Navigating the medical world as a caregiver or patient can be difficult, especially regarding personal health information. Several federal and some state laws establish protections, so your private health information and other information in your health records are protected from unauthorized disclosure.
Helping older family members can be more difficult unless they have signed the proper releases. Signing these before someone's health declines will make it easier for loved ones to navigate their health care.
Health Insurance Portability and Accountability Act of 1996 provided protections and mandated the so-called "Privacy Rule." The Department of Health and Human Services (HHS) issued the Privacy Rule in December 2000 to carry out HIPAA's mandate that HHS establish federal standards for safeguarding the privacy of individually identifiable health information.
The Privacy Rule establishes, for the first time, a foundation of Federal protections for the privacy of protected health information. The rule does not replace any other federal or state law that grants individuals even greater privacy protections, and covered entities are free to retain or adopt more protective policies or practices.
The Security Rule is a federal law that requires security for health information in electronic form. HHS says it this way:
The Privacy Rule, a federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information. The Privacy Rule applies to all forms of individuals' protected health information, whether electronic, written, or oral.
HIPAA and Health Information
If you or a loved one has ever needed long-term care, you've probably had to deal with HIPAA. HIPAA governs protected health information (PHI). HIPAA can make navigating caregiving situations a little complex at times, and it may make you wonder why personal health information is protected.
Dr. Yasir Al-Khalili, MD, and Dr. Yasir Al-Khalili say that protected health information can sometimes identify an individual, and it is important to protect that information.
It is imperative that protected health information remains confidential because disclosing it to unauthorized recipients, whether intentionally or by accident, can have harmful consequences for patients.
What is Personal Health Information (PHI)?
PHI includes individually identifiable information about an individual's health in all written, digital, and oral formats. It doesn't matter if that information stays in a folder in a doctor's office or if it's an oral report your nurse gives you after surgery.
Protected information is more than just information about someone's health. It also includes billing information and any information that could be used to identify an individual that may appear in records.
Permitted Disclosures Under HIPAA
The law's goal is to ensure that an individual's health information is appropriately protected while allowing the flow of health information needed to provide and promote high-quality health care and to protect the public's health and well-being.
These permitted disclosures include:
To the individual
Treatment, payment, and health care operations
Public interest and benefit activities like law enforcement purposes or a serious threat to health and safety
Any individual can approve disclosure for any reason. For example, when applying for Long-Term Care Insurance or life insurance, the applicant will often sign a medical record release.
There are also other allowed disclosures, for example:
A surgeon who did emergency surgery on you may tell your spouse about your condition, either in person or by phone, while you are unconscious.
A pharmacist may give your prescription to a friend or family member you send to pick it up.
A doctor may discuss your drugs with your caregiver, who calls your doctor with a question about the correct dosage.
A nurse may not tell your friend or family about a past medical problem that is unrelated to your current condition - UNLESS you have signed a release allowing them that access.
Privacy from Family and Friends
In some situations, individuals may not want their friends and relatives who visit them to know exactly what's going on with their health. It could be embarrassing or considered controversial, and the point is that the patient should be able to choose if and when they share that information.
Requiring patient permission to disclose information also protects you from having anyone obtain your medical records by pretending to be a family member or close friend. In other words, knowing a person's name and basic information would not be a reason for disclosure.
Privacy From Research
Imagine if research institutions could access everyone's medical data without their permission. While it might speed up the process of curing certain diseases and conditions, it could also fuel for-profit research using your health records. An individual must give informed consent to participate in research studies that allow accessing medical records.
There are situations where your information may be released without permission as long as all your identifiable information is removed.
Protecting Your Health Information
The above reasons are just a few of the situations that make it important to protect personal health information. It's why, for example, doctors and nurses must correctly label patient files and limit what information they put on the outside. It's also why you have to sign a HIPAA authorization form to let a caregiver have access to your medical information.
Your Access to Your Health Information
Generally speaking, your health information is yours. HHH says that The Privacy Rule gives you, with few exceptions, the right to inspect, review, and receive a copy of your medical records and billing records that are held by health plans and health care providers covered by the Privacy Rule.
Only you or your personal representative has the right to access your records. Providers can provide copies of your information to help provide your treatment or, as necessary, receive payment from insurance without additional permissions.
HIPAA gives individuals important rights to access their medical records - PDF and to keep your information private. However, a provider can charge you to provide those records. The provider cannot charge you a fee for searching for or retrieving your records. The law says "reasonable costs for copying and mailing the records" are allowed.
Can the Government Get My Private Health Information
The answer is - maybe. Your medical records and your protected health information can be shared if a court order is issued by a judge. However, the provider or plan may only disclose the information described in the court order.
Even though HIPAA can be difficult to navigate at times, it's there to protect you and your loved ones from abuse and neglect. HIPAA makes sure that only the people who need to know your medical information are the ones who have access to it.
About the Author
Mallory Knee is a freelance writer for multiple online publications where she can showcase her affinity for all things beauty and fashion. She particularly enjoys writing for communities of passionate women who come together for a shared interest and empower one another in the process. In her free time, you can find Mallory trying a fun new dinner recipe, practicing calligraphy, or hanging out with her family.
Contributor since September 25th, 2020
Why all the fuss about medical records? It is your health and private identifying information that is being protected. However, when you get older, that privacy might prevent your family from helping you make health decisions or providing the proper care. Now you might want to prevent family members from getting this information. But you can decide who gets the information - plus, you can sign health directives that provide the proper guidance.
Aging has complications. The consequences of declining health, mobility problems, memory issues, and the frailty of aging will impact you, your family, your finances, and your legacy.
Long-term health care costs are exploding worldwide. The cost of care services in the U.S. varies depending on where you live and the type of services you require.
Being prepared for the cost and burdens of aging is a vital part of retirement planning. You probably don't want to burden loved ones with the role of being your caregiver. You probably also want to protect your savings as well. The solution is affordable Long-Term Care Insurance.
You might hear that Long-Term Care Insurance is expensive. The fact is, for many people, LTC Insurance is affordable, more so if you obtain coverage younger and when you still have pretty good health. Most people are getting coverage in their 50s.
When you have a Long-Term Care Insurance policy, you remain in control with access to your choice of quality care services, including in-home care. Having a policy allows your loved ones to have the time to remain family, instead of becoming your caregiver.
Locate a Pro to Assist You in Shopping for LTC Coverage
There are numerous types and options for Long-Term Care Insurance. In accordance with Section 7702(b) of U.S. Code, tax-qualified Long-Term Care Insurance policies include significant consumer protections, regulated benefit triggers, and tax incentives.
But many financial advisers and general insurance agents lack the necessary education regarding these products, underwriting, and policy design.
Some states are considering adding a tax as part of a long-term care program similar to the one already approved in the State of Washington. A tax is applied on earned income unless you already have a qualified Long-Term Care Insurance policy in force.
To navigate the numerous options, you need the assistance of a knowledgeable Long-Term Care Insurance specialist. Additionally, a specialist can assist you in discovering the most cost-effective option based on your age, health, and family history.
Locate a specialist you can rely on who has dealt with all the top companies and understands underwriting, policy design, and claims - Work With a Specialist.
Tools and Resources Available on LTC NEWS
There is much inaccurate or incomplete information about long-term care planning on the internet. Not every financial advisor or insurance agent has the knowledge to help you with long-term health care planning. LTC NEWS can help.
If you have questions about long-term health care planning, LTC NEWS answers the most often asked questions - Frequently Asked Questions.
You can find all the resources available on LTC NEWS right here - Resources for Long-Term Care Planning.
The cost of long-term health care services is rising sharply nationwide. The LTC NEWS Cost of Care Calculator shows you the current and future cost of care services where you live - Cost of Care Calculator - Choose Your State.
How About Elderly Parents?
If your older parents or family members are declining and need help now, what can you do to help? Regardless of whether they have an LTC policy, you can get assistance choosing reliable caregivers or long-term care facilities and get recommendations for an appropriate plan of care - Filing a Long-Term Care Insurance Claim | LTC News.
Make sure your loved one uses their Long-Term Care Insurance coverage if they are fortunate enough to have one. Families sometimes postpone using the benefits because they believe they should save them for later. It is not a good idea to put off using the available Long-Term Care Insurance benefits.
Is a Reverse Mortgage Helpful?
Today's reverse mortgages for those aged 62 and older could be an ideal resource. You can fund a Long-Term Care Insurance policy OR even provide money to pay for care if you, or a loved one, already needs help and assistance.
You might be eligible at younger ages as well.
Some people have much of their savings invested in their homes. With today's reverse mortgages, you can find ways to fund care solutions, care itself, and even help with cash flow during retirement.
Learn more by asking questions to an expert. Mike Banner, LTC NEWS columnist and host of the TV Show "62 Who Knew," will answer your questions regarding caregiving, aging, health, retirement planning, long-term care, and reverse mortgages.
Just "Ask Mike." - Reverse Mortgages | LTC News.
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