know what medication his grandfather should be taking, as > long as John Smith has received your NPP, has not objected to such > disclosure, and has identified his grandson as someone involved in > his care, you can disclose to the caller without doing anything to verify > that he really is John Smith's grandson." > > Section 164.510b deals with a directory and specifically states "(C) > The individual's condition described in general terms that does not > communicate specific medical information about the individual". > > So if someone claiming to be John Smiths grandson calls and asks if his > gransfather is there and what is his general condition, you may release > that. Anything more than that and I think you must verify to whom > you are disclosing PHI as required in section 164.514h. > > Anyone disagree? > > Jim Kelly > TPA Computer Corp. > > -----Original Message----- > From: Noel Chang [mailto:[EMAIL PROTECTED]] > Sent: Wednesday, February 19, 2003 5:14 PM > To: WEDI SNIP Privacy Workgroup List > Subject: Re: "family" phone calls > > Traci, > > These types of disclosures are specifically addressed in section > 164.510(b). > The disclosures do have to be limited to family or friends > IDENTIFIED BY THE INDIVDUAL. > > You are required to inform the individual in advance if you are > going to make such disclosures and give them an opportunity to > object. The Rule does not specify how you inform the individual. I > would suggest that if you identify that you may make such > disclosures in your NPP, then that is adequate advance notice. You > also have give them the opportunity to agree or object to such > disclsoures so beyond giving them the NPP you should be asking them > specifically if they object to this practice. While you are at it, > I would ask them to identify exactly who they consider to be > "involved in their care" and authorized to receive such disclosures. > > If you do all this, then you are going to have to come up with a system > to > document that the person was informed (but this could be satisfied by > knowing > they received the NPP, as noted earlier), whether they agreed or > objected to > such disclosures, and who they have identified as involved in their care > and > authorized to receive PHI relevant to their involvement. > > A final footnote, these types of disclosures are specifically exempt > from the > requirements of section 164.514(h) to verify a person's identity and > authority to receive PHI. So if someone calls, claiming to be John > Smith's > grandson and wanting to know what medication his grandfather should > be taking, as long as John Smith has received your NPP, has not > objected to such disclosure, and has identified his grandson as > someone involved in his care, you can disclose to the caller without > doing anything to verify that he really is John Smith's grandson. > > Good Luck, > > Noel Chang > > PS - Your code word idea is interesting, even though you are not > required to > verify the identity of people requesting 164.510 disclosures. If you > decide > to implement such a system anyway, I don't know that I would use the > same > word for all patients. If I knew the code word for a given month > then I > > could get information about all of your patients over the phone, not > just the > one I am involved with. > > -- > Open WebMail Project (http://openwebmail.org) > > ---------- Original Message ----------- > From: "Traci Winter" <[EMAIL PROTECTED]> > To: "WEDI SNIP Privacy Workgroup List" <[EMAIL PROTECTED]> > Sent: Wed, 19 Feb 2003 09:43:49 -0500 > Subject: "family" phone calls > > > Here we go again... the post committee meeting question. > > > > Our home care agency frequently receives phone calls from patients > > families and/or caregivers wanting an update on how the patient is > > doing. Quite often the phone call is a result of a patient's MD > > appointment and the patient not being able to recall what the doctor > > has told them. (Our patients are usually elderly) The family members > > know it is quicker and easier to call our agency and speak to the > > Case Manager or a Nursing Supervisor rather than to call the > > doctor's office. > > > > Our debate is this: > > How should the nurses receiving these calls handle them? > > Do they release info to only a POA, health care proxy, designated > > emergency contact, and/or primary caregiver? Do they not give any > > information, directing them to talk to their family member..who's > > lack of recall triggered their call? > > > > Our initial proposal is to provide the patient with a "code" word > > for a caller to use when contacting our office so we have some > > indication that they are calling with the patient's > > knowledge/permission. We discussed setting up a code word of the > > month list so all patients admitted within that month would have the > > same code word. The other thought is if they don't have a request > > for restriction then we are ok to release info to family members or > > caregivers. (I don't see releases/disclosures such as these covered > > under TPO but am willing to consider other peoples impressions. > > > > Thanks, > > Traci Winter > > Hospitals Home Health Care, Inc. > > > > --- > > 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 > ------- End of Original Message ------- > > --- > 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 leave-wedi- > [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 ------- End of Original Message ------- --- 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
