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One further thought on Noel's ideas.
If there is a requirement that each member of an OHCA have its
own Privacy Officer, I don't believe that this Privacy Officer has to be a
unique individual for each member, so that the same person could be the Privacy
Officer for the group. I think that this person could even be paid by the
OHCA (it may have to be arranged as each member hiring the services of an
outside contractor).
The opinions expressed here are my own and not necessarily the opinion of
LCMH.
Douglas M. Webb Computer System Engineer Little Company of Mary
Hospital & Health Care Centers [EMAIL PROTECTED]
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----- Original Message -----
Sent: Friday, March 07, 2003 12:48
PM
Subject: Re: OCHA Answer and Disclosure
Question
I like your answer since it confirms some of my thoughts.
We joined the OHCA just to make sure there would be no problems with
credentialing, peer review, etc. We also thought sharing the NPP and
policies would be a nice gesture to our medical staff so we would carry the
burden of getting all of the paperwork done and then they could just modify it
to meet their needs instead of creating it all from scratch. Downsides
to OHCA......hm....hope there's not too many, but maybe it makes the hospital
more liable when a physician violates the NPP or HIPAA in
general?
>>> "Noel Chang" <[EMAIL PROTECTED]> 03/07/03
12:17PM >>>
Here are my thought on OHCA's but they are just
that. I have no experience
with OHCA's and would love for someone to
tell me if they agree or disagree.
I would only ask that you please
cite the applicable section of the rule,
preamble, or guidance document
that supports your position:
The only places I can find OHCA's even
mentioned in the rule, other than the
definition of an OHCA
are:
Section 164.520(d) says participants in an OHCA can have a
joint notice and
distribution by one member of the OHCA is sufficient to
fulfill the
distribution requirements of all members of the
OHCA
Section 164.506(c)(5) says members of an OHCA can exchange PHI for
ANY health
care operations, instead of the more limited health care
operations allowed
under section 164.506(c)(4).
Is anyone aware of
any other references to OHCA's in the rule?
Applying these two
citations to the questions in this thread, including the
original ones
asked by Patricia Conroe, here are my thoughts:
Do requests to exercise
patient rights submitted to one member of an OHCA
apply to all? I
would say no. I cannot find any citation in the sections on
patients
rights to support otherwise. Except if a patient amends their PHI a
covered entity must inform other affected by the amendment which I think
would naturally include any other memebers of an OHCA that the CE
participates in. But with regard to rights such as restrictions on
U&D or
alternate communications, I believe the individual would have
to submit the
same request separately to each member of the
OHCA.
Aren't we already allowed to disclose PHI to other CE's in our
OHCA under the
rule that allows disclosure for TPO? Yes but with
some limitation. The rule
allows disclosure of PHI by a CE for their
OWN TPO, which under section
164.506(c) is extended to include treatment
of OTHER providers, payment of
OTHER providers, and only CERTAIN
operations of OTHER covered entities as
limited by section
164.506(c)(4)(i) and (ii). By participating in an OHCA
you will get
the added benefit of being able to share PHI with other members
of the
OHCA for ANY health care operations purposes.
Does each member of the
OHCA have to identify their own Privacy Official and
Contact Official in
the NPP? I do not see any provision that allows OHCA's
to share
these roles so I assume each member of the OHCA needs to have their
own,
and therefore any joint Notice prepared for the OHCA would have to
identify the Privacy Official and Contact Official for EACH member of the
OHCA.
The bottom line of all this is that the only real benefit I
see in joining an
OHCA is it may simplify distributino of your NPP.
For example, I have a
client who is an interventional cardiologist.
Aside from seeing patients in
his office he also performs procedures at a
local hospital. The hospital
checks in the patient, provides the
nursing staff, etc, so I believe the
procedures he performs at the
hospital would qualify as delivery of care in
a "clinically integrated
setting" therefore his practice could form an OHCA
with the
hospital. The only benefit I see in doing this is from time to time
he is called by the hospital to come see a patient he has not previously
seen
in his office. If he were not in an OHCA with the hospital, he
would have to
carry around a bunch of copies of his NPP and acknowledgment
forms so he
could hand them out to the patient when he sees them (assuming
he is not in
an emergency situation, and assuming he is not just
consulting as a provider
with an "indirect" treatment relationship).
By being in the OHCA he is
relieved of the responsibility to deliver
notice assuming the hospital has
already done so.
If anyone else
can explain any other benefits of joining an OHCA I'd love to
know what
they are?
I'd also like to know what people perceive to be the down
side(s) of joining
an OHCA?
Thanks,
Noel
Chang
--
Open WebMail Project (http://openwebmail.org)
----------
Original Message -----------
From: Kathy Findley <[EMAIL PROTECTED]>
To:
"WEDI SNIP Privacy Workgroup List" <[EMAIL PROTECTED]>
Sent:
Wed, 5 Mar 2003 10:30:16 -0500
Subject: OCHA Answer and Disclosure
Question
> Hello All!
> Recently I asked a question about
members of an Organized Health Care
> Agreement and the issue of naming
their Privacy Officer or Contact
> Person in a "joint" Notice of
Privacy Practices? Further reading has
> indicated that each entity
would have to have their own Privacy
> Officer, conduct their own
training etc. (unless mutually agreed
> upon etc.) If anyone disagrees,
please let me know.
>
> Does anyone have any thoughts about the
following scenerio?
>
> Several hospitals in this area are
partial owners of a centralized "lab".
> The Infection Control
departments of all of these hospitals are requesting
> from the lab, a
regular listing of patients who test positive for
> VRE and MRSA
(whether those patients are currently in their
> hospital
or not). Is it allowable for the lab to provide these
> lists to
their "owner" hospitals as part of treatment or some other
> law, or
would the minimum necessary apply limiting that release to
> only the
hospitals who have the patient at this time?
>
> Thank you for
any advice.
> kf
>
> Kathy Findley
> Coordinator -
Information Services and HIPAA
> St. Joseph's Hospital Health
Center
> Phone - (315) 448-6111
> Beeper - (315) 467-4180
>
Text Page - [EMAIL PROTECTED]
>
> ---
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