Four Common HIPAA Misconceptions

June 8, 2015

Experts say there are common compliance misconceptions that are costing practices unnecessary time and resources.

While practices must work hard to comply with HIPAA, some are taking HIPAA compliance efforts a bit too far. That's according to risk management experts, who say there are some common compliance misconceptions that are costing practices unnecessary time and resources.

Here's what they say many practices are avoiding that they don't necessarily need to avoid, and some extra steps they say practices are taking that they don't necessarily need to take.

1. Avoiding leaving phone messages

While it's true that a phone message from your practice to a patient could be overheard by the wrong party, phone messages that contain protected health information (PHI) don't need to be strictly off limits at your practice, says Jim Hook, director of consulting services at healthcare consulting firm The Fox Group, LLC."Many offices adopt a blanket policy of, well, 'We can't leave you any phone messages because HIPAA says we can't,' and, that's really not true," he says. "You can always get consent from a patient on how they want to be communicated with."

Hook recommends asking all of your patients to sign a form indicating in what manner you are permitted to communicate with them, such as by mail, e-mail, text, and phone message. "If the patient says, 'Yes, you can call and leave me phone messages at this phone number I'm giving you,' then it's not a HIPAA violation to use that method of communication," he says.

2. Avoiding discussing PHI

It's important to safeguard PHI as much as possible, but some practices are taking unnecessary precautions, says Michelle Caswell, senior director, legal and compliance, at healthcare risk-management consulting firm Clearwater Compliance, LLC.

"I think there's still a fear among small providers ... that they can't discuss protected health information anywhere in the [practice]," she says. "They feel that they have to almost build soundproof walls and put up bulletproof glass or soundproof glass to prevent any sort of disclosure of protected health information, and that's not what HIPAA requires at all. HIPAA allows for incidental disclosures, [which] are disclosures that happen [incidentally] around your job. So if you've got a nurse and a doctor talking, maybe at the nurses' station, and someone overhears that Mr. Smith has blood work today, that probably wouldn't be a violation because it's incidental to the job. Where else are the doctors and nurses going to talk?"

As long as you are applying "reasonable and appropriate" safeguards, Caswell says you should be in the clear.

3. Requiring unnecessary business associate agreements

HIPAA requires practices to have written agreements, often referred to as business associate agreements (BAAs), with other entities that receive or work with their PHI. Essentially, the agreements state that the business associates will appropriately safeguard the PHI they receive or create on behalf of the practice.

Still, some practices take unnecessary precautions when it comes to BAAs, says Robert Tennant, senior policy adviser of government affairs for the Medical Group Management Association. "A lot of practices are very concerned about people like janitorial services [and] plant maintenance folks, and they have them sign business associate agreements, but those folks are not business associates for the most part," says Tennant. "You may want to have them sign confidentiality agreements basically saying, 'If you do come across any information of a medical nature, protected health information, you are not permitted to look at it, copy it, keep it ...,' But, you do not need to sign a business associate agreement with anybody other than those folks that you actually give PHI to for a specific reason, like if you've got a law office or accounting office or a shredding company that is coming in to pick up PHI to destroy it."

4.Requiring unnecessary patient authorizations

While it's critical to comply with HIPAA's requirement that only those who have a valid reason to access a patient's medical record, such as treatment purposes, payment purposes, or healthcare operations, have access to it - some practices are misconstruing that rule, says Tennant. "They demand patient authorization before they transfer data to another provider for treatment purposes," he says. "I understand why they do it, but it's one of those things that … can cause delays and confusion, and even some acrimony between the patient and the provider. If it's for treatment purposes specifically, you do not need a patient authorization."