patients’ rights tagged posts

HIPAA in Mental Health Care

JenniferPhotoJennifer Bernstein, JD, MPH
Senior Attorney, The Network for Public Health Law – Mid-States Region
University of Michigan School of Public Health

This is the second of three posts discussing privacy rights for mental health care provided by Attorney Jennifer Bernstein. Read the first installment from earlier this week. Additionally learn more by reading FAQs from the U.S. Department of Health & Human Services.

When and How Can A Family Member Become Involved in Care?
Now that we have discussed some of the basics of the HIPAA Privacy Rule, let’s consider some specific concerns that family members often have regarding treatment and care of their adult family members with a mental health disorder. Generally, HIPAA gives ultimate deference to a patient’s wishes as to the sharing of their health information. There are some exceptions that are important for the family members of individuals with mental illness.

When does mental illness constitute incapacity under the Privacy Rule?
The HIPAA Privacy Rule does make allowance for when a patient is unable to authorize disclosure due to incapacity. A major determining factor on whether to disclose a patient’s information to the their family, friends or other persons involved in their care is whether or not the disclosure is in the best interests of the patient.  Incapacity criteria may include when a patient is incoherent or suffering from psychosis.

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Patient Privacy in Mental Health: Balancing Rights while Trying to Ensure Appropriate Treatment

JenniferPhotoJennifer Bernstein, JD, MPH
Senior Attorney, The Network for Public Health Law – Mid-States Region
University of Michigan School of Public Health

Patient Privacy in Mental Health: Balancing Rights while Trying to Ensure Appropriate Treatment

Privacy rights and protection of health information take on special meaning in mental health care, whether because of the stigma associated with mental health conditions, or issues of family dynamics, or a variety of other reasons. The on-going debate takes on increased importance in light of the tragedy this past weekend at the University of California at Santa Barbara.

Before we explore particular instances of how patient privacy has affected people with mood disorders and their families, we’ve asked attorney Jennifer Bernstein to provide an overview of privacy in mental health care. 

What is HIPAA?
The Health Insurance Portability and Accountability Act, commonly referred to as HIPAA, provides consumers with privacy rights and protections for their health information, including mental health information. Though enacted in 1996, HIPAA’s Privacy Rule governing individually identifiable health information took effect in 2001. The Privacy Rule seeks to strike a balance between protecting patient’s privacy by safeguarding sensitive health information and allowing for the sharing of a patient’s health information to ensure the best treatment and the health and safety of the patient or others. The following information applies generally to adult patients.

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Final Parity Ruling and Obamacare

healthinsurance2Cause for celebration or just one victory in a long-term battle

On November 8, 2013 the Obama administration released the final rule providing guidance on how health insurance plans should implement mental health parity. In short, the rule states that mental health coverage must be equitable to how insurance plans cover other physical conditions. Restrictions accessing care and reimbursement for services can no longer be different for mental health in relation to other health care services. Additionally the ACA, more popularly known as Obamacare, requires that mental health coverage be included as an essential health benefit for plans available through the market exchange.  In short, as of January 1, 2014 private, marketplace exchange and Medicaid Expansion plans must offer mental health care and it must be with parity.

Much has been written about the ruling. Most of it positive. Bloomberg BNA states advocates are praising the rule. The National Council applauds the ruling saying it is “a huge victory for people living with mental health needs and for the nation as a whole.

CFYM has covered the topic in past blogs and has provided instructions on how to fight for your coverage rights by challenging an insurance claim denial. Carol McDaid of the Parity Implementation Coalition posted on September 19 that now is the time to become an informed, empowered, and vocal consumer. There is much work still to be done to ensure the civil rights and protection of people living with a mental health condition when it comes to access, however.

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