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Make sense of the privacy rights of minors: Murky areas surround disclosures

HIPAA Training Advisor, November 29, 2007

It is no secret that many state laws intersect with HIPAA requirements when it comes to disclosing PHI to patients' family members. Many covered entities (CE) struggle to understand the various and occasionally conflicting regulations that apply to situations involving young patients and their parents or guardians. Even CEs that are adept at dealing with the intricacies of patient confidentiality often balk when trying to decide what to tell the parents of a minor.

Survey says

Both William Miaoulis, CISA, CISM, principal and security service line leader for Phoenix Health System in Montgomery Village, MD, and David Ermer, managing partner of Gordon & Ermer, a Washington, DC-based healthcare law firm, urge CEs to use all the resources available to their organizations to ensure compliance with state and federal regulations. For example, trade associations, the AMA, and the American Hospital Association all provide various resources that can help CEs stay on top of state requirements that may be updated because of new regulations and court case decisions.

To help CEs comply with various state regulations, Ermer and his colleagues analyzed and condensed relevant state laws to provide a survey, titled "State law survey for use in applying the personal representative for minor section of the HIPAA privacy rule," that highlights differences in state laws.

According to the survey, most states have laws concerning minors who receive the following services:

  • Contraceptive services
  • Prenatal care
  • Treatment of STDs, including HIV
  • Alcohol and/or drug abuse treatment
  • Mental health treatment
  • Abortion services

To view the survey, click here.

You are not alone

Ermer offers the following advice to help CEs comply with this complex issue:

  • Provide training, training, and more training for your staff. Although every CE has heard this over and over, Ermer says it is vital to comply with the rights of minors. A slip of the tongue, a telephone call revealing a test result, a letter detailing follow-up treatment can all lead to a privacy disaster. Well-trained staff members who are aware of state laws and the effect of federal regulations are crucial to compliance.
  • Take the time you need to ensure you can disclose PHI. Ask parents or guardians to put their requests for PHI in writing. Then, verify the validity of the inquiry and your ability to disclose the information.
  • Regularly review your state laws. New regulations and court decisions that affect the rights of minors can become effective at any time.
  • Use available resources. Consult state medical associations, national trade associations, and other resources for assistance in understanding the requirements of HIPAA, state, and other federal laws.

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