Title: RE: PHI MAP is here ( was RE: Yoo-hoo!! Kristi?!! Where are you!! Yoo-hoo!!
I think these thought processes are substantially flawed.  However, it occurs to me that we are seeing a significant issue emerge that requires addressing: 
 
What are the actual requirements for legal non-participation in HIPAA?  >From my perspective, I can not see how any modern practice can not engage in some form of arguably covered transactions which trigger HIPAA covered entity or business associate status.  Even if they sub-contract the transactions services, they're still a covered entity per CMS/OCR.   And, as I have stated before, I think the Privacy and Security Rules are generally a good steps forward.
 
So, exactly what does a business have to give up to not be covered under HIPAA?  What I am asking is: should SNIP develop a document that clearly states what these requirements are?  Until such a document exists, business people can not objectively evaluate non-applicability from non-compliance.  Nor can they look at the real loss of business that I believe such moves would entail.
 
I, for one, would be very interested in participating is such a project.  I, like many, have found it difficult to express to potential covered entities what their options are in this regard.  So I believe that a non-applicability implementation guide is ultimately the only way to resolve this.  Or do we simply leave it up to OCR enforcement and case law to determine this?
 

Tim McGuinness, Ph.D.
Consulting Specialist in Regulatory Privacy, Security, and Application Compliance (HIPAA/ASCA/FDA/CMS-HCFA/ICH/ADA 508c),
 
President,
HIPAA Help Now
 
Executive Co-Chairman for Privacy,
HIPAA Conformance Certification Organization (HCCO)

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-----Original Message-----
From: Deborah Campbell [mailto:[EMAIL PROTECTED]]
Sent: Monday, September 23, 2002 2:14 PM
To: [EMAIL PROTECTED]
Subject: RE: PHI MAP is here ( was RE: Yoo-hoo!! Kristi?!! Where are you!! Yoo-hoo!!



While I did have some questions about this governmental database of PHI, I must admit, we expect many of our providers to stop sending encounter info electronically because of HIPAA. In many of the small dentist offices we deal with, the encounter info they use DDE to supply is the only electronic transactions they perform. And many don't even have internet capability, or the dentists computer in his office is the only one with it. We expect many of these offices to stop the few transactions they do electronically to keep from complying with all of HIPAA.

Now, I don't expect many MD doctor's offices to do this, since they are dealing with Medicare, Medicaid, etc. But I think you will see this in dentist offices.....and maybe vision.

Deborah Campbell
Compliance Coordinator

Dominion Dental Services, Inc.
115 South Union Street, Suite 300
Alexandria, Virginia 22314

Phn: (703) 518-5000 ext. 3035
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-----Original Message-----
From: fwdanby [mailto:[EMAIL PROTECTED]]

Many of my colleagues are getting pretty fed up with the requirements
dictated by HIPAA. To know them is not to love them!
Some see the following as a way to save time and money that would be FAR FAR BETTER APPLIED TO PATIENT CARE.
What do you think of this approach (aside of course from envying the less than 10 crowd).
Yes I know there are some debatable quibbles in the content.
Bill D.

MODEL PATIENT PRIVACY PROTECTION ADVISORY
Notice of Non-participation in Government Medical Records Program


I have chosen to remain a non-covered entity under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that goes into effect in October 2002.  If I agreed to participate, I would have to comply with more than 3,000 pages of federal laws and regulations that decide how and when your private medical files are used, as well as who has access to them.This would be done without your permission.  Instead, you would only have a chance to read a statement of general ways your records might be used, rather than requiring your consent for their use.

Under these rules, thousands of government agencies would have virtually unrestricted access to your medical records.The HIPAA standards will result in a nationwide data base of medical records accessible to marketers, government agents, researchers, and many private entities whose interests may conflict with the best interest of patients. It is not possible to protect confidentiality once records are in a networked computer, no matter how many rules are in force.

Further, the regulations enable a centralized government database of
everyone's medical records. Information in your medical record could be used against you, for example, to ration your care or even to prosecute you, as for an allegedly false statement to an insurer.

By choosing to be a "non-covered entity" and not filing a compliance program with the government, I am better able to protect the confidentiality of your medical record.

I am also better able to serve your medical needs by concentrating on
medical problems rather than complex, ever-changing rules, and by organizing my practice in an efficient manner rather than the way dictated by government rules.

Our practice will not participate in the entry of your private data into this data base. Your records will be released only with your written consent, except as may be specifically required by law.

To do this, I must file only paper claims, not electronic ones. This may delay processing.

You may choose to file your own claim. This may lead to faster payment and possibly even to a higher rate of reimbursement. Our office will gladly provide you with any documentation you need if you choose to file your own claim.  We will continue to make the trust of our patients our highest priority.



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