[Med-privacy] Phil Inquirer: March 8: Doctors, patients grapple with specifics of privacy rule
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DPeelMD@aol.com
Wed, 30 Mar 2005 01:15:23 EST
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Posted on Tue, Mar. 08, 2005
Doctors, patients grapple with specifics of privacy rule
By Virginia A. Smith and Dawn Fallik
Inquirer Staff Writers
Howard Miller's office is primed for privacy. The computers have plastic
shields to ward off prying eyes. The patient files are coded by number, not
name. The files hanging outside the examining rooms face inward to hide names
and ages.
But sometimes Miller, a Center City internist, thinks privacy protections
have gone too far.
"I have this one huge Italian extended family I've been treating for years,"
he said. "One of them got sick and they were all calling to ask questions.
And I couldn't say anything to them because they weren't on the list of
contacts the patient had approved."
That's the only way Miller can comply with the patient-privacy rule of the
federal Health Insurance Portability and Accountability Act of 1996, better
known as HIPAA. The law profoundly changed how doctors talk to and about
patients, as well as how patients themselves negotiate the health-care system.
But two years after the privacy rule took effect, there is still widespread
confusion about who can give what medical information to whom and grumbling
about bureaucracy and weak enforcement. There is an even deeper debate: Does
the law protect or undermine patient privacy?
Tomorrow, that debate will be heard by the U.S. Court of Appeals for the
Third Circuit in Philadelphia.
The Clinton administration required a patient's written permission to
release confidential information for "routine purposes," such as treatment and
payment. The Bush administration made consent optional. Now, patients simply
sign a basic "notice of privacy practices."
In April, U.S. District Judge Mary A. McLaughlin in Philadelphia ruled that
the new provisions did not violate patient privacy and that the government
had no legal responsibility to "act affirmatively to protect such rights." Fede
ral officials also said it would be too cumbersome to get consent every time
an insurance company or medical specialist needed patient data.
Deborah Peel, for one, was appalled by the ruling.
"You can have your information disclosed for 'routine purposes' with no
consent, no notice, no recourse. Excuse us, you have just eliminated a
fundamental constitutional right," said Peel, a psychiatrist in Austin, Texas, and a
plaintiff in the case with Citizens for Health, a patient advocacy group, and
others.
Without a privacy guarantee, patients might withhold crucial information
from doctors, fearing it could be used against them by bosses, banks and
others.
"The joke is that soon you're going to call Domino's Pizza and they're going
to know that they can't send the extra cheese because you've got high
cholesterol," said plaintiff Janis G. Chester, who teaches psychiatry at Thomas
Jefferson University.
The federal Health Insurance Portability and Accountability Act, which grew
out of President Clinton's failed effort to revamp health care, was designed
to reduce fraud and prevent people from losing insurance when they leave
jobs. But the privacy rule soon became the most talked about part of the law.
It required written consent to release test results, diagnoses and other
information to doctors, dentists, hospitals, HMOs, group health plans, insurance
companies, billing companies and others. The rule also gave patients access
to their records and the right to find out when and to whom they have been
disclosed.
In the long term, HIPAA was supposed to simplify electronic health records,
which would save money. In the short term, however, it has created
inconsistencies from one institution to another and cost millions for training and
paperwork, lawyers and compliance officers.
Laurinda B. Harman, head of Temple University's department of health
information management, jokes that HIPAA stands for Huge Increase in Paperwork and
Aggravation Act. "Is it hard to comply?" she asked. "No, but it's one more
form."
Richard Campanelli, director of the federal Office of Civil Rights, which
oversees HIPAA, believes the privacy rule has done exactly what it set out to
do: give medical consumers power over their records. While acknowledging
confusion early on, he said that most patients and providers now understand the
boundaries of the law.
"People are very sensitive to their rights and they know that they have
these rights," he said.
Of the 10,785 HIPAA complaints received by the agency, more than 60 percent
have been resolved without penalties and 38 percent remain under
investigation. Critics note only 170 were referred to the U.S. Department of Justice for
criminal investigation - and not a single civil penalty has been issued.
Kate O'Brien, 24, of Lindenwold, N.J., believes the law has only
complicated matters for consumers. A program specialist for the Association for
Retarded Citizens in Camden, she was told HIPAA would not permit her to get her
medical test result over the phone.
"I had to drive all the way over from Pennsauken to Voorhees to pick it
up," she said. "Was it really necessary?"
The truth is: no. Doctors, with patient approval, can release information
over the phone.
The act also has made it hard for some agencies to help those in their
care.
Joe Young, deputy director of New Jersey Protection and Advocacy Inc., a
medical advocacy group in Trenton, said that psychiatric hospitals sometimes
refuse to contact family members when his mentally ill clients are in crisis -
and cannot remember their medical history.
"It's wrong to freeze out family members who may be able to provide
assistance," he said.
Still, many doctors acknowledge HIPAA has had some positive effects.
"It's created a new sort of awareness in the office, even in the idle
chatter between physicians and the nursing staff," said urologist Al Ruenes of
Central Bucks Urology in Warminster and Doylestown.
A few years ago, he said, doctors routinely left X-rays on light boxes, and
it was not uncommon for a patient to overhear staff ask for "Mark Summer's
CAT scan" over the intercom.
Many researchers complain that they can no longer recruit patients directly
from doctors' records. They must rely on doctors for referrals.
"Most physicians are just too busy to do that," said Roberta B. Ness, a
University of Pittsburgh epidemiologist, who saw recruits for one study fall by
half after HIPAA.
But at the University of Pennsylvania, oncologist Julia Draznin said, new
patients now sign several consents at once, including one for research. No
more time-consuming searches for study volunteers.
"Things are definitely getting better" with HIPAA, she said. "Common sense
prevails."
____________________________________
Contact staff writer Virginia Smith at 215-854-5720 or
_vsmith@phillynews.com_ (mailto:vsmith@phillynews.com) .
HIPAA Myths and Facts
ONLINE EXTRA: For details on the privacy rule, answers to your questions
and other information, go to _http://go.philly.com/hipaa_
(http://go.philly.com/hipaa) .
Myth: One doctor's office cannot send a patient's medical records to another
doctor's office without patient consent.
Fact: No consent is necessary.
Myth: Doctors cannot communicate with patients by e-mail.
Fact: E-mails, with proper safeguards, are permitted.
Myth: A patient cannot be listed in a hospital directory without consent and
the hospital cannot share that information with the public.
Fact: Hospitals may provide a patient's name, location and general
condition to the public unless the patient specifically opts out.
Myth: Clergy members are not entitled to information about hospitalized
members of their religious affiliation unless they know the person by name.
Fact: Clergy are entitled to this information unless the patient objects.
Myth: Patient information cannot be shared with family members without
patient consent.
Fact: Relevant information may be disclosed to relatives or friends named
by the patient. In case of emergency or patient incapacity, the doctor's
"professional judgment" prevails.
Myth: Family members may not pick up a patient's prescriptions.
Fact: Relatives or friends acting on patient's behalf may pick up
prescriptions, but some pharmacies may prohibit this on their own.
Myth: Patients can sue health-care providers for not complying with HIPAA
privacy rules.
Fact: Patients cannot sue. They can file written complaints with the
federal Office for Civil Rights.
Myth: Patients' medical records cannot be used for marketing.
Fact: HIPAA permits the use of medical information for certain
health-related marketing, such as a plan's health-related products or alternative
treatments.
Myth: If a patient refuses to sign a form acknowledging receipt of privacy
practices, a doctor or hospital can refuse treatment.
Fact: The law does not allow this.
Myth: HIPAA makes hospital fund-raising almost impossible.
Fact: Hospitals, with patient permission, may use or disclose basic patient
information for fund-raising, but patients must be given the option of
declining future fund-raising communications.
SOURCE: The Health Privacy Project
2005 Philadelphia Inquirer and wire service sources. All Rights Reserved.
http://www.philly.com
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N><SPAN=20
class=3Dheadline1><B><SPAN=20
style=3D"FONT-SIZE: 14pt; COLOR: black; FONT-FAMILY: Verdana">Doctors,=
=20
patients grapple with specifics of privacy rule</SPAN></B></SPAN><SPAN=
=20
style=3D"FONT-SIZE: 8pt; COLOR: black; FONT-FAMILY: Verdana"><BR><BR><=
/SPAN><SPAN=20
class=3Dbyline1><B><SPAN style=3D"COLOR: #666666; FONT-FAMILY: Verdana=
">By=20
Virginia A. Smith and Dawn </SPAN></B></SPAN><SPAN class=3Dspelle><B><=
SPAN=20
style=3D"COLOR: #666666; FONT-FAMILY: Verdana">Fallik</SPAN></B></SPAN=
><SPAN=20
style=3D"FONT-SIZE: 8pt; COLOR: black; FONT-FAMILY: Verdana"><BR></SPA=
N><SPAN=20
class=3Dcreditline1><B><SPAN=20
style=3D"FONT-SIZE: 7pt; COLOR: #666666; FONT-FAMILY: Verdana">Inquire=
r=20
Staff Writers</SPAN></B></SPAN><SPAN=20
style=3D"FONT-SIZE: 8pt; COLOR: black; FONT-FAMILY: Verdana"><o:p></o:=
p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana"><!-- begin body-=
content -->Howard=20
Miller's office is primed for privacy. The computers have plastic shie=
lds=20
to ward off prying eyes. The patient files are coded by number, not na=
me.=20
The files hanging outside the examining rooms face inward to hide name=
s=20
and ages.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">But sometimes Mi=
ller,=20
a <st1:place w:st=3D"on"><st1:PlaceType=20
w:st=3D"on"><u1:place><u1:PlaceType>Center</st1:PlaceType></u1:PlaceTy=
pe>=20
<st1:PlaceType=20
w:st=3D"on"><u1:PlaceType>City</st1:PlaceType></st1:place></u1:PlaceTy=
pe></u1:place>=20
internist, thinks privacy protections have gone too=20
far.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">"I have this one=
huge=20
Italian extended family I've been treating for years," he said. "One o=
f=20
them got sick and they were all calling to ask questions. And I couldn=
't=20
say anything to them because they weren't on the list of contacts the=20
patient had approved."<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">That's the only=20=
way=20
Miller can comply with the patient-privacy rule of the federal Health=20
Insurance Portability and Accountability Act of 1996, better known as=20
HIPAA. The law profoundly changed how doctors talk to and about patien=
ts,=20
as well as how patients themselves negotiate the health-care=20
system.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">But two years af=
ter=20
the privacy rule took effect, there is still widespread confusion abou=
t=20
who can give what medical information to whom and grumbling about=20
bureaucracy and weak enforcement. There is an even deeper debate: Does=
the=20
law protect or undermine patient privacy?<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Tomorrow, that d=
ebate=20
will be heard by the U.S. Court of Appeals for the Third Circuit in=20
<st1:City w:st=3D"on"><st1:place=20
w:st=3D"on"><u1:City><u1:place>Philadelphia</st1:place></st1:City></u1=
:place></u1:City>.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">The <st1:City=20
w:st=3D"on"><st1:place=20
w:st=3D"on"><u1:City><u1:place>Clinton</st1:place></st1:City></u1:plac=
e></u1:City>=20
administration required a patient's written permission to release=20
confidential information for "routine purposes," such as treatment and=
=20
payment. The Bush administration made consent optional. Now, patients=20
simply sign a basic "notice of privacy practices."<o:p></o:p></SPAN></=
P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">In April, U.S.=20
District Judge Mary A. McLaughlin in <st1:City w:st=3D"on"><st1:place=20
w:st=3D"on"><u1:City><u1:place>Philadelphia</st1:place></st1:City></u1=
:place></u1:City>=20
ruled that the new provisions did not violate patient privacy and that=
the=20
government had no legal responsibility to "act affirmatively to protec=
t=20
such rights." Federal officials also said it would be too cumbersome t=
o=20
get consent every time an insurance company or medical specialist need=
ed=20
patient data.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Deborah Peel, fo=
r one,=20
was appalled by the ruling.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">"You can have yo=
ur=20
information disclosed for 'routine purposes' with no consent, no notic=
e,=20
<SPAN class=3Dgrame>no</SPAN> recourse. Excuse us, you have just elimi=
nated=20
a fundamental constitutional right," said Peel, a psychiatrist in=20
<st1:place w:st=3D"on"><st1:City=20
w:st=3D"on"><u1:place><u1:City>Austin</st1:City></u1:City>, <st1:State=
=20
w:st=3D"on"><u1:State>Texas</st1:State></st1:place></u1:State></u1:pla=
ce>,=20
and a plaintiff in the case with Citizens for Health, a patient advoca=
cy=20
group, and others.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Without a privac=
y=20
guarantee, patients might withhold crucial information from doctors,=20
fearing it could be used against them by bosses, banks and=20
others.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">"The joke is tha=
t soon=20
you're going to call Domino's Pizza and they're going to know that the=
y=20
can't send the extra cheese because you've got high cholesterol," said=
=20
plaintiff Janis G. Chester, who teaches psychiatry at <st1:place=20
w:st=3D"on"><st1:PlaceName=20
w:st=3D"on"><u1:place><u1:PlaceName>Thomas</st1:PlaceName></u1:PlaceNa=
me>=20
<st1:PlaceName=20
w:st=3D"on"><u1:PlaceName>Jefferson</st1:PlaceName></u1:PlaceName>=20
<st1:PlaceType=20
w:st=3D"on"><u1:PlaceType>University</st1:PlaceType></st1:place></u1:P=
laceType></u1:place>.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">The federal Heal=
th=20
Insurance Portability and Accountability Act, which grew out of Presid=
ent=20
Clinton's failed effort to revamp health care, was designed to reduce=20
fraud and prevent people from losing insurance when they leave jobs. B=
ut=20
the privacy rule soon became the most talked about part of the=20
law.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">It required writ=
ten=20
consent to release test results, diagnoses and other information to=20
doctors, dentists, hospitals, HMOs, group health plans, insurance=20
companies, billing companies and others. The rule also gave patients=20
access to their records and the right to find out when and to whom the=
y=20
have been disclosed.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">In the long term=
,=20
HIPAA was supposed to simplify electronic health records, which would=20=
save=20
money. In the short term, however, it has created inconsistencies from=
one=20
institution to another and cost millions for training and paperwork,=20
lawyers and compliance officers.<o:p></o:p></SPAN></P>
<P><SPAN class=3Dspelle><SPAN=20
style=3D"COLOR: black; FONT-FAMILY: Verdana">Laurinda</SPAN></SPAN><SP=
AN=20
style=3D"COLOR: black; FONT-FAMILY: Verdana"> B. Harman, head of <st1:=
place=20
w:st=3D"on"><st1:PlaceType=20
w:st=3D"on"><u1:place><u1:PlaceType>Temple</st1:PlaceType></u1:PlaceTy=
pe>=20
<st1:PlaceType=20
w:st=3D"on"><u1:PlaceType>University</st1:PlaceType></st1:place></u1:P=
laceType></u1:place>'s=20
department of health information management, jokes that HIPAA stands f=
or=20
Huge Increase in Paperwork and Aggravation Act. "Is it hard to comply?=
"=20
she asked. "No, but <SPAN class=3Dgrame>it's</SPAN> one more=20
form."<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Richard <SPAN=20
class=3Dspelle>Campanelli</SPAN>, director of the federal Office of Ci=
vil=20
Rights, which oversees HIPAA, believes the privacy rule has done exact=
ly=20
what it set out to do: give medical consumers power over their records=
.=20
While acknowledging confusion early on, he said that most patients and=
=20
providers now understand the boundaries of the law.<o:p></o:p></SPAN><=
/P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">"People are very=
=20
sensitive to their rights and they know that they have these rights,"=20=
he=20
said.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Of the 10,785 HI=
PAA=20
complaints received by the agency, more than 60 percent have been reso=
lved=20
without penalties and 38 percent remain under investigation. Critics n=
ote=20
only 170 were referred to the U.S. Department of Justice for criminal=20
investigation - and not a single civil penalty has been=20
issued.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Kate O'Brien, 24=
, of=20
<st1:place w:st=3D"on"><st1:City=20
w:st=3D"on"><u1:place><u1:City>Lindenwold</st1:City></u1:City>, <st1:S=
tate=20
w:st=3D"on"><u1:State>N.J.</st1:State></st1:place></u1:State></u1:plac=
e>,=20
believes the law has only complicated matters for consumers. A program=
=20
specialist for the Association for Retarded Citizens in <st1:City=20
w:st=3D"on"><st1:place=20
w:st=3D"on"><u1:City><u1:place>Camden</st1:place></st1:City></u1:place=
></u1:City>,=20
she was told HIPAA would not permit her to get her medical test result=
=20
over the phone.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">"I had to drive=20=
all=20
the way over from <st1:place=20
w:st=3D"on"><u1:place>Pennsauken</st1:place></u1:place> to Voorhees to=
pick=20
it up," she said. "Was it really necessary?"<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">The truth is: no=
.=20
Doctors, with patient approval, can release information over the=20
phone.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">The act also has=
made=20
it hard for some agencies to help those in their=20
care.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Joe Young, deput=
y=20
director of New Jersey Protection and Advocacy Inc., a medical advocac=
y=20
group in <st1:City w:st=3D"on"><st1:place=20
w:st=3D"on"><u1:City><u1:place>Trenton</st1:place></st1:City></u1:plac=
e></u1:City>,=20
said that psychiatric hospitals sometimes refuse to contact family mem=
bers=20
when his mentally ill clients are in crisis - and cannot remember thei=
r=20
medical history.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">"It's wrong to f=
reeze=20
out family members who may be able to provide assistance," he=20
said.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Still, many doct=
ors=20
acknowledge HIPAA has had some positive effects.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">"It's created a=20=
new=20
sort of awareness in the office, even in the idle chatter between=20
physicians and the nursing staff," said urologist Al <SPAN=20
class=3Dspelle>Ruenes</SPAN> of Central Bucks Urology in Warminster an=
d=20
Doylestown.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">A few years ago,=
he=20
said, doctors routinely left X-rays on light boxes, and it was not=20
uncommon for a patient to overhear staff ask for "Mark Summer's CAT sc=
an"=20
over the intercom.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Many researchers=
=20
complain that they can no longer recruit patients directly from doctor=
s'=20
records. They must rely on doctors for referrals.<o:p></o:p></SPAN></P=
>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">"Most physicians=
are=20
just too busy to do that," said Roberta B. Ness, a <st1:place=20
w:st=3D"on"><st1:PlaceType=20
w:st=3D"on"><u1:place><u1:PlaceType>University</st1:PlaceType></u1:Pla=
ceType>=20
of <st1:PlaceName=20
w:st=3D"on"><u1:PlaceName>Pittsburgh</st1:PlaceName></st1:place></u1:P=
laceName></u1:place>=20
epidemiologist, who saw recruits for one study fall by half after=20
HIPAA.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">But at the <st1:=
place=20
w:st=3D"on"><st1:PlaceType=20
w:st=3D"on"><u1:place><u1:PlaceType>University</st1:PlaceType></u1:Pla=
ceType>=20
of <st1:PlaceName=20
w:st=3D"on"><u1:PlaceName>Pennsylvania</st1:PlaceName></st1:place></u1=
:PlaceName></u1:place>,=20
oncologist Julia <SPAN class=3Dspelle>Draznin</SPAN> said, new patient=
s now=20
sign several consents at once, including one for research. No more=20
time-consuming searches for study volunteers.<o:p></o:p></SPAN></P>
<P><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">"Things are defi=
nitely=20
getting better" with HIPAA, she said. "Common sense=20
prevails."<o:p></o:p></SPAN></P><!-- end body-content --><!-- begin bo=
dy-end -->
<DIV class=3DMsoNormal style=3D"MARGIN: 0in 0in 0pt; TEXT-ALIGN: cente=
r"=20
align=3Dcenter><I><SPAN=20
style=3D"FONT-SIZE: 8pt; COLOR: black; FONT-FAMILY: Verdana">
<HR align=3Dcenter width=3D"100%" color=3D#cccccc noShade SIZE=3D1>
</SPAN></I></DIV>
<P class=3DMsoNormal=20
style=3D"MARGIN: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bot=
tom-alt: auto"><SPAN=20
class=3Dtagline1><I><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana"=
>Contact=20
staff writer Virginia Smith at 215-854-5720 or </SPAN></I></SPAN><SPAN=
=20
class=3Dtagline1><I><SPAN=20
style=3D"FONT-SIZE: 8pt; COLOR: black; FONT-FAMILY: Verdana"><A=20
title=3Dmailto:vsmith@phillynews.com=20
href=3D"mailto:vsmith@phillynews.com"><SPAN=20
style=3D"FONT-SIZE: 12pt">vsmith@phillynews.com</SPAN></A></SPAN></I><=
/SPAN><SPAN=20
class=3Dtagline1><I><SPAN=20
style=3D"COLOR: black; FONT-FAMILY: Verdana">.</SPAN></I></SPAN><I><SP=
AN=20
style=3D"COLOR: black; FONT-FAMILY: Verdana"> <o:p></o:p></SPAN></I></=
P></TD>
<TD=20
style=3D"BORDER-RIGHT: #d4d0c8; PADDING-RIGHT: 0in; BORDER-TOP: #d4d0c8;=
PADDING-LEFT: 0in; PADDING-BOTTOM: 0in; BORDER-LEFT: #d4d0c8; WIDTH: 0.1in;=
PADDING-TOP: 0in; BORDER-BOTTOM: #d4d0c8; BACKGROUND-COLOR: transparent"=20
width=3D10>
<P class=3DMsoNormal=20
style=3D"MARGIN: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bot=
tom-alt: auto"><FONT=20
face=3D"Times New Roman"> <o:p></o:p></FONT></P></TD></TR>
<TR style=3D"mso-yfti-irow: 3">
<TD=20
style=3D"BORDER-RIGHT: #d4d0c8; PADDING-RIGHT: 0in; BORDER-TOP: #d4d0c8;=
PADDING-LEFT: 0in; BACKGROUND: white; PADDING-BOTTOM: 0in; BORDER-LEFT: #d4=
d0c8; PADDING-TOP: 0in; BORDER-BOTTOM: #d4d0c8"=20
vAlign=3Dtop rowSpan=3D2>
<TABLE class=3DMsoNormalTable=20
style=3D"WIDTH: 423pt; mso-cellspacing: 0in; mso-padding-alt: 0in 0in=20=
0in 0in"=20
cellSpacing=3D0 cellPadding=3D0 width=3D564 border=3D0>
<TBODY>
<TR=20
style=3D"mso-yfti-irow: 0; mso-yfti-firstrow: yes; mso-yfti-lastrow:=
yes">
<TD=20
style=3D"BORDER-RIGHT: #d4d0c8; PADDING-RIGHT: 0in; BORDER-TOP: #d=
4d0c8; PADDING-LEFT: 0in; PADDING-BOTTOM: 0in; BORDER-LEFT: #d4d0c8; WIDTH:=20=
100%; PADDING-TOP: 0in; BORDER-BOTTOM: #d4d0c8; BACKGROUND-COLOR: transparen=
t"=20
width=3D"100%">
<H4 style=3D"MARGIN: auto 0in"><SPAN=20
style=3D"COLOR: black; FONT-FAMILY: Verdana">HIPAA Myths and=20
Facts<o:p></o:p></SPAN></H4>
<P><B><SPAN=20
style=3D"FONT-SIZE: 8pt; COLOR: black; FONT-FAMILY: Verdana">ONL=
INE=20
EXTRA:</SPAN></B><SPAN=20
style=3D"FONT-SIZE: 8pt; COLOR: black; FONT-FAMILY: Verdana"> Fo=
r=20
details on the privacy rule, answers to your questions and other=
=20
information, go to <A title=3Dhttp://go.philly.com/hipaa=20
href=3D"http://go.philly.com/hipaa">http://go.philly.com/hipaa</=
A>.<B><o:p></o:p></B></SPAN></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Myth: O=
ne=20
doctor's office cannot send a patient's medical records to anoth=
er=20
doctor's office without patient consent.<o:p></o:p></SPAN></B></=
P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Fact: N=
o=20
consent is necessary.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Myth: D=
octors=20
cannot communicate with patients by=20
e-mail.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Fact:=20
E-mails, with proper safeguards, are=20
permitted.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Myth: A=
=20
patient cannot be listed in a hospital directory without consent=
and=20
the hospital cannot share that information with the=20
public.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Fact:=20
Hospitals may provide a patient's name, location and general=20
condition to the public unless the patient specifically opts=20
out.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Myth: C=
lergy=20
members are not entitled to information about hospitalized membe=
rs=20
of their religious affiliation unless they know the person by=20
name.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Fact: C=
lergy=20
are entitled to this information unless the patient=20
objects.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Myth: P=
atient=20
information cannot be shared with family members without patient=
=20
consent.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Fact:=20
Relevant information may be disclosed to relatives or friends na=
med=20
by the patient. In case of emergency or patient incapacity, the=20
doctor's "professional judgment" prevails.<o:p></o:p></SPAN></B>=
</P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Myth: F=
amily=20
members may not pick up a patient's=20
prescriptions.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Fact:=20
Relatives or friends acting on patient's behalf may pick up=20
prescriptions, but some pharmacies may prohibit this on their=20
own.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Myth:=20
Patients can sue health-care providers for not complying with HI=
PAA=20
privacy rules.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Fact:=20
Patients cannot sue. They can file written complaints with the=20
federal Office for Civil Rights.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Myth:=20
Patients' medical records cannot be used for=20
marketing.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Fact: H=
IPAA=20
permits the use of medical information for certain health-relate=
d=20
marketing, such as a plan's health-related products or alternati=
ve=20
treatments.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Myth: I=
f a=20
patient refuses to sign a form acknowledging receipt of privacy=20
practices, a doctor or hospital can refuse=20
treatment.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Fact: T=
he law=20
does not allow this.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Myth: H=
IPAA=20
makes hospital fund-raising almost=20
impossible.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">Fact:=20
Hospitals, with patient permission, may use or disclose basic=20
patient information for fund-raising, but patients must be given=
the=20
option of declining future fund-raising=20
communications.<o:p></o:p></SPAN></B></P>
<P><B><SPAN style=3D"COLOR: black; FONT-FAMILY: Verdana">SOURCE:=
The=20
Health Privacy Project<o:p></o:p></SPAN></B></P></TD></TR></TBOD=
Y></TABLE>
<P class=3DMsoNormal=20
style=3D"MARGIN: 0in 0in 12pt; mso-margin-top-alt: auto"><SPAN=20
style=3D"FONT-SIZE: 8pt; COLOR: black; FONT-FAMILY: Verdana"><o:p></o:=
p></SPAN></P></TD>
<TD=20
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PADDING-TOP: 0in; BORDER-BOTTOM: #d4d0c8; BACKGROUND-COLOR: transparent"=20
width=3D184>
<P class=3DMsoNormal=20
style=3D"MARGIN: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bot=
tom-alt: auto"><FONT=20
face=3D"Times New Roman"> <o:p></o:p></FONT></P></TD>
<TD=20
style=3D"BORDER-RIGHT: #d4d0c8; PADDING-RIGHT: 0in; BORDER-TOP: #d4d0c8;=
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width=3D10>
<P class=3DMsoNormal=20
style=3D"MARGIN: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bot=
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<TD=20
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PADDING-TOP: 0in; BORDER-BOTTOM: #d4d0c8; HEIGHT: 9.7pt; BACKGROUND-COLOR:=20=
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<P class=3DMsoNormal style=3D"MARGIN: 0in 0in 0pt"><SPAN=20
style=3D"FONT-SIZE: 10pt; FONT-FAMILY: Verdana"><o:p> </o:p></SPA=
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yline1><SPAN=20
style=3D"COLOR: #666666"><SPAN=20
style=3D"mso-spacerun: yes"> </SPAN></SPAN></SPAN><SPAN class=3Dgrame><=
SPAN=20
style=3D"COLOR: #666666">2005 Philadelphia Inquirer and wire service=20
sources.</SPAN></SPAN><SPAN class=3Dbyline1><SPAN style=3D"COLOR: #666666">=20=
All=20
Rights Reserved.</SPAN></SPAN></FONT></FONT><SPAN=20
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face=3D"Times New Roman"><SPAN class=3Dbyline1><SPAN=20
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