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1 hipaa

2 history

3 3 min.

4 1996

5 purposes

6 purposes 1. improve portability and continuity of coverage

7 1. improve portability and continuity of coverage 2. combat waste, fraud, and abuse in health insurance and healthcare delivery purposes

8 1. improve portability and continuity of coverage 2. combat waste, fraud, and abuse in health insurance and healthcare delivery 3. promote use of medical savings accounts purposes

9 1. improve portability and continuity of coverage 2. combat waste, fraud, and abuse in health insurance and healthcare delivery 3. promote use of medical savings accounts 4. improve access to long term care services and coverage purposes

10 1. improve portability and continuity of coverage 2. combat waste, fraud, and abuse in health insurance and healthcare delivery 3. promote use of medical savings accounts 4. improve access to long term care services and coverage 5. simplify administration of health insurance purposes

11 1. improve portability and continuity of coverage 2. combat waste, fraud, and abuse in health insurance and healthcare delivery 3. promote use of medical savings accounts 4. improve access to long term care services and coverage 5. simplify administration of health insurance purposes 6. end world hunger and usher in everlasting peace on earth

12 1. improve portability and continuity of coverage 2. combat waste, fraud, and abuse in health insurance and healthcare delivery 3. promote use of medical savings accounts 4. improve access to long term care services and coverage 5. simplify administration of health insurance purposes 6. end world hunger and usher in everlasting peace on earth

13 1. improve portability and continuity of coverage 2. combat waste, fraud, and abuse in health insurance and healthcare delivery 3. promote use of medical savings accounts 4. improve access to long term care services and coverage 5. simplify administration of health insurance purposes

14 purposes simplify administration of health insurance

15 purposes simplify administration of health insurance

16 purposes simplify administration of health insurance

17 purposes simplify administration of health insurance

18 purposes simplify administration of health insurance

19 purposes simplify administration of health insurance

20 purposes simplify administration of health insurance

21 purposes simplify administration of health insurance

22 purposes simplify administration of health insurance

23 purposes simplify administration of health insurance

24 purposes simplify administration of health insurance

25 simplify administration of health insurance purposes privacy

26 privacy

27 privacy

28 privacy

29 privacy afterthought

30 privacy

31 privacy

32 privacy

33 privacy Standards for Privacy of Individually Identifiable Health Information

34 Standards for Privacy of Individually Identifiable Health Information S.P.I.I.H.A. privacy

35 Standards for Privacy of Individually Identifiable Health Information S.P.I.I.H.A. privacy

36 Standards for Privacy of Individually Identifiable Health Information PRIVACY RULE privacy

37 history

38 The Privacy Rule prohibits covered entities and business associates from using or disclosing protected health information except as HIPAA requires or permits privacy rule

39 required disclosures: privacy rule

40 required disclosure: 1. patient requests it privacy rule

41 required disclosure: 2. HHS requests it to enforce HIPAA privacy rule

42 permissive disclosures: privacy rule

43 permissive disclosures: 1. to the patient (even absent patient request) privacy rule

44 permissive disclosures: 2. treatment, payment or healthcare operations privacy rule

45 permissive disclosures: 3. inadvertently occurring during permitted or required disclosure privacy rule

46 permissive disclosures: 4. Written patient authorization privacy rule

47 permissive disclosures: 5. agreed disclosures privacy rule

48 permissive disclosures: 6. public interest privacy rule

49 permissive disclosures: 6. public interest privacy rule

50 permissive disclosures: 6. public interest privacy rule

51 permissive disclosures: 6. public interest a. required by law privacy rule

52 permissive disclosures: 6. public interest a. required by law b. public health privacy rule

53 permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) privacy rule

54 permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight privacy rule

55 permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings privacy rule

56 privacy permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings f. about decedents rule

57 privacy rule permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings f. about decedents g. law enforcement

58 privacy rule permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings f. about decedents g. law enforcement h. cadaver donation

59 privacy rule permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings f. about decedents g. law enforcement h. cadaver donation i. research

60 privacy rule permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings f. about decedents g. law enforcement h. cadaver donation i. research j. avert threats

61 privacy rule permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings f. about decedents g. law enforcement h. cadaver donation i. research j. avert threats k. gov t functions

62 privacy rule permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings f. about decedents g. law enforcement h. cadaver donation i. research j. avert threats k. gov t functions

63 privacy rule permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings f. about decedents g. law enforcement h. cadaver donation i. research j. avert threats k. gov t functions

64 a. required by law e. judicial proceedings privacy rule

65 a. required by law privacy rule

66 a. required by law privacy rule

67 a. required by law TRCP 176.6(e) privacy rule

68 a. required by law TRCP 176.6(e) privacy rule.... A person need not comply with the part of a subpoena from which protection is sought under this paragraph unless ordered to do so by the court....

69 a. required by law TRCP 176.6(e) privacy rule.... A person need not comply with the part of a subpoena from which protection is sought under this paragraph unless ordered to do so by the court....

70 privacy rule permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings f. about decedents g. law enforcement h. cadaver donation i. research j. avert threats k. gov t functions

71 privacy rule permissive disclosures: 6. public interest a. required by law b. public health c. victims (abuse... ) d. health oversight e. judicial proceedings f. about decedents g. law enforcement h. cadaver donation i. research j. avert threats k. gov t functions

72 a. required by law e. judicial proceedings privacy rule

73 e. judicial proceedings privacy rule

74 e. judicial proceedings privacy rule

75 e. judicial proceedings privacy rule

76 e. judicial proceedings privacy rule

77 e. judicial proceedings privacy rule

78 e. judicial proceedings privacy rule

79 e. judicial proceedings privacy rule

80 e. judicial proceedings notice or protective order privacy rule

81 e. judicial proceedings notice or protective order privacy rule

82 e. judicial proceedings notice: satisfactory assurance privacy rule

83 e. judicial proceedings notice: satisfactory assurance in writing privacy rule

84 e. judicial proceedings notice: satisfactory assurance in writing accompanying docs privacy rule

85 e. judicial proceedings privacy notice: satisfactory assurance in writing accompanying docs good faith attempt to provide written notice rule

86 e. judicial proceedings privacy rule notice: satisfactory assurance in writing accompanying docs good faith attempt to provide written notice sufficient information re: litigation to object

87 e. judicial proceedings privacy rule notice: satisfactory assurance in writing accompanying docs good faith attempt to provide written notice sufficient information re: litigation to object and time lapsed without objection or court overruled

88 e. judicial proceedings privacy rule notice: satisfactory assurance in writing accompanying docs good faith attempt to provide written notice sufficient information re: litigation to object and time lapsed without objection or court overruled

89 e. judicial proceedings notice or protective order privacy rule

90 e. judicial proceedings protective order privacy rule

91 e. judicial proceedings protective order: privacy rule

92 e. judicial proceedings protective order: satisfactory assurance privacy rule

93 e. judicial proceedings protective order: satisfactory assurance in writing privacy rule

94 e. judicial proceedings protective order: satisfactory assurance in writing with docs showing privacy rule

95 e. judicial proceedings protective order: privacy rule satisfactory assurance in writing with docs showing parties agreed to a qualifying protective order and submitted it to the court

96 e. judicial proceedings protective order: privacy rule satisfactory assurance in writing with docs showing parties agreed to a qualifying protective order and submitted it to the court OR party seeking info requested

97 e. judicial proceedings protective order: privacy rule satisfactory assurance in writing with docs showing parties agreed to a qualifying protective order and submitted it to the court OR party seeking info requested

98 e. judicial proceedings protective order: privacy rule satisfactory assurance in writing with docs showing parties agreed to a qualifying protective order and submitted it to the court OR party seeking info requested use limited to litigation

99 e. judicial proceedings protective order: privacy rule satisfactory assurance in writing with docs showing parties agreed to a qualifying protective order and submitted it to the court OR party seeking info requested use limited to litigation and return or destruction at end

100 required by law notice qualifying protective order privacy rule

101 violation consequences

102 Bad Things

103 for the responding party: no express private right of action violation consequences

104 for the responding party: courts refused to imply private right of action violation consequences

105 for the responding party: government investigation violation consequences

106 for the responding party: government civil penalties violation consequences

107 for the responding party: government criminal penalties violation consequences

108 for the responding party: may set the standard of care in torts: violation consequences Byrne v. Avery Center for Obstetrics

109

110 for the requesting party: potential criminal liability violation consequences

111

112 for the requesting party: DOJ Opinion: person not limited to covered entity violation consequences

113 for the requesting party: DOJ Opinion: violation consequences knowingly means person knew facts not that conduct violated the law

114 for the requesting party: DOJ Opinion: no direct violation for causing another to violate hipaa violation consequences

115 for the requesting party: DOJ Opinion: aiding and abetting liability violation consequences aids, abets, counsels, commands, induces,... crime

116 for the requesting party: sanctions civil procedure rules for subpoenas violation consequences

117 for the requesting party: retaliatory conduct BNSF v. White violation consequences

118 for the requesting party: retaliatory conduct violation consequences Noerr- Pennington Doctrine

119 for the issuing lawyer: lawyer immunity may not apply to criminal liability violation consequences

120 for the issuing lawyer: violation consequences lawyer immunity may not apply to civil liability for issuing a subpoena Rodrigues v. City of New York

121 for the issuing lawyer: violation consequences lawyer immunity may not apply to civil liability for hipaa subpoena Fuhler v. Gateway Medical

122 for the issuing lawyer: lawyer immunity may not protect client from exposure violation consequences

123 use of medical in litigation: violation ADA civil exposure for filing public pleadings that disclose medical consequences

124 use of medical in litigation: violation ADA civil exposure for filing public pleadings that disclose medical consequences

125 good practices: plan

126 good practices: plan for plaintiff s counsel: gather medical

127 good practices: plan for plaintiff s counsel: gather medical write doctors

128 good practices: plan for defense counsel: know hipaa rules give assurances

129 good practices: plan for in-house counsel: have a protocol for outside counsel on subpoenas for medical and use

130 David L. Wiley Gibson Wiley PLLC thank you!

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