I'm willing to bet I am the only person on Lactnet who has read every single
word of the federal regulations that comprise HIPAA. So it is with no
small amount of hubris that I condense it for you as follows:
(1) HIPAA was orginally designed to streamline paperwork and processing of
health insurance in the USA. Privacy protections are just one part of it.
(2) HIPAA prevents a health care practitioner (HCP) from disclosing
(talking about) a mother's PHI unless it is *permitted* or *required* by the
regulation, OR the mom gives her written permission to do so.
(3) Every "covered entity" must have a "notice of privacy practices" that
it gives to the mother. The infamous form she is signing is mom's
acknowledgement that she received the notice of privacy practices.
(4) "Covered entities" are a health plan ... a health care clearinghouse
... or a health care provider (like IBCLCs) who furnish, bill, or are paid
for providing health care, incl. the sending of an "encounter form"
(5) WIC is a bit wobbly on this point: it depends on how the WIC office is
set up. If it serves as a clinic, it falls under HIPAA. If it merely
offers information about nutrition, it is not providing "health care"
(6) HIPAA has a huge loophole (so big I call it a pothole) which allows any
healthcare provider to discuss with any other healthcare provider whatever
they want about Mom, if the discussion involves "treatment, payment or
health care operations" involving the Mom's case. And they don't have to
get her permission first.
Sounds whacky, but it makes some sense when you look at it this way: health
care practitioners need to have full and unfettered access to information
about a patient in order to make the time-sensitive recommendations or
decisions that are inherent to quality health care. The physical therapist
needs to know about the surgery done on the knee, and the knee surgeon needs
to know about the allergy to certain foods and medicines, and the dietitian
needs to know about the patient's history of obesity ....
(7) Mom is certainly within her rights to restrict the sharing of
information with people who are OUT of the health-care loop. Her boss
doesn't need to know that she is allergic to certain meds, or that she is
considered obese, but he probably does have the right to know that knee
surgery took place (so he can authorize insurance coverage, for example, and
permit sick leave during recuperation). And the man-in-the-street doesn't
need to know any of this stuff, which is why we are all running aroung
covering up our charts and computer screens ....
Liz Brooks, JD, IBCLC
Wyndmoor, PA, USA
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