The Health Insurance Portability and Accountability Act

Many parties other than the health care team are involved in providing care to patients—laboratories for testing, insurance agents for health insurance, or pharmacists for medications. As a patient moves from one facility to another, so does his or her personal health information. It is likely that a patient’s personal health information might be passed on to a third party if proper care is not exercised. How does a medical social worker protect and disclose the identifiable health information of a patient? As a prospective medical social worker, you are required to become familiar with the privacy rules.

This week, you examine the Health Insurance Portability and Accountability Act (HIPAA). You gain a clear understanding about the applications of the HIPAA to your professional responsibilities.

Learning Objectives

Students will:

• Apply the Health Insurance Portability and Accountability Act to medical social work practice
• Analyze the impact of the Health Insurance Portability and Accountability Act on medical social work practice

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Myers, R. K. (2009). The fundamentals of HIPAA. Privacy, security and electronic data transfer in clinical settings: What we need to know. Retrieved from http://www.clinicalsocialworkassociation.org/HIPAA

U.S. Department of Health & Human Services. (n.d.). Summary of the HIPAA privacy rule. Retrieved from https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html

Caine, K., & Hanania, R. (2013). Patients want granular privacy control over health information in electronic medical records. Journal of the American Medical Informatics Association, 20(1), 7–15.
Note: Retrieved from Walden Library databases.

Harman, L. B., Flite, C. A., & Bond, K. (2012). Electronic health records: Privacy, confidentiality, and security. Virtual Mentor, 14(9), 712–719.

Optional Resources

Colvin, J. D., Nelson, B., & Cronin, K. (2012). Integrating social workers into medical–legal partnerships: Comprehensive problem solving for patients. Social Work, 57(4), 333–341.

English, A., & Ford, C. A. (2004). The HIPAA privacy rule and adolescents: Legal questions and clinical challenges. Retrieved from http://www.guttmacher.org/pubs/journals/3608004.html

National Association of Social Workers. (2001). What social workers should know about the HIPAA privacy regulations. Retrieved from http://www.socialworkers.org/practice/behavioral_health/mbh0101.asp

University of North Carolina at Chapel Hill. (2012–2013). Welcome to the HIPAA, privacy & security training module. Retrieved from http://www.unc.edu/hipaa/Annual%20HIPAA%20Training%20current.pdf

Discussion 1: HIPAA, Patient Rights, and Medical Social Worker Dilemmas

Medical social workers must comply with the Health Insurance Portability and Accountability Act (HIPAA) regulations, especially the Privacy Rule. HIPAA gives patients the right to access their medical records and ensures that identifiable health information is not shared without their written consent. In practice, medical social workers often face predicaments involving the disclosure of health information. Besides following HIPPA guidelines and policies in their daily work, medical social workers may be called upon to educate patients and their families about HIPAA regulations.

To prepare for this Discussion, review this week’s resources, including the media and two case scenarios. Select one case and focus on the dilemma illustrated in the case.

Case Scenario 1:

You are a medical social worker in an outpatient clinic at a major teaching hospital. A woman shows up at the clinic who claims she is one of your patient’s sisters. She states, “I am here to find out whether my brother George has been coming to his appointments. I am very worried because he is so sick and does not seem to be getting better. All I want to do is help him.” She goes on to say, “I don’t think he’s taking his medication. Can you tell me what meds he should be taking?”

Case Scenario 2:

You are a medical social worker at a skilled nursing facility. You receive a phone call from a man who states he is one of your patient’s brothers. Your patient was admitted to the skilled nursing facility for rehabilitation after a long stay at an acute care hospital. In addition to his medical issues, your patient has rather severe mental health issues. The man on the phone is frantic and wants to know whether his brother is still a patient at the skilled nursing facility. He also asks about his brother’s condition. He asks, “Is he stable? Is he ok? Is he getting better? Is he taking his medication?” The man on the phone explains that your patient’s mother just passed away. He needs to tell his brother but does not want to do so unless his brother is able to handle the news.

By Day 3

Post a brief description of a medical social worker’s responsibilities, under HIPAA guidelines, that apply to the case you selected. Describe the rights of the person making the inquiry, and explain how you as a medical social worker should respond. Then, describe the rights of the patient and the actions you might consider to safeguard your patient’s information. Briefly describe your professional responsibilities to protect your patient.

Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.