Corporate Compliance

HIPAA Q&A: Opt in or opt out?

Compliance Monitor, May 2, 2012

Q. How do “opt out” and “opt in” arrangements differ?

A. This question is becoming more frequent with the creation of health information exchanges (HIE) and accountable care organizations. In some states, patients must sign a form indicating their willingness to participate in an HIE. If they don’t sign, they don’t participate; this is “opting in.”

In other states, an assumption exists that patients are part of an HIE unless they specifically say (usually in writing) that they do not want to participate. This is “opt out.” With this approach, patients are participants unless they specifically indicate otherwise.

As might be expected, “opt out” arrangements tend to have many more participants because patients need do nothing to participate. Some privacy advocates say this arrangement does not represent true informed consent, even though it usually includes some type of patient education. Patients may not realize their information is included in an HIE unless they take time to learn details.

Editor's note: Chris Simons, RHIA, director of health information and privacy officer at Cheshire Medical Center/Dartmouth-Hitchcock in Keene, N.H., answered this questions in the May Medical Records Briefing. This information does not constitute legal advice. Consult legal counsel for answers to specific privacy and security questions.

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