Was this really a HIPAA violation

[rainbowsfolly]

I was recently terminated for a hipaa violation. I do not believe it was a hipaa violation and I need some advice and insight.

I am (was) a medical assistant level 1 at a hospital off-sight clinic for 9 years. Worked in the medical field for 18 years. I am well aware of hipaa but this shocked me. I am devistated personally, professionally and financially.

My 25 y/o son became a pt at my clinic under emergent curcumstances. At the time of his first visit I helped him fill out medical record releases for myself and his grandfather as we are his primary care givers/helpers. For three months I was directly involved in my sons care. Everyone knew this, and his doctors discussed everything w/me. A month later my son developed seizures of unknown orig. w/ retrograde amnesia which involved a hospital stay. After this more than ever I was involved and with him at each appointment at my clinic because he could not drive and had lowered mental capabilities, and cognative issues.

My son had given me his disability form to give to his doctor as he now had driving restrictions. I went to our medical records staff and asked them to pull his chart for me to give to his doctor. I clipped the form to it and delivered it to the doctor without looking at it. The doctor needed the neurologists dictation which was not in the chart, so I went to his (the requesting pcp) staff and asked that they print the neuorolgy dictation for the doctor. An hour later I was handed the dictation. It was folded up. I didnt know what it was, I looked at it, saw that it was full of holes because the neuro is hard to understand. Then I noticed it was my sons. I went to the neuro's nurse (also @ my clinic) and asked her how quickly the neuro fixes his dictations because my sons pcp needed info to give my son meds. which he was almost out of. She answed my question and we both walked away. I gave the dictation to my sons pcp and went about my regular duties.

The next day i was called in by my supervisor and asked if I had hipaa violated my son. I was shocked. I denyed it. How could I hipaa violate with record releases in place. She insisted that i had pulled the chart, looked up and printed the neuro dictation, which I had not. I explained it all to her. The investigation continued and it was proven that I had NOT pulled the chart and I had NOT looked up or printed the neuro dictation. She chastised me for getting other people into trouble and said that regardless of record releases I could not ask for or transport my sons records or ask about them. Again I explained that I asked for the chart, yes, and I had given to the doctor.I did not read it because I didnt have to, I knew everything anyway. And I did not ask the dictation be printed for me, but for the doctor... the nurse misunderstood I guessed and handed it to me. And was that really wrong if I had rights to release? They said it was.

I can not find anything after months of research that says what I did was a violation. I can not find any help. Lawyers want money upfront and I have none after 3 months of unemployment.

My son or the rest of my family dont know what really happened. I told them that I quit. My husband knows, and is very upset w/me. I have not been able to find another job.... my boss told alot of people why I was terminated. I am devastated.

I know of many situations where family are pts at offices. In some cases family to the only nurse in the place... and she pulls the chart, puts them in the room, writes their scripts, discharges etc.

Other cases where the doctor see's his own family members, reviews labs etc.

In my own clinic nurses are involved with family members as pts all the time, including chart handling and putting them in rooms to be seen without record releases! I dont understand why what I did was a violation with releases in place?!

Please help.

Is this really a HIPAA violation if you have record releases in place?

Is there an address or number for healthcare workers rights regarding hipaa laws and terminations? All I find is pts rights regarding hipaa laws.

They even documented the wrong reason for my termination on my paperwork! They put 42.c which is a much more severe violation than what I actually did which was a 42.b (or so they claim) 42.c is accessing medical records for malicious intent or personal gain. 42.b is accessing families records. Which holds a much less severe punishment.

However there is no information about accessing with record releases. And in my opinion I didnt access. I asked for things to be released to me. I didnt pull the chart myself, or look up anything in the system, or read his chart. They said that by reading the dictation after it was handed to me I accessed.

Please, any help or advise would be wonderful. My career is over and my marriage and home are next!

Thank you.

[tencat]

You need a lawyer. If a medical release authorizes you to have access to the records, then I wouldn't think it was a violation. But again, you really need to consult a lawyer. The fact that your boss told others why you were terminated is also lawyer worthy.

[fsaav]

I don't have any documentation to back this up, but I know at our hospital it is a violation for an employee to view their own records rather than going through the proper procedures (signed release through medical records department, etc.) and your situation sounds similar to that.

I wish you the best and I hope things work out for you.

[NRSKarenRN, BSN, RN]

an hour later i was handed the dictation. it was folded up. i didnt know what it was, i looked at it,saw that it was full of holes because the neuro is hard to understand. then i noticed it was my sons. i went to the neuro's nurse (also @ my clinic) and asked her how quickly the neuro fixes his dictationsbecause my sons pcp needed info to give my son meds

this statement is what got you into hot water at work. pointing out documentation "full of holes", "how quickly doctor fixes things" and that corrected info needed by your pcp to give sons meds crossed the line from business relationship i.e. getting records corrected by another department, into personal one: getting records corrected for immediate family member.

i have access to all emr as central intake manger in home care agency. when my parents needs our care, i'm the one that generates the referral. i add phone calls reporting info to me from parents/physician, added nurse name staffing case cause missing x3 weeks, look at visit schedule section "when my nurse coming" calls.... all activities essential to my job. however i do not look at visit note reports/plan of treatment as not involved in that section of business.

my manger crystal ball says that you how you pointed out issue of incomplete documentation triggered someone's ire. did the facility have a hipaa polcy re access when caring for family member? having access to info during visits and you carrying chart is two seperate concerns. if your directly work with physician who needed chart for orders, there should not be a problem as handling chart in course of normal duties unless policy states otherwise. if no clear policy in place, i'd fight termination --grieve that should have been warning /suspension with clear policy to be put in place. hipaa allows business to set up own standards--- somehow you crossed this practices.

i'd file for unemployment. best wishes moving forward.

[sirI, MSN, APRN, NP]

Agree with NRSKarenRN.

Having access to info during visits and you carrying chart is two seperate concerns.

Since you were "on the clock", you blended employee duties with personal use. By critiquing (verbally to the nurse) the neurologists dictation, you crossed the line of employee and made it personal.

Patients have a right to request their PCP amend medical records (dictation), but one must follow the rules/regs set forth by the facilitie's HIPAA Privacy Officer.

Correcting information

If you think the information in your medical or billing record is incorrect, you can request that the health care provider or health plan amend the record. The health care provider or health plan must respond to your request. If it created the information, it must amend the information if it is inaccurate or incomplete. If the provider or plan does not agree to your request, you have the right to submit a statement of disagreement that the provider or plan must add to your record.

http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/medicalrecords.html

By bypassing this, is sounds as if you were in violation of your facilities rules/regs.

Despite records release, you (as the caretaker) still must follow the facilities policy/procedure via the Privacy Officer. Being on duty as an employee and acting as personal caretaker of your son, again sounds as if you violated your facilities rules/regs.

HIPAA outlines that the "minimum amount necessary" rule:

..disclosure to an individual who is the subject of the information, or the

individual's personal representative;

http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/privacysummary.pdf

You may be the personal representative, but you must follow, once again, the facilities rules/regs.

Privacy Policies and Procedures. A covered entity must develop and implement

written privacy policies and procedures that are consistent with the Privacy Rule.

Privacy Personnel. A covered entity must designate a privacy official responsible

for developing and implementing its privacy policies and procedures, and a contact

person or contact office responsible for receiving complaints and providing

individuals with information on the covered entity's privacy practices.

http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/privacysummary.pdf

As NRSKarenRN pointed out:

If no clear policy in place, I'd fight termination --grieve that should have been warning /suspension with clear policy to be put in place. HIPAA allows business to set up own standards--- somehow you crossed this practices.

I would definitely investigate this.

[Pepperlady]

I really don't know about the HIPPA, sounds like you have gotten great advice from the others. I would take great exception to my boss telling others that I was terminated and I would most certainly be taking that to a lawyer.

[lsyorke, RN]

Let me get this straight....your son's doc asked you to get the information in the setting that you were in, you have legal standing and written release to get that information and have many times in the past...and they file Hipaa violations on you?

If this is the case, then they were way out of line.

[Straydandelion]

I have not worked with the public in awhile to run into the much more stringent rules of Hippa as yet, but wonder if you have a Power of Attorney for healthcare for your son seeing he is disabled, if that would solve future problems?

[azhiker96, BSN, RN]

I agree with NRSKAREN and SIRI. The HIPPA policy at your old employer may have been violated. At my hospital, people have been terminated for accessing their own records on the computer. Employees are required to follow the same steps as any other patient, put in a request/signed release with medical records.

[Batman24]

You should have filed for unemployment the minute you were fired. Go Monday morning and apply. Just because you are fired doesn't mean you are ineligible for unemployment. That should be your first step to get some money coming into the household.

I would then follow the advice above about investigating the policy in place and getting a lawyer. Depending on their HIPAA policy you might have a good case for wrongful termination. You also need to address your boss telling everyone your business.

[Mulan]

How about Legal Aid?

Don't they help people with no or little means to pay?

I would contact them in your state and see what they have to say.

[nghtfltguy, BSN, RN]

i would suggest getting a lawyer to protect you...

in my personal opinion... HELL NO.. that was not a hippa violation.. its your son!!..... i don't know the entire circumstances... but sounds to me like you did what any parent would do....

i wish you the best of luck... i don't think you did anything wrong~~