The Health Insurance Portability and Accountability Act of 1996 (HIPAA) gives you, the healthcare consumer, more say in how your health care information is used and shared. Not only can you request an amendment to your health care record, as discussed in the September article, you can request to have access to health records restricted.
That's right, under the HIPAA Privacy regulation you have a right to ask your doctor to restrict the use and sharing of your protected health information (PHI) within your medical records. This means you may request that your doctor, and Blue Cross Blue Shield (BCBS), restrict the use and sharing of your confidential medical information.
While you can make this request, you must remember that you may only request certain types of restrictions. For example, you may ask for a restriction on how your doctor uses and shares your PHI for treatment, payment and health care operations. You may also ask for a restriction on uses and sharing your PHI when your doctor is talking to a family member or to other individuals involved in your care.
What does all that mean?
First, you may ask that your PHI be restricted when used or shared:
- For your treatment;
- For payment by BCBS for your medical care and services; and
- The activities of your doctor's office when it conducts quality assessment and outcomes activities, or business planning, or business management and administrative activities. In other words, when they are doing their normal business and administrative chores.
Regarding your doctor's office - you may ask your doctor not to share your PHI with another doctor or clinician. You may also ask your doctor to restrict the use and sharing of your PHI if any of the administrative and business operations are handled outside of the doctor's office by a third party, a contractor.
As in amending your PHI your doctor may ask that you make your request in writing. Your doctor, hospital and BCBS do not have to honor your request for a restriction. Most doctors and health plans honor your requests if the request is reasonable and they are able to comply with it.
Second, you may ask your doctor or hospital to restrict the use and sharing of your PHI to specific individuals. You may not want one of your children to be involved in your care as it would be too complex to have more than one child speaking for you. There are many other reasons why you might chose one or several individuals, and not others.
You may also ask the hospital not put your name in the hospital directory. By requesting this when a person calls to ask for your room number or phone number that information is not given out. You can make this request to screen visitors also, only allowing the people you want to visit or call. Most likely you will have a family member calling other family members and your friends.
How do you release a restriction?
If you no longer want the restriction there are several ways that a restriction can be released. You can tell your doctor or the hospital that you no longer want the restriction. Again, they will ask you to put this in writing. Also your doctor or the hospital may tell you they are terminating the restriction. Only the new PHI will not be restricted. Your entire previously created PHI will still be covered by your restriction. So, if your ex-sister-in-law retires and not longer works at the hospital they may remove the restriction.
Even with these restrictions in place your PHI may be shared with law enforcement personnel, public health agencies, and in judicial proceedings under different HIPAA requirements.