There is general agreement between Congress with what appear enough votes to pass and President Bush regarding the need for a patient’s Bill of rights. This Bill would allow for patients to sue their insurer in state court for certain damages and in federal court for others. The federal court does not allow punitive damages but under the bill would allow for civil assessments up to $5 million, the equivalent of punitive damages. Tagged on to the bill would be tort reform to allow fewer patients to be able to access the courts and go to independent appeals first. The managed care industry does not support the legislation. Top

HCFA has changed the six-month rule regarding Medicare patients entering hospice. The new rule states the physician certification only state "the physician’s or medical director’s clinical judgment regarding the normal course of the individual’s illness. Top

President Bush has placed a hold on Clinton’s last minute regulations. This includes OSHA, Medicaid, Stark II and HIPAA. They are all to be reviewed in the near future. Top

Ohio Governor Taft has signed into law a requirement that all physicians in the state including those that only wish a telemedicine certificate must have 50 hours of continuing education every two years. Those who obtain the special telemedicine certificate will need an additional special activity certificate to practice medicine in person in Ohio. Top

The new HIPAA regulations, currently on hold, involve not only electronic transmissions but also written and oral communications. This includes the faxing that is currently done between labs, offices, LTC facilities and hospitals. The lab will need to get consent initially for the report transmission. All providers of care should develop a universal consent form covering consent for treatment, consent for assigning benefits and consent to use protected health information for treatment, payment or health care operations. This form may cite examples in plain language for what is meant be each type of consent. This consent should be signed prior to initial treatment and if not signed the provider should consider strongly not seeing the patient.

In medical records, hospitals and offices should have a system in place to deal with complaints dealing with the patient’s right to access and amend the record and how to respond to complaints of a violation of privacy. When a patient wishes to amend the medical record again there must be an explicit policy of what will be accepted and what will not be accepted. The system should have an appeals process with a strict timeline.

A good policy will turn an angry patient to a satisfied customer. Be careful if the patient has access to those sections that have pulled the record for any reason such as routine Quality Assurance. The patient might think something was done wrong and wonder who gave permission for the record to be examined. If you keep these types of records be prepared in your systems to show the policy to the patient with an explanation.

Most, if not all, medical facilities currently have compliance hotlines. These same tools may be used to report breaches of privacy as well. Some larger institutions may have a privacy officer just like they have a compliance officer. These people should be given authority to immediately fix problems within the policies of the hospital and approved by legal counsel. Top

The Government Genetic Testing Committee stated it would allow the life insurers to use genetic testing to evaluate the potential for Huntington’s Disease. The Committee is now looking into other types of insurance and other diseases such as breast cancer. Top

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DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.