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Council on Chiropractic Practice - page 162 / 202

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12 Patient Privacy - Added

RECOMMENDATION - Added

Respecting patients' right of privacy has always been both an ethical and a legal duty. New federal regulations place specific, enforceable obligations on most chiropractors and their employees. Knowledge of and compliance with these regulations is essential in order to remain in practice.

Rating: Established Evidence: E, L

Commentary - Added

Chiropractors have always had an ethical obligation to safeguard confidential information that they obtain from and about their patients. Some states have adopted laws codifying this duty, and most states recognize a private cause of action in tort for invasion of privacy.

It is not always clear, however, where the outer boundaries of this obligation are located. May a chiropractor discuss a person's condition with his or her parent or spouse? Such a question might have been answered in the past on the basis of the doctor's view of the patient's best interest. In the twenty-first century, however, the answer must be informed by a myriad of federal and state statutes, regulations and court decisions. Violations of these laws may result in lawsuits, revocation or suspension of licenses, and/or debarment from Medicare.

One manner in which chiropractors can limit their exposure to liability, while meeting their patients expectations at the same time, is by posting a Notice of Privacy Practices is his or her office and by handing a copy to every new patient (and by repeating this process every time a change is made in the text of the Notice). This is required of those doctors who are covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and is a sound legal practice for every healthcare professional to state his policy in advance and then adhere to it.

It is also mandated by HIPAA, and important for all chiropractors, to have patients (or the parents or guardians of minor patients) sign an "Authorization for Use or Disclosure of Information for Purposes Requested by Chiropractor" and a "Consent for Purposes of Treatment, Payment & Healthcare Operations" before collecting, utilizing, transmitting or disclosing any "protected health information" as that phrase it defined by law.

Finally, it is mandated by HIPPA to have a "Business Associate Agreement" signed by all those vendors and others who might have access to protected health information. (1-10)

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_________________________________________________________ Council on Chiropractic Practice Clinical Practice Guideline Number 1 Vertebral Subluxation in Chiropractic Practice – 2003 Update & Revision

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