For those who can stand the minutiae, here is a little primer on HIPAA, and
whether or not little 'ol private practioners in the USA need to comply.
There are those who have argued that IBCLCs are not "covered entities" who
must follow the HIPAA requirements as health care provers (HCPs). My
reading of the language of the regulation, and the legislative history that
went along with it, led me to conclude -- and I fought it every inch of the
way -- that IBCLCs are covered. I went back to the source, and drew my own
conclusions, having pored over this stuff with my (jaundiced) but
well-trained eye as an attorney who practiced as a Congressional and federal
regulatory lobbyist. I *know* how that regulatory language gets
interpreted. The clincher for me: the "electronic transactions" that most
of us little ol' PPLCers think we *aren't* engaging in includes our
processing of the money received for our services (cash or check or EFT or
credit card. And if you're getting paid by an insurance co. you are
definitely in).
NOW -- all that being said -- I also think that HIPAA was originally
portrayed as some sort of boogeyman we all had to flee in horror from.
Actually, anyone practicing at par level as an IBCLC is already protecting a
mother's privacy in the ways contemplated by HIPAA. Furthermore, the
materials we need to be handing out are not allthat complicated -- again,
despite what the original purveyors of HIPAA-related documents would have us
believe.
FURTHER -- there are IBCLCs who still believe that HIPAA does not and should
not apply to them. They aren't being contrary or short-sighted ... they
are choosing to interpret HIPAA differently from me. That's what makes a
horse-race.
I interpreted HIPAA as I have because (a) I prefer to interpret legal
requirements conservatively, and (b) I think it is incumbent upon us IBCLCs
(esp. in private practice), if we are to be taken seriously as HCPs, to look
and act and talk like all the other HCPs in a mother's life. They are all
handing her a HIPAA form -- why not the IBCLC?
We just had a lengthy thread a few weeks back about mothers and doctors who
are surprised to learn that IBCLCs rightfully charge for their professional
time. If I expect a mother to hand over money to me, I am going to return
the favor by handing over to her copies of her: (1) consent form, (2) HIPAA
NPP, (3) individualized care plan, (4) hand-outs about her situation of
concern; (5) receipt for payment; (6) superbill or HCFA form for seeking
reimbursement from her insurance provider for our consult and (7) my report
to her MD (after I go back, write it, and fax it to the doc).
--
Liz Brooks JD IBCLC
Wyndmoor, PA, USA
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