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HITECH Tip: Be aware of new restriction requests and marketing requirements

HIPAA Weekly Advisor, February 1, 2010

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Effective this month, if a patient goes to a physician or other provider and pays in full for treatment, a prescription, or durable medical equipment out of pocket, the patient may request that his or her medical information be restricted.

For example, if the patient requests that the provider not release that information to his or her insurer for payment or healthcare operations, the covered entity must honor that request, says Chris Apgar, CISSP, president of Apgar & Associates, LLC, in Portland, OR. In the past, the provider could tell the patient that he or she could request restrictions on the disclosure of information, but the covered entity did not have to agree to restrict access, he says.

Restriction requests may also be a challenge in the 40 states with pharmacy registries, he adds. The registries allow a physician to see certain prescriptions a patient is taking, including pain medications such as OxyContin®. If a patient pays out of pocket and requests that a pharmacist not report that information, federal law trumps the state requirements for reporting to pharmacy registries, Apgar says.

Editor’s note: This except is from the February edition of Briefings on HIPAA, HCPro, Inc.’s 12-page newsletter. To learn more about the newsletter or to purchase this article in full, please go to HCPro, Inc.’s Health Information Management page.

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