Florida/Hippa Medical CA letter-critique?

[cotterpin]

actually you dont need to sue.  if you have a hipaa violation all you have to do is complain to the AG and the agency controlling the provider they are the ones who impose the fines and they dont discount them from what Ive seen in Florida.  IN Florida for a provider the fine is 50k for each offense whereas the CA could be imposed a fine of 5k just for having the information

<{POST_SNAPBACK}>

 

 

Do you have cases to point to?

 

the AG's usually publish when they fine for things of this nature

 

ALSO, I'm going to point this out one more time:

 

FEDERAL = HIPAA

 

FL STATE LAW is NOT HIPAA, using the terms for the two interchangeably is going to confuse people. Please use the correct terms when referring to the respective laws, thanks.

Edited May 17, 2005 by cotterpin

[hurricanesfans27]

again there is no case law and floridas law is even stronger. you can sue but you would be establishing precedent. The AG only publicizes cases where there is enough violations to make it worthwhile to them. Just like everything else in politics. this isnt rocket science.

[hurricanesfans27]

here is some case law

 

 

Humana Medical Plan et al. v. Charles M. Fischman, MD

Venue: Florida's Fourth District Court of Appeal

 

Case Numbers: 98-3651 and 99-0311

 

also read section 456.057(5)(a) and 395.3025 of the Florida statutes..

[jas77]

Here is a little blurb about that case in case anyone is interested.

 

http://www.ama-assn.org/amednews/2000/02/07/gvsc0207.htm

[hurricanesfans27]

case closed..

[hurricanesfans27]

if a huge Medical insurance company couldnt beat the Florida law what makes any CA think they can.. Thats why they cave so quickly.

[jas77]

I had mentioned earlier I had seen a post by enigma regarding whether a DV constitutes authorization for medical records. Here is what I was reading it from:

 

http://creditboards.com/forums/lofiversion...php/t85453.html

 

not sure if all this applies to me or not, there is soooo much to take in!!

 

 

 

"When you DV a CA/JDB, the fact you are asking for proof of the account does not convey consent or authorization.

 

Quote:

 

QUOTE

What is the difference between “consent” and “authorization” under the HIPAA Privacy Rule?

 

The Privacy Rule permits, but does not require, a covered entity voluntarily to obtain patient consent for uses and disclosures of protected health information for treatment, payment, and health care operations. Covered entities that do so have complete discretion to design a process that best suits their needs.

 

By contrast, an “authorization” is required by the Privacy Rule for uses and disclosures of protected health information not otherwise allowed by the Rule. Where the Privacy Rule requires patient authorization, voluntary consent is not sufficient to permit a use or disclosure of protected health information unless it also satisfies the requirements of a valid authorization. An authorization is a detailed document that gives covered entities permission to use protected health information for specified purposes, which are generally other than treatment, payment, or health care operations, or to disclose protected health information to a third party specified by the individual. An authorization must specify a number of elements, including a description of the protected health information to be used and disclosed, the person authorized to make the use or disclosure, the person to whom the covered entity may make the disclosure, an expiration date, and, in some cases, the purpose for which the information may be used or disclosed. With limited exceptions, covered entities may not condition treatment or coverage on the individual providing an authorization.

 

 

Breaking it down.

 

You seek medical treatment.

 

You are billed for services, less what insurance pays, if any.

 

In my case I was billed and was paying, but they sent it to a CA anyway.

 

Or the provider outsources billing, in FL not allowed.

 

For point of reference, I am not telling you not to pay a medical provider, you should, no matter how small the amount. You pay what you can afford.

 

Let say it is sent to a CA, they dunn you.

 

You send DV letter.

 

They respond with proper validation, or send medical records, or do nothing.

 

The very fact the provider sent the informtion to a third party is a violation, is actionable, fine is $5,000.00.

 

Question is did you consent?

 

I just took my daughter for a well check. First time at this Dr. this year. Had to fill out papers again. At the bottom was a little one line blurb saying if I did not pay they could send it to a CA and I had to pay for costs.

 

Again, in FL not allowed. Does not meet the test for authorization.

 

Provider sends to CA the CA then puts it on your CR. FL - not allowed. Now the CA has put themselves in a position of being a holder of the medcial record and are subject to the same law. But without your written consent, they have obtained the record illegally.

 

Best practice is to write to your provieders recinding any "implied" authorizations.

 

There is case law on this, the best one I have found so far is:

 

 

 

QUOTE

Humana Medical Plan et al. v. Charles M. Fischman, MD

Venue: Florida's Fourth District Court of Appeal

 

Case Numbers: 98-3651 and 99-0311

 

 

 

Again, this only applies to FL.

 

But check your states medical/patient medical records laws"

[hurricanesfans27]

yup thats where I got it from Thanks to another forum.. but I think he had it here also.

[cotterpin]

again there is no case law and floridas law is even stronger.  you can sue but you would be establishing precedent.  The AG only publicizes cases where there is enough violations to make it worthwhile to them.  Just like everything else in politics.  this isnt rocket science.

<{POST_SNAPBACK}>

 

No, it's NOT rocket science, but you have one case. There was NO agreement at ALL in that case, first of all, and there was no FINE issued by the AG like you stated and like I asked you to show me.

 

The OP clearly states there were documents signed, and without you OR I reading the VERBAGE in those documents, advising the OP that their rights were "oh so definitely violated under FL laws" is incorrect.

 

You made a statement that the AG of FL is quick to move in cases like this, I've asked you to show that.

 

Providing me with CASE LAW doesn't show that the AG has issued ANY fines for cases like this.

 

SO, again, show some examples for us where the AG has fined providers for providing COLLECTION AGENCIES with medical records when a PATIENT has DV'd them.

 

I'm not stating that a DV DOES constitute authorization (I don't personally think it does), but MY opinion means diddly squat, it all depends on how a JUDGE looks at it.

[hurricanesfans27]

not debating the judge factor but one several judges including the 4th court of appeal have ruled against one huge insurance company there is no chance a CA will win against the Florida law. Also the fine is not levied after a court case its imposed by the sanctioning body

[hurricanesfans27]

anyways cotter I have a bed calling my name looking forward to debating this tomorrow ...

[cotterpin]

not debating the judge factor but one several judges including the 4th court of appeal have ruled against one huge insurance company there is no chance a CA will win against the Florida law.  Also the fine is not levied after a court case its imposed by the sanctioning body

<{POST_SNAPBACK}>

 

 

and there was a DV involved there?

 

 

I failed to see anywhere in the HUMANA judgement where the issue of a DV was concerned.

 

It's dependent upon the judge.

 

new case law gets made all the time, and unless it's handed down by the US Supreme court, I wouldn't take it as the word of law.

 

Maybe you should read a little around here about those who've lost cases in court for some pretty obvious things based on judges who either didn't KNOW or IGNORED laws.

 

Just because you have "case law" or "laws on the books" doesn't mean a JUDGE will not look at your intention when sending out a DV and rule AGAINST you.

[hurricanesfans27]

this wouldnt be a trial ... the OCs dont take a chance against the possibility of losing their license they cave easily I got one to do it and I know of some people who did far more than i did

[cotterpin]

this wouldnt be a trial ... the OCs dont take a chance against the possibility of losing their license they cave easily  I got one to do it and I know of some people who did far more than i did

<{POST_SNAPBACK}>

 

 

YMMV

 

What may have worked for YOU may NOT work for someone else, and you need to give your advice in that context.

 

OP was prepared to send a demand for 2K that could have VERY easily landed them in a courtroom.

 

What may work for a small balance bill with a LARGE provider who may not want the headach may NOT work with a small provider to whom you owe, or for a large balance

[hurricanesfans27]

if they had my billing records which they are NOT entitled to in the state of Florida then I would push the issue whether the bill was 100 bucks or 100000 dollars.

[cotterpin]

if they had my billing records which they are NOT entitled to in the state of Florida then I would push the issue whether the bill was 100 bucks or 100000 dollars.

<{POST_SNAPBACK}>

 

 

IF you hadn't signed forms upon admission which allowed for the transfer of records

 

Again, YMMV

 

Some may not have signed forms which had the verbage, some may have

[hurricanesfans27]

at the time those authorizations were signed hipaa wasnt around but hipaa and florida law DOES apply to them also. And I have also read the latest forms Ive signed from my dentist and they do not have me give authorization to a any billing agents other than my insurance company.. no mention at all for CAs

[cotterpin]

at the time those authorizations were signed hipaa wasnt around but hipaa and florida law DOES apply to them also.  And I have also read the latest forms Ive signed from my dentist and they do not have me give authorization to a any billing agents other than my insurance company..  no mention at all for CAs

<{POST_SNAPBACK}>

 

 

ONCE AGAIN:

 

HIPAA = FEDERAL

 

FLORIDA LAW = STATE

 

These are NOT interchangable. Regardless of whether or not HIPAA was active, Florida law still may have been. YOUR situation is YOURS, OTHERS situations MAY BE DIFFERENT. Stating YOUR experiences is FINE, but YOUR experience or situation does not make it law for the rest of the millions in Florida.

 

Now, I truly hope that you PAY your bills to your dentist for their services and they won't HAVE to send them to a CA. Unless you're just looking for ways to screw healthcare providers out of money, which IMO is what it looks like to me. In fact, you're the type of patient that looks for loopholes to GET money for the treatment that doctors provide, forget PAY. There are cases that are severe enough to warrant a provider being reprimanded, yes, but if you really want to effect some change, I suggest that you simply bring the problem to the attention of the local media or a public interest group, etc.

 

I'm sorry, but I can't advocate that "method" and I don't think that most people here just want to screw their doctors out of money, either.

[hurricanesfans27]

nice attitude for a mod ... i did just say my situation i didnt say anything else but i do know others who have done the same thing ..

[cotterpin]

My "attitude" is in response to your constant inaccurate or half accurate information. You constantly suggest that people do what YOU did and that they look up HIPAA etc. I've corrected you numerous times re: HIPAA and FL LAWS not being one in the same.

 

You don't state things like, "I had this happen" or "this worked for me". You state very matter of fact in all of your posts the provider can't send the records off to a CA etc.

 

You never ask the OP if they've signed any forms, nor about the VERBAGE in the forms, therefore you're making assumptions based on YOUR experience that everyone else has signed the same forms or will have the same results.

 

Everyone here needs to be advised properly, meaning they need to be told of ALL possible avenues, and of the possibilities of actually ending up in a Courtroom if they send a letter out demanding money, etc. Maybe in YOUR case you weren't SUED, but PLENTY of people here HAVE been sued, and SOME have even *gasp* lost some pretty clear cut cases due to judge's either incompetence or ignorance for case law.

[hurricanesfans27]

well it all depends on the judge but you wouldnt be suing in federal for florida violations and most florida judges especially in superior court are well versed in the florida statute along with the 4th court of appeal. I got my info from someone who it worked for and their balances were far higher than mine. I would also respectfully disagree with you as far as balances due to the simple fact that if someone had 10000 dollars to lose they will go all out to avoid paying if they have to especially if its an insurance or medicaid issue. Personally I was going to let the matter go with the debt until I found out about this statute but when I was shown how to do it I did and it worked. It worked for them and it worked for me. Im one of 18 million citizens of this state and the law applies to all. We also stated check your own state statutes to see if you statute is stronger than federal.

[cotterpin]

Sheesh, can ya stick to one story???

 

Now you "know someone"? I think you're making it up as you go along based on a couple of posts you've read from Enigma, who busted her butt in a long fight that took about two years from what I recall reading here, AoC and Cnet.

 

Insurance/Medicaid involvement is a different story than when YOU truly owe the money.

 

You say "we" who is "we"????

 

I always tell people to read ALL of the laws, there may be things in there that apply to them.

 

Just because something may "work" doesn't mean it is "right" and won't backfire on someone else.

 

Do YOU want to be the one responsible for the advice when it backfires on someone?

 

How about when it backfires on you?

 

Are you prepared for a multiple year legal battle like Enigma was involved in?

 

So, once again, heed MY advice, what works for YOU may NOT work for Joe Smith down the street, hence the YMMV.

 

You want to give solid advice? Start providing links to back up your spiels, start including words like "in my situation" or "in my opinion" or even "I know a guy who this worked for" rather than stating that it's FACT it will definitely work.

[hurricanesfans27]

yawn... i did say one story.. enuff said

[jas77]

gonna bump this due to letter I recieved from CA's lawyer after I sent out letter regarding needing my written permission for them to have my medical records:

 

 

I recently sent out a DV to a ca for a medical bill and I am in FLorida. They sent me a whole lot of info, including personal medical info that wasnt really pertinent to them collecting. I sent out another letter to them, with part of it stating:

 

In accordance with current Florida law, you need my written consent to obtain and view this information. Please provide me a copy of that form. Please be advised that under Florida Statutes 456.057 Ownership and control of patient records; report or copies of records to be furnished:

 

Section 10 states:

 

10) Records owners are responsible for maintaining a record of all disclosures of information contained in the medical record to a third party, including the purpose of the disclosure request. The record of disclosure may be maintained in the medical record. The third party to whom information is disclosed is prohibited from further disclosing any information in the medical record without the expressed written consent of the patient or the patient's legal representative.

 

Although the Privacy Rule may permit the disclosure of PHI without the patient's authorization for purposes of payment, Florida law does not. Medical records may not be furnished to, and the medical condition of a patient may not be discussed with, any person other than the patient or the patient's legal representative or other health care practitioners and providers involved in the care or treatment of the patient, except upon written authorization of the patient. No exception is provided for disclosure of PHI to insurance companies for purposes of payment. (Fla. Stat. 456.057(5)(a)).

 

Please provide me with the specific written consent for you to have this private medical information. The act of me sending you a validation request is by no means written consent for you to have my private medical information, nor a waiver of my rights under Florida statutes or HIPPA.

 

 

 

Sooooo the Ca forwared the letter to their legal counsel, who replied to me saying:

 

"although that you have correctly cited florida statute 456.057 regarding prohibitions of third party disclosure of medical records, your validation request pursuant to 15 U.S.C section 1692g provided my client with not only your written consent to request and disclose this information to you, but legally obligated my client under the FDCPA to provide such validation before further collection activity could resume against you."

 

It goes onto to say that "the purpose of the section 456.057 FLA Statute is to deter the UNAUTHORIZED disclosure of health care and or medical records. However, your actions taken by your validation request satisfies the written consent requirement under this section as well as florida and federal consumer protection laws."

 

It then says that it is unlikely that the ACA, BBB or attorney general will find that their clients actions or that of its healthcare provider creditor violates federal of florida law given my specific request and consent to demonstrate to you compent evidence that I have a legal obligation to pay.

It then says that their client, scumbag CA, has no legal obligation to remove credit bureau information unless it determines the info is incomplete or inaccurate. and it says that I may submit my dispute and request reinvestigation directly to the CA by providing the required info under the 2003 FACTA provisions.

It then says: "finally, your use of the CREDITOR/ DEBT COLLECTOR DECLARATION is not binding and is not required under any federal or state law. Particulary, my client is not legally obligated to provide you with any information other than what is required under floridas consumer collection practices act of the FDCPA verification provisions, nor is it legally required to fill out your attached form."

 

 

 

So, what to make from this, what do I do next???

[Subprime]

Can this be moved to the medical collections forum?

 

-Subprime