HIPAA privacy question

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A co-worker of mine placed a patient with her mother into an exam room. The patient is 19 years old and the nurse turns to her and in front of the mother asks if she is on any other medication besides her birth control. The mother of the patient blows a fuse and causes a scene because she just found out her daughter isn't a what she said she is. Is this a violation of the HIPAA law? Can there be any legal persuing if the nurse admits guilt?

I don't go into the exam room with her, but I do think I have a right to know what I am paying for. When the hospital bill comes to me, should I simply pay it without knowing what it is for? I also pay the pharmacy bill...should I just pay it because it arrives? Should the pharmacy simply send me a bill for $175 and not itemize the bill? My daughter agrees that as long as she lives in our house and we pay the bills we have a right and obligation to know.

Also...I think it is important to have someone else who knows a person's medical history. If she is traveling out of town and somehow ends up in the ER, isn't important that someone knows her history, medication, etc in case she cannot speak for herself? I'm much easier to track down at midnight than her clinic chart is.

Then I think it's her job to tell you everything medically, or she should find another source for her medical insurance herself. If you must know, the she probably has no choice. I see your point. :nurse:

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I don't think the fact that she lives under your roof and you pay her medical insurance makes her any less of an adult with adult privileges, like right to privacy. I say that in all honesty and fairness to both you and your daughter. I remember when my sons both turned 18 (they're both in their 30's now) before HIPPA, they (the office staff) encouraged me to not go into the room with them. I respected that. Just my :twocents:. It would be interesting to hear where a person in your daughter's situation legally stands. Any RN/JD's out there?

Once our kids are 18 (or whatever age their state defines as an adult; there are a couple with higher ages), we have no "legal rights" to their health information no matter how financially dependent upon us they are. If THEY have given written permission or have legally given us power of attorney for health care, we can access their information, but still, unless they are ruled to be incompetent or so ill that they cannot make decisions for themselves, the control of their information is theirs. Now, we may have an agreement with our kids that amounts to "if I'm paying for your life, you will share your health information with me," but the bottom line is that legally they must give us permission to access their health information. Same for college records. My daughter has officially waived her right to privacy regarding her grades at college, so I can access them. But the university required her to fill out and sign the waiver before access was granted.

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Then I think it's her job to tell you everything medically, or she should find another source for her medical insurance herself. If you must know, the she probably has no choice. I see your point. :nurse:

I wouldn't expect the medical staff to fill me in...that is her job. My niece just turned twenty and is still on her parent's insurance. She goes to the doctor or to the ER for EVERYTHING...every sniffle, every cough, every ache and pain. If my daughter suddenly had a bunch of doctor and ER visits, I would want to know why.

HIPAA allows information to be disclosed for purposes of TPO (treatment, payment, and operations). It's a pretty gray area if someone won't pay unless they know what they are paying for (I would pay the bill either way, but I can see where some people might not).

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Thanks to each and every single one of you for posting your thoughts. This is one hard situation for her to deal with and I will relay all the messages I received. Thanks again!

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Specializes in Hospice.

Cotjocky, I can certainly see your point, and it's clear that you've worked disclosure issues out with your daughter.

However, should she develop a problem she does not want to disclose to you, the law will be on her side, regardless of who's paying the bills. Any health professional who discloses her information without her permission, even to you, is liable and can be prosecuted.

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My son was on medicine for chronic headaches, I ordered the med through mail order pharmacy. He needed a refill and I went to order the medicine and it no longer showed up on my account for mail order. I called them and they said because he turned 18 2 days ago. He has to go online open his own account and then he can elect to have it show up on my account again. I had to wait for him to come home from high school and ask him to set up an account. He was "too busy" and said just set it up for me. So I did.

When the kids turned 18 I got forms from both insurances allowing me to discuss their medical stuff. I said if you don't sign this than you can spend the time on the phone figuring out the problems which inevitably happen with medical bills. They gladly signed on the dotted line. I know they will need to deal with this themselves at some point and I do make them take care of certain things but when it is my dime paying for stuff I want it done right.

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IMHO, I do not believe that anyone still in HS and living at home being cared for by a parent should have that "privacy"....but it is what the law states. IMHO, if they want that level of privacy at 18 then MOVE and pay your own bills!

I do respect the law. And that being said, My DD, under 18 at the time, was to be examined by the PCP. The PCP knew she would get to sensitive subjects that my DD may feel inclined to lie about in front of her mother so she judiciously (sp?) asked me to leave the room. (This was in a Navy Hosp.) I knew why and I also knew that DD would share the info with me after the fact.

The only time I saw a physician be "insensitive" to a situation was when an older woman had her grown daughter (who was driving her to appts) and had in the exam room before doc arrived. Doc asks Para/gravida/Living questions. When the numbers added up to PG but no living child he asked the mom "how many of these were miscarriages and how many were abortions?" Talk about your deer in headlights moment!

Maybe one of our OB/GYN nurses could enlightened this fairly new nurse as to what difference that distinction makes after 20+ years and in a menopausal woman?

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Specializes in Clinical Research, Outpt Women's Health.

It is up tp the adult patient and nobody else. If she chooses to bring mom in the exam room with her then she takes responsibility for whatever mom may hear unless she specifically tells me before not to mention something.

It is not our right/or responsibility to kick mom out, but the adult patients.

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It is up tp the adult patient and nobody else. If she chooses to bring mom in the exam room with her then she takes responsibility for whatever mom may hear unless she specifically tells me before not to mention something.

It is not our right/or responsibility to kick mom out, but the adult patients.

While I agree with that in theory, would that hold up legally if challenged? That's what I'm wondering.

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Specializes in Clinical Research, Outpt Women's Health.

I believe so, but I am not a lawyer. Even as a teen I would simply ask if she wanted her mom in the room and again it is her choice.

I think too often we think we have to go way to far in the name of HIPPO:lol2:

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This wouldn't be a violation as the patient has the right to bring her mother into the exam room. I do however think this should be a good learning experience for your friend for the future. Next time ask for a few minutes alone with the patient to ask a few personal questions to avoid a situation like this. Legally she didn't do anything wrong but this is a situation that could have been handled better by all involved.

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Our 19 year old daughter is still on my husband's insurance plan...we pay the premium, we pay the deductable, we pay the pharmacy bill...we have every "right" to know our daughter's medical history.

Yes and no.

You have the 'right' to demand your child disclose her healthcare information and provide or withhold medical insurance as you see fit.

You do NOT have the right to require a health care worker violate Federal law by disclosing your daughter's information.

Personally I always felt that by the age of 18-19 my kids had the right to some privacy (high school or not), I stopped going in the exam room with them when they were very young teens unless they asked me to. My kids and I have always communicated well, I know the important things about their medical history and care to communicate in an emergency.

They also signed limited disclosures that made it possible for me to navigate any complicated financial issues, the simple ones the managed on their own (good practice for Independence).

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