HIPPA Authorization Lawyer in Wisconsin
What is a HIPPA Authorization?
HIPAA (Health Insurance Portability and Accountability Act) introduced federal standards for the disclosure of health information related to uses and to whom and under what circumstances information can be disclosed. The purpose of HIPAA is to protect the privacy and security of patient health information (PHI), ensure health insurance portability, and decrease administrative costs. HIPAA also prevents healthcare providers from sharing information about a patient with loved ones.
A HIPAA Authorization allows an individual to outline entities or individuals whom patient health information (PHI) can be disclosed to for a purpose not permitted by the HIPAA Privacy Rule. PHI can include a range of records; including medical bills, health insurance claims, applications for health insurance, and even the fact that a person is a physician’s patient or a health plan enrollee. Without a HIPAA Authorization, disclosure of PHI would violate HIPAA Rules, which is considered a serious violation of HIPAA compliance and may be determined to be a criminal offense.
A HIPPA Authorization must be written and signed by the patient, among other requirements, to be valid. The authorization can also be revoked at any time by the individual in writing.
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How does Healthcare Power of Attorney Work in my Estate?
The HIPAA Authorization works together with a Healthcare Power of Attorney to create a comprehensive estate plan related to health care. A HIPAA Authorization allows you to direct any physician, health care professional, health care provider, or medical care facility and health insurance provider to provide any information related to your physical and mental condition and the diagnosis, prognosis, care and treatment thereof to a selected individual or entity, such as your Healthcare Power of Attorney agent. This authorizes the release of medical information to your selected agent as if it was you personally making the request.
A Healthcare Power of Attorney gives someone authority to make broader medical decisions on your behalf and may outline your directives for your agent related to a nursing home or community-based residential facility, feeding tubes, hospice care, comfortable or heavy medication, and anatomical gifts/organ donation. A HIPAA Authorization, on the other hand, is more specific and is only related to the disclosure of medical information.
When is HIPAA Authorization required?
- Use or disclosure of PHI otherwise not permitted by the HIPAA Privacy Rule
- Use or disclosure of PHI for marketing purposes (unless the communication occurs in person between the covered entity and the individual, or involves a promotional gift of nominal value)
- Use or disclosure of psychotherapy notes, except for specific purposes related to treatment, payment, or healthcare operations
- Use or disclosure of substance abuse and treatment records.
- Use or disclosure of PHI for research purposes.
- Before selling protected health information.
Exceptions:
There are some very specific circumstances under which the HIPAA Privacy Rule permits covered entities to use and/or disclose PHI without patient authorization. Exceptions include:
- Healthcare regulations and licensing
- Public health (such as reporting to a state health department or the CDC)
- Medical research
- Workers compensation
- Legal proceedings and law enforcement purposes
- To inform next of kin, identify a body, determine cause of death, or for a medical examiner/coroner
State vs. Federal Regulations:
"HIPAA is a set of standards on the federal level and preempts state law unless a state law has stronger privacy provisions and is more stringent. Overall, Wisconsin law generally follows the federal rule but has stricter data breach notification policies."