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Legal Aspects of Health Administration

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You are the administrator on duty at General Hospital. It is Friday afternoon and the day shift is anxious to get off work on time and start the weekend. Mrs. Anderson, a mid-level administrator on her day off, brings her 15 year old daughter, Sandra, in for a check-up of abdominal pain. Examinations and diagnostic work-up reveal that Sandra is pregnant.

Sandra reveals to the physician that her step-father has molested her and she does not wish her mother to know. Mrs. Anderson demands Sandra's original medical records - claiming that as the mother, she has a legal right to the records. You are called by the emergency room physician and the supervisor in the medical records department with pleas for help. Mrs. Anderson confides in you that her religious beliefs demand that she alter the medical records for the sake of family unity. Accordingly she demands the medical records.

*Discuss the foregoing scenario (provide a resolution) in light of HIPAA and applicable state laws pertaining to medical records and privacy. The questions that must be answered are:

*What are the obligations regarding reporting of the alleged abuse under federal and state laws? Who are mandated reporters and what is their legal obligation?

*What do you say to Mrs. Anderson about her access to records? What laws regulate the access or disclosure of medical records/information of a minor (receiving reproductive care/treatment)?

*What practical recommendations do you have to avoid similar problems in the future?

*You will need to refer to the laws of your state (south carolina) of residence/employment as well as federal law.

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Solution Preview

Hi,

Interesting scenarios and questions! Let's take a closer look. I also attached one informative article and several links for further research and consideration.

RESPONSE:

1. Discuss the foregoing scenario (provide a resolution) in light of HIPAA and applicable state laws pertaining to medical records and privacy.

The Department of Health and Human Services (DHHS) established minimum privacy standards in 1996 through the Health Insurance Portability and Accountability Act (HIPAA) [32] (http://www.medscape.com/viewarticle/456472_6).

Health care providers, health plans, and health care clearinghouse are all affected by HIPAA. HIPAA is intended to establish security and privacy standards and promote the standardized electronic transmission of administrative and financial health care records that are currently carried out manually on paper. There were two issues that slowed progress in establishing HIPAA regulations: The first issue was the relationship of federal law to state law and the second issue concerned the rules regarding minors' rights and parental access to their medical records [32-34] (http://www.medscape.com/viewarticle/456472_6).

The short answer to this question is that if the health care provider or facility concurs with the minor that the parents should not have access to his or her treatment records, the minor has a good chance of precluding parents from access to the records or granting access to others. However, if the facility or provider does not concur, the minor's chances of precluding such access are minimal. This is the short answer; the route to this answer is longer and more circuitous (http://www.ftnys.org/HIPAA%20rights.pdf).

See summary of HIPAA rules at http://www.hhs.gov/ocr/privacysummary.pdf.

2. What are the obligations regarding reporting of the alleged abuse under federal and state laws? Who are mandated reporters and what is their legal obligation?

Under state and federal, the alleged abuse needs to be reported to the appropriate authorities. Both state ...

Solution Summary

Referring to the case scenario, this solution discusses HIPAA and applicable state laws pertaining to medical records and privacy e.g.the obligations regarding reporting of the alleged abuse under federal and state laws, who mandated reporters and what is their legal obligation, what to say to Mrs. Anderson about her access to records and what laws regulate the access or disclosure of medical records/information of a minor (receiving reproductive care/treatment), the practical recommendations to avoid similar problems in the future ane refer to the laws of South Carolina as well as federal law.

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