Tanya,
Thanks for your comment.  

I re-reviewed the rule and the exclusions to the accounting and have
done a 180 on my position on the need to account for disclosures to
other CEs for their TPO purposes.  The use of PHI for another entities
TPO purposes is in 164.506 - and that is an exclusion in the accounting
of disclosures, 164.528(a)(1)(i).

Thank you for careful reading and questioning. 

Christine Jensen
HIPAA Project Manager
Denver Health
303.436.7942


-----Original Message-----
From: Lang, Tanya [mailto:[EMAIL PROTECTED]]
Sent: Monday, September 09, 2002 7:20 AM
To: Jensen, Christine
Subject: RE: Disease Registry


Hi Christine,

I am interested in your comment regarding accounting for a disclosure of
PHI
made to another CE for TPO.  I didn't believe this is part of what needs
recording and tracking.  I'm wondering if you could share your thoughts
as
to why we need to account for this.  Thank you in advance.

Best regards,
Tanya Lang, MPA, RHIA
Privacy Analyst
Hospital of Saint Raphael
New Haven, Connecticut
203.789-5917
[EMAIL PROTECTED]



-----Original Message-----
From: Jensen, Christine [mailto:[EMAIL PROTECTED]]
Sent: Friday, September 06, 2002 7:24 PM
To: Lamb, Tina; [EMAIL PROTECTED]
Subject: RE: Disease Registry


Tina
In relation to registries there are a few issues to consider--
In many states they are required by law, and the disclosures are
permitted by the privacy rule to the extent they are required by law.
What I wonder is if over time we've had "scope creep".  The state law
requires reporting 12 data elements for example - but over time agencies
have asked CEs to also provide some additional data.  Without individual
authorization the CE is restricted to report only the data required by
law - so check your state's laws carefully to ensure your organization
is reporting no more than the required data. 

You could check and see if the limited data set or de-identified data
would suffice for reporting.  Knowing what the laws are in Colorado the
response would be "no" - but it is worth a try. 

Accreditation is considered part of health care operations, so following
patients will be permitted.  Of course I suspect that you have issues of
getting some of the follow-up information from other providers.  The
change in consent provision does allow one CE to disclose PHI to another
CE for the 2nd CE's payment and healthcare operations purposes.  The
downside is the disclosure by the CE holding the PHI has to be included
in the accounting of disclosures.

I also think it is an important issue to raise with the American College
of Surgeons - there will be individuals that you may not be able to
follow related to the privacy rule and how various providers choose to
comply.  It seems like they will have to cut some slack if you make a
good faith effort. 

Christine Jensen
HIPAA Project Manager
Denver Health
303.436.7942

-----Original Message-----
From: Lamb, Tina [mailto:[EMAIL PROTECTED]]
Sent: Thursday, September 05, 2002 12:09 PM
To: [EMAIL PROTECTED]
Subject: Disease Registry


We are looking at how HIPAA is going to impact our disease registry
program,
e.g. cancer and trauma.  I am aware that state law requires this
reporting,
however, for our cancer registry program, we follow patients progress to
be
accredited by and in accordance with the American College of Surgeons.
If
we have to obtain a patient's authorization and the patient refuses, we
have
not met our obligation... how are hospitals interpreting this process
under
the HIPAA guidelines? Thanks for any assistance you can provide. 

Tina C. Lamb
HIPAA and Corporate Compliance Coordinator
St. Francis Hospital, Inc. 
706/596-4411 x 5657 



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