1. A false positive on a syphilis tests is sent by the lab to state public health agency. Is this a HIPAA violation?
A: HIPAA provides protection for reporting of communicable diseases.
2. If relatives or friends are present in the examining room, is there an implicit permit to release info to that person in the future? How do we document that?
A: If another person is present with the patient during a visit it should be documented that the person was there with patient consent.
3. An elderly patient comes with her family member(daughter/son), who came with her once before. Will it be ok to release medical info (e.g., lab results) or conduct treatment with the daughter or son present if the patient’s authorization is signed?
4. What about two MDs with different specialties and practices who share a common office? How does one establish a HIPAA agreement between two groups?
A: Policy should indicate that records are not shared more than necessary, and precautions should be taken to make certain that information is only provided to those who need it.
5. Is it helpful to have a sign at the checkout window asking whether a private area for scheduling tests is preferred?
A: If possible the scheduling should be done in a separate area. If not, a sign-in should suffice or alternatively a buffer zone should be created so that others cannot overhear.
6. Should family members be present in the exam room, even after the agreement of the patient?
A: If patient agrees it is ok, then document agreement.
7. How much structural modification to reduce voice transmission is necessary in the office setting?
A: Technically HIPAA should not require major modification of office physical structure. However, procedural structure should be changed to accommodate privacy.
8. If pharmaceutical reps come to the office for a preceptorship (to spend the day following the physicians), is verbal consent sufficient from each patient, or is it necessary to get written consent?
A: To be safe, get written agreement, as the patient may feel pressured and forget verbal consent with a pharmaceutical rep.
9. For “Incident to” and “in facility,” what if you have two offices, you're at one, the nurse is at another?
A: If the physician is not in the facility where the services are being provided then they cannot be billed by the nurse, unless the service is considered to be “general supervision only.”
10. Does a list of problems count as chief complaint, for example, patient returns for follow-up of the following problems listed: RA and osteoporosis.
11. Should pharmaceutical reps have access to the patient care area?
A: They should not be allowed to have access to PHI either verbal or written unless the patient agrees.