Re: Copying reform/HIPPA

[Guest guest]

Hi Danno,

Do you have a copy of the ChiroCode book? The President, Mr. Leavitt outlines how to remain HIPPA Free, which goes beyond transmitting data. You also must be very careful about anything your sign that implies you are a HIPPA Entity, this includes verification forms from other sources. Different companies who are HIPPA compliant must make sure their other contacts are also HIPPA compliant, which CHP does need to do, but the contract goes beyond that. However, other type of HIPPA Entities must also send out forms to providers that they work with regularly. For Example, an Orthotic provider or a PT clinic you refer too, that are HIPPA. Usually they forget to have a section for the "HIPPA Free" to sign and acknowledge, so by signing their form, you are now HIPPA too. Mainly it is because they were also lead astray by some Seminar that said "All Providers" must be under the HIPPA law. CHP's contract is a perfect example of what Mr. Leavitt and other's sources have advised providers to avoid. Below is a link on HIPPA from Chirocode. I don't know if I can scan a copy of the pages from ChiroCodes's book with the steps to avoid, as it could be copy right infringement, since it would be posted online? If I can talk to an attorney soon, then I can find out if I can release a copy CHP's section to show the exact language that we all need to avoid, but trust me, the language is extremely clear and intent confirmed when I talked to CHP about the contract, which is why we have to get an attorney now.

http://www.chirocode.com/HIPAA.cfm

Thanks for your help,

Stockton

Cedar Mill Chiropractic Clinic

Copying reform

Listmates:

HI all. I am not attempting to be anyone's business attorney here so take what I am writing with a grain of salt and certainly pass it by your own legal.

There has been some questions regarding the State law of copying charges for medical records being at a rate that is not reasonable, ie it is costing you more than you can charge.

In the HIPAA law the federal law takes precedence over state law whenever state law is less stringent than the federal law with respect to patient's medical privacy. HIPAA states that copying of medical records be of "reasonable costs". Since the state law is less stringent here, ie costs do not equate to more stringent protection of privacy, the federal law takes precedence. I personally am taking the position that I will charge a "reasonable cost" and will not send records nor appear without being compensated at a reasonable rate.

Secondarily if you are directed to follow a pattern that you do not like you can always chose to be a "hostile witness" or you could choose to be an "expert witness" for the other side.

I wonder if the attorney would pay a reasonable cost given that information.

Cheers

DannoOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

Hi Danno,

CHP won't let us amend the contract to state we are not a covered entity. It has already been discussed with them. That would have been the appropriate thing to do, to have a section on the signature page that the provider signs that states that and removes them from specific contract language that states otherwise. Unfortunately, because it is in the contract, legally it is not moot at all.

I will let you know what else I find out.

Thanks again,

Stockton

Copying reform

Listmates:

HI all. I am not attempting to be anyone's business attorney here so take what I am writing with a grain of salt and certainly pass it by your own legal.

There has been some questions regarding the State law of copying charges for medical records being at a rate that is not reasonable, ie it is costing you more than you can charge.

In the HIPAA law the federal law takes precedence over state law whenever state law is less stringent than the federal law with respect to patient's medical privacy. HIPAA states that copying of medical records be of "reasonable costs". Since the state law is less stringent here, ie costs do not equate to more stringent protection of privacy, the federal law takes precedence. I personally am taking the position that I will charge a "reasonable cost" and will not send records nor appear without being compensated at a reasonable rate.

Secondarily if you are directed to follow a pattern that you do not like you can always chose to be a "hostile witness" or you could choose to be an "expert witness" for the other side.

I wonder if the attorney would pay a reasonable cost given that information.

Cheers

DannoOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

.....this is simply co-opting on an ever enlargening scale.....it doesn't matter what's best for YOU the provider and YOU the patient, it's 'the Corporation'......[Rant/on] [insert Rant here] [Rant\off]

SOMEbody has to take a stand. I've taken mine. Although it pays poorly the hours are nice.

How's that for brevity?

J. Pedersen DC

Copying reform

Listmates:

HI all. I am not attempting to be anyone's business attorney here so take what I am writing with a grain of salt and certainly pass it by your own legal.

There has been some questions regarding the State law of copying charges for medical records being at a rate that is not reasonable, ie it is costing you more than you can charge.

In the HIPAA law the federal law takes precedence over state law whenever state law is less stringent than the federal law with respect to patient's medical privacy. HIPAA states that copying of medical records be of "reasonable costs". Since the state law is less stringent here, ie costs do not equate to more stringent protection of privacy, the federal law takes precedence. I personally am taking the position that I will charge a "reasonable cost" and will not send records nor appear without being compensated at a reasonable rate.

Secondarily if you are directed to follow a pattern that you do not like you can always chose to be a "hostile witness" or you could choose to be an "expert witness" for the other side.

I wonder if the attorney would pay a reasonable cost given that information.

Cheers

DannoOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

Dr. Pedersen,

You always make me laugh and you get the Medal of Honor for taking a stand. We are trying, but it is hard when the other DC's on the panel can't see what is happening to them and how we are allowing ourselves to prostitute the profession. Well if we leave, I will probably be laid off by my husband, as with CHP gone, he can no longer afford me, but I would gladly sacrifice my job to do the right thing.

I don't wish ill of CHP, but their new direction is not a positive one and why should we all suffer, because they couldn't do the right things to retain HealthNet and Providence. What happens if they go under someday? What kind of profession will we be left with, the damage will already have been done and carriers will know that in Oregon, the DC's like to bend over and take it and patients will never fight for better coverage, as they won't know what better is. If anyone is on the list serve that is with CHP, I hope you know about Kaiser's even more restrictive referral policy. It is in writing finally, but you don't get a copy until a request for future services are denied and with their new protocol, there is nothing to appeal on, they've tied your hands and your patient is then in a state of confusion. Unfortunately, CHP has decided we all shouldn't have a copy of this, but if you would like one, so you are prepared, just call and I will gladly fax it to you. A good thing to keep in mind with the new highly reduced fee schedule for Kaiser referral patients. It is not based on the print out of fees, that CHP includes, that is for the self-referral patients. Read the fine print. There is a new Relative Unit value you must multiply by the value assigned to the CPT code, do the math and be surprised.

Thanks,

Stockton

Cedar Mill Chiropractic Clinic

503-646-3393

Copying reform

Listmates:

HI all. I am not attempting to be anyone's business attorney here so take what I am writing with a grain of salt and certainly pass it by your own legal.

There has been some questions regarding the State law of copying charges for medical records being at a rate that is not reasonable, ie it is costing you more than you can charge.

In the HIPAA law the federal law takes precedence over state law whenever state law is less stringent than the federal law with respect to patient's medical privacy. HIPAA states that copying of medical records be of "reasonable costs". Since the state law is less stringent here, ie costs do not equate to more stringent protection of privacy, the federal law takes precedence. I personally am taking the position that I will charge a "reasonable cost" and will not send records nor appear without being compensated at a reasonable rate.

Secondarily if you are directed to follow a pattern that you do not like you can always chose to be a "hostile witness" or you could choose to be an "expert witness" for the other side.

I wonder if the attorney would pay a reasonable cost given that information.

Cheers

DannoOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

;

You said:

"I don't wish ill of CHP, but their new direction is not a positive one and why should we all suffer, because they couldn't do the right things to retain HealthNet and Providence. What happens if they go under someday? What kind of profession will we be left with, the damage will already have been done and carriers will know that in Oregon, the DC's like to bend over and take it and patients will never fight for better coverage, as they won't know what better is."

I used to have a dog named Spot when I was 8 years old. Spot was a great dog, (God rest his doggy soul). Spot was a loving and dedicated pointer/dalmation of good heart. Somehow Spot got the idea that the mail man was a bad guy and he bit him. He never bit anyone before. Spot was on trial in the family court in a capital case that could have sent him to doggy hell in a heartbeat. I represented Spot in the deliberations (pro-bone-o). The argument I presented was that were Spot, in fact, a "bad dog" that we would see a pattern of behaviour that supported such a damning label. No, I argued that Spot's record was one of unfailing loyalty and service, and that the single "nibble" incident was an aberration. Perhaps, the dog food was tainted (an anticipation of the "twinkie defense" of two decades later in the Moscone murder trial). To find Spot guilty under these circumstances would be un- American. That was always a good defense in the 1950's (and is still the last refuge of the scoundrel).

The problem with CHP is that there has been an unfailing pattern in CHPs actions, and policies to damage the chiropractic profession and subject it to ever more restrictive, expensive, and hurtful regulation. The same defense that saved Spot would be completely unconvincing to try to justify the long and sad history of CHP and its exploitation of chiropractors. Bad dog, bad bad dog!!!!

Best regards,

S. Feinberg, D.C.

From: Stockton [mailto:stockton@...] Sent: Tuesday, February 24, 2004 11:50 PMOregondcs ; D Beebe, D.C.; kdpSubject: Re: Copying reform/HIPPA

Dr. Pedersen,

You always make me laugh and you get the Medal of Honor for taking a stand. We are trying, but it is hard when the other DC's on the panel can't see what is happening to them and how we are allowing ourselves to prostitute the profession. Well if we leave, I will probably be laid off by my husband, as with CHP gone, he can no longer afford me, but I would gladly sacrifice my job to do the right thing.

I don't wish ill of CHP, but their new direction is not a positive one and why should we all suffer, because they couldn't do the right things to retain HealthNet and Providence. What happens if they go under someday? What kind of profession will we be left with, the damage will already have been done and carriers will know that in Oregon, the DC's like to bend over and take it and patients will never fight for better coverage, as they won't know what better is. If anyone is on the list serve that is with CHP, I hope you know about Kaiser's even more restrictive referral policy. It is in writing finally, but you don't get a copy until a request for future services are denied and with their new protocol, there is nothing to appeal on, they've tied your hands and your patient is then in a state of confusion. Unfortunately, CHP has decided we all shouldn't have a copy of this, but if you would like one, so you are prepared, just call and I will gladly fax it to you. A good thing to keep in mind with the new highly reduced fee schedule for Kaiser referral patients. It is not based on the print out of fees, that CHP includes, that is for the self-referral patients. Read the fine print. There is a new Relative Unit value you must multiply by the value assigned to the CPT code, do the math and be surprised.

Thanks,

Stockton

Cedar Mill Chiropractic Clinic

503-646-3393

Copying reform

Listmates:

HI all. I am not attempting to be anyone's business attorney here so take what I am writing with a grain of salt and certainly pass it by your own legal.

There has been some questions regarding the State law of copying charges for medical records being at a rate that is not reasonable, ie it is costing you more than you can charge.

In the HIPAA law the federal law takes precedence over state law whenever state law is less stringent than the federal law with respect to patient's medical privacy. HIPAA states that copying of medical records be of "reasonable costs". Since the state law is less stringent here, ie costs do not equate to more stringent protection of privacy, the federal law takes precedence. I personally am taking the position that I will charge a "reasonable cost" and will not send records nor appear without being compensated at a reasonable rate.

Secondarily if you are directed to follow a pattern that you do not like you can always chose to be a "hostile witness" or you could choose to be an "expert witness" for the other side.

I wonder if the attorney would pay a reasonable cost given that information.

Cheers

DannoOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.