Confidentiality of Medical Information Act

[direred]

A collector came to another board asking if they could report to a CRA. A long thread ensued, but, basically, the answer appears to be no.

 

A CA can receive medical information under 56.10©(3):

 

The information may be disclosed to any person or entity that provides billing, claims management, medical data processing, or other administrative services for providers of health care or health care service plans or for any of the persons or entities specified in paragraph (2). However, no information so disclosed shall be further disclosed by the recipient in any way that would be violative of this part.

 

This section is part of 56.10:

 

No provider of health care, health care service plan, or contractor shall disclose medical information regarding a patient of the provider of health care or an enrollee or subscriber of a health care service plan without first obtaining an authorization, except as provided in subdivision ( or ©.

 

Subdivision ( deals entirely with cases where COMPELLED (e.g. by a court or a board or a search warrant, coroner, or "When otherwise specifically required by law."). Since credit reporting is voluntary, this is not applicable.

 

Subdivision © deals with normal business uses. In summary:

 

1) Health care providers.

2) Insurers.

3) Billing. (see first quote above)

4) Medical review boards.

5) Licensing and accrediting bodies.

6) Coroner.

7) Public health agencies.

8) Workmen's comp.

9) Insurer or insurance administrator prior to coverage.

10) Health care service plan.

11) ""

12) Probate court.

13) Organ procurement.

14) FDA for adverse drug reactions.

15) Disaster relief when applicable.

16) Third party for anonymizing (e.g. for medical studies)

17) Disease management programs.

 

Note that there is no exception for credit reporting agencies.

 

Even if one could exclude a CA reporting to a CRA under ©(3), one cannot exclude a CRA re-reporting the information. That is clearly impermissible.

 

Oh, the capper on this. You might ask, "but they're not saying I have some specific medical condition, so how could it be reporting 'Medical Information' by reporting to a CRA?"

 

Good question. Let's look at the statute's definition of medical information:

 

Medical information" means any individually identifiable information, in electronic or physical form, in possession of or derived from a provider of health care, health care service plan, pharmaceutical company, or contractor regarding a patient's medical history, mental or physical condition, or treatment. "Individually identifiable" means that the medical information includes or contains any element of personal identifying information sufficient to allow identification of the individual, such as the patient's name, address, electronic mail address, telephone number, or social security number, or other information that, alone or in combination with other publicly available information, reveals the individual's identity.

 

Clear now?

[mstigerlily]

Still not clear. I am in California. So - I've read through it a few times now and you seem to be saying that CAs cannot report to CRAs on medical information in California without authorization from me. If that were the case, wouldn't all people in CA be free of medical collections on their CR?

 

Melissa

 

 

A collector came to another board asking if they could report to a CRA. A long thread ensued, but, basically, the answer appears to be no.

 

A CA can receive medical information under 56.10©(3):

 

The information may be disclosed to any person or entity that provides billing, claims management, medical data processing, or other administrative services for providers of health care or health care service plans or for any of the persons or entities specified in paragraph (2). However, no information so disclosed shall be further disclosed by the recipient in any way that would be violative of this part.

 

This section is part of 56.10:

 

No provider of health care, health care service plan, or contractor shall disclose medical information regarding a patient of the provider of health care or an enrollee or subscriber of a health care service plan without first obtaining an authorization, except as provided in subdivision ( or ©.

 

Subdivision ( deals entirely with cases where COMPELLED (e.g. by a court or a board or a search warrant, coroner, or "When otherwise specifically required by law."). Since credit reporting is voluntary, this is not applicable.

 

Subdivision © deals with normal business uses. In summary:

 

1) Health care providers.

2) Insurers.

3) Billing. (see first quote above)

4) Medical review boards.

5) Licensing and accrediting bodies.

6) Coroner.

7) Public health agencies.

8) Workmen's comp.

9) Insurer or insurance administrator prior to coverage.

10) Health care service plan.

11) ""

12) Probate court.

13) Organ procurement.

14) FDA for adverse drug reactions.

15) Disaster relief when applicable.

16) Third party for anonymizing (e.g. for medical studies)

17) Disease management programs.

 

Note that there is no exception for credit reporting agencies.

 

Even if one could exclude a CA reporting to a CRA under ©(3), one cannot exclude a CRA re-reporting the information. That is clearly impermissible.

 

Oh, the capper on this. You might ask, "but they're not saying I have some specific medical condition, so how could it be reporting 'Medical Information' by reporting to a CRA?"

 

Good question. Let's look at the statute's definition of medical information:

 

Medical information" means any individually identifiable information, in electronic or physical form, in possession of or derived from a provider of health care, health care service plan, pharmaceutical company, or contractor regarding a patient's medical history, mental or physical condition, or treatment. "Individually identifiable" means that the medical information includes or contains any element of personal identifying information sufficient to allow identification of the individual, such as the patient's name, address, electronic mail address, telephone number, or social security number, or other information that, alone or in combination with other publicly available information, reveals the individual's identity.

 

Clear now?

[Why Chat]

Several States have statutes forbidding medical accounts on credit reports, Fl. is another besides Ca., and there may be more. HOWEVER, just as in the case of the prohibition against ANY CA reporting in Mass. the only way you can obtain enforcement, ( and deletion) is to dispute it to the CRA. The medical dispute letter works particularly well to obtain a complete deletion in those States that prohibit medical accounts from appearing on your reports, HOWEVER, if it is a legitimate bill, and it is disputed off your reports you STILL may be sued.

[ocdb8r]

Several States have statutes forbidding medical accounts on credit reports, Fl. is another besides Ca., and there may be more. HOWEVER, just as in the case of the prohibition against ANY CA reporting in Mass. the only way you can obtain enforcement, ( and deletion) is to dispute it to the CRA. The medical dispute letter works particularly well to obtain a complete deletion in those States that prohibit medical accounts from appearing on your reports, HOWEVER, if it is a legitimate bill, and it is disputed off your reports you STILL may be sued.

 

Let me get this straight, if I dispute with CRA they must remove and my only possible liability is being sued?

 

What is the SOL in California? What about D.C.?

 

Finally, what if I am a California resident but have a bill for services in D.C. Do the California disclosure rules apply?

 

Thanks!

[ficowarrior]

Cali SOL is 4 years on medical bill, i am in CA too, So Cal to be exact. Dunno about DC. IF i dispute with CRA using why chat's medical dispute letter and CRA still ignores me, what else can be done to get the account delete from credit report? Is it a violation of CA privacy law by collection agent? or OC?

[ficowarrior]

morning bump

[Guest mixedup]

Whychat,

So are you saying this acct.(medical) should not be listed on my CR AT ALL? PERIOD?? I am in Florida.

The way this reads, it doesnt mention medical, Is this how they CA agency is bypassing this law/statue. simply not reporting it as a med coll? And then when i dispute with the letter, the CRA sees its med and removes?---OMG, is it possible that I have finally gotten it.. I have read, read and read.. Please be patient WhyChat, there are some of us (ME) that have to have it spelled out , repeatedly..

 

Account Name: screwball coll agency

Account Number: 7XXXX

Acct Type: Collection Department / Agency / Attorney

Acct Status: Closed

Monthly Payment:

Date Open: 9/1/2005

Balance: $79.00

Terms: 1 Month

High Balance:

Limit:

Past Due: $79.00

Payment Status: Seriously past due date / assigned to attorney, collection agency, or credit grantor's internal collection department

Comments:

 

 

24-Month Payment History ? Legend

 

 

 

Date: Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov

03 04 04 04 04 04 04 04 04 04 04 04 04 05 05 05 05 05 05 05 05 05 05 05

CO CO CO CO CO CO CO

[Guest mixedup]

anybody???????????????????????????????????????????????????????????????

[Rebuilder2006]

anybody???????????????????????????????????????????????????????????????

You know, I have been reading this section for awhile now, and it still confuses me.....

 

I consider myself somewhat intelligent, college educated, but for some reason every time I try to understand this, I get a huge headache.

[ficowarrior]

Whychat,

So are you saying this acct.(medical) should not be listed on my CR AT ALL? PERIOD?? I am in Florida.

Whychat, is it true? If the account listed as medical on my credit report my mortgage broker gets, i can use the medical dispute letter and it will get deleted? since i am in CA. What if the CRA just ignore my medical dispute and ignores me FTC complaint. Is suing them the only option left if they refuse to dispute nor delete?

[Guest mixedup]

REBUILDER2006,

 

 

Here...have some of my advil...LOL.. I agree 100%

How long have you been working on your stuff? I am making some progress....

 

[Rebuilder2006]

REBUILDER2006,

 

 

Here...have some of my advil...LOL.. I agree 100%

How long have you been working on your stuff? I am making some progress....

 

I have been working on my CR for about 6 weeks now, I understand pretty much everything else, but I just cant get a hold on this HIPAA and Medical Privacy Laws, and how to use it to get deletion...

 

My have my Advil right here, its no joke......lol

Edited February 24, 2006 by Rebuilder2006

[mstigerlily]

REBUILDER2006,

 

 

Here...have some of my advil...LOL.. I agree 100%

How long have you been working on your stuff? I am making some progress....

 

I have been working on my CR for about 6 weeks now, I understand pretty much everything else, but I just cant get a hold on this HIPAA and Medical Privacy Laws, and how to use it to get deletion...

 

My have my Advil right here, its no joke......lol

 

I had a little trouble at first but WhyChat's web page is pretty detailed, just make sure you follow the stuff in order. But honestly I've had success with the HIPAA thing - even when I did it wrong. I wasn't ready to PIF yet since it was $180 - so I didn't send do the HIPAA process with one creditor, instead I sent a letter to the CA requesting to validate, didn't even mention medical issues at all and they sent a letter dismissing the debt within two weeks. I was amazed, I was all prepared to pay it through the HIPAA process or pay to delete, etc but poof it's gone.

 

I can't remember where I got this letter - I think on PsychDoc's transcripts...but this is the one I sent that worked (modified of course for my situation.

 

To Whom it May Concern:

 

My name is xxxx. After an application for credit was denied, I investigated and was disturbed to see a collection account on my credit report assigned to your agency. If this is indeed my bill, I must have assumed this bill was assigned to insurance and paid, or that it was sent in error. Either way, I have no knowledge or records of account number: xxxxx for xxxxxx for $180.00 reported as a collection account.

 

This letter is not a refusal to pay, but a notice that your claim is disputed. Under the Fair Debt Collections Practices Act (FDCPA), I have the right to request validation of the debt you say I owe you. I am requesting proof that I am indeed the party you are asking to pay this debt, and there is some contractual obligation which is binding on me to pay this debt.

 

Please advise me as to the name and address of the medical provider, the date(s) of service, to whom the service was provided, and what it was for. If you can get this information, I also would need the name of the person providing this data, and the manner in which it was provided.

 

Your legal staff will agree that compliance with this request is required under the laws of California and Federal Statutes. I have notified the credit reporting agencies of this dispute.

 

In addition to the questionnaire below, please attach copies of 1) the agreement with your client that grants you the authority to collect on this alleged debt, or proof of acquisition by purchase or assignment and 2) the agreement that bears the signature of the alleged debtor wherein he or she agreed to pay the creditor.

 

I ask for compliance with the terms and conditions of this letter within 30 days or a complete withdrawal, in writing, of any claim.

 

Sincerely,

xxxxxxxxxx

 

-------------------------------------------

Debt Validation Form

Questionnaire to be returned :

Account #: ____________________

Original Creditor's Name: _________________________________

Name of Debtor: ______________________________________

Address of Debtor: ___________________________________

Balance of Account: __________________________________

Date you acquired this debt: _________________________

This Debt was: assigned ___purchased___

Please indicated any credit bureaus to which you have reported on this account:

Experian ______

Equifax ______

TransUnion _____

[Rebuilder2006]

Thats a great letter...

 

Problem is the medical collection was discharged in BK, so they cant validate it...

 

The Bk was, oddly enough, because of excessive medical bills, go figure.....

[mstigerlily]

Thats a great letter...

 

Problem is the medical collection was discharged in BK, so they cant validate it...

 

The Bk was, oddly enough, because of excessive medical bills, go figure.....

 

Oh I see...well maybe WhyChat can help you, don't know much about how to get rid of bankruptcy discharged debts. My BK is 7 years old and all my discharged stuff is gone, just the BK remains and that is proving very difficult to get rid of. I will probably just wait 3 more years till it falls off or keep trying every 6 months or so to challenge it and get rid of it. Have you tried the BK forum for info on how to get rid of those type of accts?

[Guest mixedup]

Mstigerlily,

 

I also have used one pretty close to that.. Also, it has worked for me.

I did have 1 write me back to notify me"they didn't have to answer my questionaire"

And for some unknown reason, it just magically disppeared off of my file.

 

I am just extremly interested in this situation, because if in fact it is the case, that could potentially

delete about 15 collection accts for me. Which is the majority of my baddies..

 

And I could not have done it without the help here.. I have even gotten brave enough to get a lawyer

over an acct that I cant resolve myself. And with the knowledge I've gained I have enough courage

to fight for myself..... It is amazing what the bottom feeders will try to do.

 

Sissy

I will get my credit back

[Guest mixedup]

REBUILDER,

 

I filed BK in 98 ..same reason.. I DO KNOW that they cannot be attempting to collect on a debt dc

in a BK- MAJOR violation(per my attoney) If that is the case you may want to look into a lawyer.

[Rebuilder2006]

REBUILDER,

 

I filed BK in 98 ..same reason.. I DO KNOW that they cannot be attempting to collect on a debt dc

in a BK- MAJOR violation(per my attoney) If that is the case you may want to look into a lawyer.

They aren't trying to collect the debt, the debt has a 0 balance due to the BK...I just need to get the account off my CR, hopefully using the HIPAA and state medical privacy laws....

[Guest mixedup]

Morning Bump........

[ocdb8r]

OK, I'm a newbie so take this with a grain of salt....BUT I have been pouring over this issue to understand it.

 

For California (and possibly FL) it looks like what the information in the OP means is that we should be able to start whyChat's process at the final step - Her "Medical Dispute" to CRA's that is basically a verify. You can do this because the intepretation above implies the OC's and CA's can not legally verify to the CRA without being in violation of the CMIA (in California). If they do verify you then take the verification evidence from the CRA and send it to the OC and/or CA informing them of the violation and demand they stop reporting (maybe with a threat to sue).

 

Basically WhyChat's initial strategy is to make it illegal for an OC to Verify with the CRA (or to validate with the CA). To do this you must send a check to the OC with the endorsement - this ends any "permisible business purpose" the OC may have in communicating this info. With that you then proceed to the CRA "Medical Dispute" letter to remove the item because it can no longer be verified (or if it is the OC/CA are in violation of HIPAA).

 

California (possibly FL) are unique in that it appears you don't even have to end a "permissible business purpose" to restrict sharing of info. The OP inerprets the CMIA to forbid this so the initial step of sending a check with the endorsement and letter is not necessary. The only thing that might be seen as different is by going WhyChat's route you do a bit of pre-emptive warning that if they disclose they would violate HIPAA which may ensure they don't verify to the CRA's and may even motivate them to request deletion of the info. Aslo, if you are in the SOL WhyChat's method might be better because you could still get sued if the debt is unpaid (which it would be if you skipped her 1st step as I've suggested may be possible in CA or FL).

[Guest mixedup]

Today, I sent the MDL to all 3 CRA's. I will wait and see how it turns out.

I DID send it in the pretty purple, italic font

[ficowarrior]

Today, I sent the MDL to all 3 CRA's. I will wait and see how it turns out.

I DID send it in the pretty purple, italic font

Hi Mixedup, do you think the CRA will really contact CA to verify the medical dispute, or they will do another computer data transfer and update our file as 'verified', if that's the case, i don't think CA has any violation other than under FCRA. And CRA always refuse to provide PR.

[Guest mixedup]

Hey Ficowarrior,

 

Well, it would seem to me that it would be in CRA best interest to REALLY verify and get correct

information.. somewhere i saw where they can do that electronic BS 1 or 2 times. But when you ask

for proof of the verification, they need a little more than tapes.. especially if the acct was previously verified..

 

Also, if they can get all that information.. someone may have a problem because of the Hippa thing.

 

Whychat had told me a while back to send this letter on another acct. BUT as stated I have to read the crap aboubt 50 times before I THINK I may have an idea...

 

But on a more screwed up note, I did have a stupid CA send me ACTUAL COPIES OF 3 bills, that is actually on the letterhead from the hospital.... so, i do need to run that back by Whychat. because if Im understanding this, that is a violation.. everything is on that, insurance, patient, meds that were used...

 

Any luck on your end with that file of yours?

[lorcan]

subscribing

[ficowarrior]

Any luck on your end with that file of yours?

 

I had filed police report on this particular medical collection, cuz the CA send me their version of validation, it has my name ssn dob info on, and it has a fake address and fake phone number, and CA didn't send me their contract with OC or anything that has my signature on it. I had someone fraud me on an auto loan application and have to file police report anywaz, so i just include this medical account in my report. And i had send the report to EX and TU, waiting for their response, Eq already deleted and my fico score raise 100 pts in 2 days, yes, 100 pts after the freaking 1 year old med CO deleted. I am still going after the CA, since they have so many violation on different things.