HIPAA Consult

July 7, 2006

Answers to your questions about...releasing nonmedical data; the rights of minors; copying and mailing fees

Releasing nonmedical data

A. No, provided the patient has agreed to a release of the full record. Under HIPAA, an authorization for release of medical information must specify what, in fact, the patient is agreeing to have released. For this reason, and in order to protect yourself from any potential problems, ask patients who authorize release of their medical records if they want their entire record released, including both psychosocial and medical information, or just a partial record. If the latter, release only that part of the record that the patient has authorized.

Q. Many of the teenage patients who come to our ob/gyn practice, located in Georgia, don't want us to release information to their parents about pregnancy tests and other gynecological matters. However, their parents find out about their visits anyway, when they see the EOBs that their health plans send out. At that point, the parents call us, demanding to know why we saw their daughter without their consent. As physicians, are we required to speak to the parent of a minor regarding contraception and other issues or is our first obligation to honor the wishes of our patients, even if they are minors?

A. The right to control or restrict information generally goes hand-in-hand with the right to consent to treatment, which a minor (typically, anyone under 18) doesn't typically enjoy. But in some situations, minors do enjoy these rights. For example, nearly half the states-including your own state of Georgia-permit minors to consent to contraceptive care. In these states, minors also have the corresponding right to refuse to share this information with anyone else, including their parents. As a physician, you must respect this right, whether or not parents find out on their own.

If you elect to (this isn't a requirement), you may inform a minor seeking contraception that your office will bill the service to her parents' or someone else's medical insurance and that that policyholder will receive an EOB alerting her to the care provided.

Copying and mailing fees

Q. Patients occasionally ask us to copy their records and send them to a law firm or some other place. Are we permitted under HIPAA to charge them for photocopying and mailing their information?

A. Yes. According to HIPAA, you may charge a reasonable, cost-based fee related to the expense of copying and postage. But what you can charge for these services may also be controlled by state statute.

Margaret M. Davino (mdavino@kbrny.com
) is a healthcare attorney with Kaufman Borgeest & Ryan, in New York City.

This department answers common HIPAA-related questions. It isn't intended to provide specific legal advice. Please submit questions via e-mail to mehipaa@advanstar.com
, or by regular mail to Medical Economics, 5 Paragon Drive, Montvale, NJ 07645, ATTN: HIPAA CONSULT. If we select your query, we’ll address it in an upcoming issue. Your name will not be used.