Clayton Vandiver, your light keeper here, once
again from the middle of the Pacific Ocean, talking
to you about HIPAA Part 2. All of the things
that you need to know, hopefully, at least to
begin the conversation about protecting your
information, your private, unique medical information,
and how it might be compromised. This is a really
exciting episode coming up on today's Light Keepers
Podcast. with us this week as always Charlene
our licensed clinical social worker here to tell
us more about HIPAA once again remind us what
HIPAA means? What are those acronyms? So HIPAA
stands for the Health Insurance Portability and
Accountability Act. Only the government could
come up with a title that long. That's amazing.
It's so unnecessarily complicated. But basically
what it boils down to is your unique information
including your medical records, medical history,
medications. Anything that can identify you as
an individual in conjunction with your medical
history is protected by federal law, which means
it cannot be shared with anyone without your
consent. Who all is concerned with HIPAA within
the medical community? Everybody should be concerned
with HIPAA. Everybody should be concerned with
HIPAA. But one of the common misunderstandings
among individuals out there, the community at
large, is that everyone is responsible for HIPAA
protection, and that's not true. Not all facilities
are required to abide by HIPAA regulations. Correct.
And forgive me if I keep looking down. I don't
want my notes to blow away. Well, we are in the
middle of the Pacific Ocean. Yes. So a HIPAA
-covered entity includes health plans, health
care clearinghouses. And providers that conduct
electronic transactions for which the Department
of Health and Human Services has published standards.
That's the government definition of who is responsible
for maintaining HIPAA regulations and policy.
Now, who that applies to is any individual that
walks in the door of one of those facilities.
Okay. And it doesn't matter if they're... a citizen
of the united states even non -citizens their
information is protected and and there are protections
in place that people don't even realize for example
if we have someone come in from a crime scene
and the police come in asking information we
can't give them information really really Really.
So the protection is that critical and that all
-encompassing? Absolutely. They have to come
back with a warrant. So with a warrant, you're
allowed to release... We are required. Required
to release that information. And that's an important
detail. Details matter, especially in legal matters.
That information has to be subpoenaed or they
have to come back with a warrant. And even then,
we're only allowed to give the least amount of
information to satisfy their request. Okay, so
the least amount necessary to... provide them
whatever it is that they need. Correct. Well,
HIPAA appears to be a very sensible protection,
but that leads us to wonder, why is it so important?
Well, HIPAA is a double -edged sword because
in the same way that it can protect, it can also
make it more difficult. For example, using families,
a couple. If you have a couple that works together
to manage each other's medical care, and the
wife tries to call the doctor's office to schedule
an appointment for the husband, she can't. Really?
She can't. Without them having a notice on his
chart that he has signed giving permission for
them to speak with her, she can't. Even to just
make an appointment. Even to just make an appointment.
They can't even confirm or deny that he's a patient
of theirs without that permission. Now, put the
spin on that. People all the time say, and I
know this happened because I've done it, when
I was my mom's medical power of attorney. call
up, identify myself. I am her medical power of
attorney. They haven't seen a form. They haven't
seen a document. A lot of times they don't even.
And with that information, I can make an appointment.
I shouldn't have been able to. Correct. Now you
put the spin on that and say you have a woman
who is in a situation of domestic violence. HIPAA
is protecting her because now she can go to the
doctor and she can confide in the doctor everything
that's going on at home and he can't find out.
That she's even been to the doctor. That she's
even been to the doctor. And that's a very good
thing. So you can see where it would be a double
-edged sword. But the really interesting thing
about HIPAA is that HIPAA is violated every day,
and people don't even realize it. And that's
really where I wanted to come with this particular
show today, because people need to know. that
their HIPAA is being violated, when it's being
violated, and how they can protect themselves
because something we're going to talk about later
on in a next show or maybe the one after is medical
identity theft, which a HIPAA violation can lead
to, just like a violation of your financial information
can lead to identity theft and fraud. Release
of your medical information can result in medical
identity theft and medical fraud. We're going
to talk about more details of what that means,
what that is, and how that happens. I've even
got a great tidbit of information from a seminar
that I attended many years ago from Medicare,
the Department of Elder Affairs. And they investigated,
and it's just fascinating. We'll do that in another
show. but the violations are important to bring
out because let me let me paint a scenario for
you okay okay and i have had this happen to me
personally before giving it any thought now i'm
looking back kicking myself going well that was
stupid you go to the emergency room maybe for
yourself or with a loved one okay their billing
person comes into the room and reads off your
information to confirm that it's correct in the
system That's common. It happens every day. If
you are in an open area. Hallway. Sometimes they'll
park you in a hallway waiting room. But just
a curtain drawn around or maybe a room but with
the door open. Or a shared room where you have
someone else in there with you. That billing
person has just violated your HIPAA information
because anyone around you could have overheard
that. Now, I wonder, and I'm sometimes considered
a conspiracy theorist because I put forward thoughts
that are plausible. That's what college professors
often do. But what if someone complained of stomach
upset, went to the hospital, knowing that it
was a very busy time in the emergency room, got
parked in a hallway where they had three or four
emergency... areas available to them with nothing
but a curtain between them and that information.
And that information was being read back, read
back, read back, read back. And they're sitting
there with a smartphone recording every word
that was said so that later they could play it
back and have a lot of people, it's private,
protected. Correct. And see, and that's a problem.
And I don't say that to give anybody an idea
of something to do. I'm giving it out as a plausible
thought of something that could happen and for
medical personnel to be on the watch for. Absolutely.
It can happen and it does happen because the
only thing that is needed for someone to steal
your medical identity is your insurance information
and an ID. That's it. Well, tell me what sort
of things can be done with medical information
when it is stolen. How serious is that? Well,
I'll give you a really good example of this,
and this is something that I've seen firsthand.
I knew someone who he and his son had very similar
names, and the insurance company mixed up their
dates of birth. So the son had dad's date of
birth, dad had son's date of birth. Because of
that mix -up, the dad was not able to fill his
prescriptions. Until the insurance company got
it straight because he was not supposed to have,
according to their records, those prescriptions.
And so they refused to fill them. Now, fortunately,
there was nothing life -threatening there. That
was the first thought I had. What if it's a life
-threatening prescription? What if that had been
an organ anti -rejection drug? Yeah. So what
they were told was the solution. Was to pay out
of pocket. Okay. Oh my gosh. There are some medications
that are five digits and that's without the decimal
Yes, how are you gonna pay for that out of pocket?
So you have no choice at that point But to go
without it until the insurance company gets it
straightened out. And we all know how long that
can take. Take out a mortgage on your home. You
destroy your finances and hope that your insurance
company will reimburse. And your finances are
another vulnerability because someone who has
assumed your medical identity can receive treatment
and you get the bill for it. Or receive prescription
drugs, sell them on the street and you get the
bill for it and perhaps even become a suspect
for. Criminal activity. Correct. So there's a
lot of risk there. And it's complicated and it's
complex. And that's why people just need to be
more aware. For example, going back to that scenario
with the emergency room, if the billing person
comes in and asks you for that information and
you provide it, you have just implied consent.
giving them permission with your HIPAA information.
Let's talk about that a little bit more in the
next episode because we're running out of time.
Remember, the Light Keepers podcast is brought
to you by a guiding light, a 501c3 nonprofit
charity that needs your help and your support.
If you're able to do so, we certainly welcome
those donations. There's a way on the screen
to actually capture that little QR code and send
in a donation. Also, please like, subscribe.
Click the little bell that tells you we put up
another episode so you don't miss a single episode
of this great, important information. But again,
it starts a conversation. Your specific, unique
medical needs need to be talked over with your
own unique physician who knows you and what your
needs are. But this show is designed to start
a conversation and get that information there
so you know the right questions to ask. and hopefully
you get the best answers to live the best possible
life. That's why we're here on the Light Keepers
podcast every Wednesday evening at 7 p .m. And
from the middle of the Pacific Ocean, I'm Clayton
Vandiver, your Light Keeper. See you next time.