Patient's Rights to Psych Records

Discussion in 'Fibromyalgia Main Forum' started by crystal72, May 4, 2007.

  1. crystal72

    crystal72 New Member

    To any one with the problem in obtaining a copy of their psych records or any medical records...below are excerpts from the federal law known as HIPAA regarding this issue. The law is a federal one that was backed by state laws covering this question.

    I have seen three psych doctors. One a psychologist who tested me to see if I was not too crazy for the police academy.lol...Both my husband and one son were police officers at one time and I took the classes for fun. I can outshoot both of them. ;-) For a nurse, this might seem strange, but it was fun and a diversion.

    The second was a psychoneurologist testing me for my SSDI claim.

    The third one is an old man that I went to see, because like my doctors were telling me the "it's all in your mind" I was beginning to believe them. He was the one who finally gave me a diagnosis...but he is also giving my attorney a hard time, refusing to release my records to me or him...his is one of the most important for the SSDI claim.

    Here are the excerpts:

    http://www.ak-pa.org/practice/hipaa/hipaa_compliance_article.htm

    HIPAA Compliance:
    A Complicated Interplay of Federal Rule and State Laws

    Sifting through the complex language and ambiguity of a federal law or regulation in order to understand what is required for compliance is a very complicated process. That process becomes even more challenging when the regulation interacts with a host of other laws and statutes.

    Such is the case with the federal Privacy Rule stemming from the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The Privacy Rule establishes patients’ rights and requires that health professionals implement various policies and procedures regarding the use of and access to health care information. Practicing psychologists face a Privacy Rule compliance deadline of April 14, 2003.

    Psychology leaders emphasize that the Privacy Rule cannot be considered in a vacuum when it comes to determining what the regulation requires. Complying with HIPAA necessitates comparing provisions of the Privacy Rule with related state laws, statutes, and common law decisions pertaining to health care delivery. The Privacy Rule requires a complex and extensive analysis to determine which provisions of relevant law – whether federal or state -- take precedence.

    That is because the HIPAA Privacy Rule establishes a “floor” in creating a minimum level of privacy for the protection of health care information. Generally speaking, a provision of law is considered more protective of health consumers if it results in less information being released to insurance companies and other third parties, or if it gives patients greater access to their health care information.

    Provisions of state law that are stricter in protecting a patient’s health information take precedence over related provisions of the HIPAA Privacy Rule– that is, the state provisions are not preempted by HIPAA. State laws that are either contrary to or not as strict as the HIPAA Privacy Rule in protecting a patient’s health information are preempted.

    The APA Practice Organization and the APA Insurance Trust have spent many hours over the past year doing a state-by-state preemption analysis specifically related to psychology practice. The work has involved contacting entities on the state level such as psychology licensing boards, state attorney generals’ offices, outside counsel for state and provincial psychological associations, and others for help in sorting through the complexities of state laws and statutes.

    A number of factors contribute to the complexity of a state preemption analysis. The U.S. Department of Health and Human Services has published hundreds of pages of “guidance” governing the interpretation and application of the Rule. Figuring out what parts of the Privacy Rule apply to solo and small psychology group practices, and how the Rule applies, is tricky; much of the guidance provided by HHS was designed for large health facilities and medical professionals.


    And also:

    CAPS Patient's Rights Related to HIPAA and Protected Health Information (PHI):

    Right to Request Restrictions – You have the right to request restrictions on certain uses and disclosures of protected health information. However, CAPS is not required to agree to the restriction that you request if we conclude that it would hinder the appropriate care that we can provide you. For example, if you are receiving medication from a family physician or psychiatrist, and you request that we restrict or not contact them, we may conclude that it would interfere with appropriate and effective treatment. If these issues arise your CAPS therapist will discuss these matters.

    Right to Inspect and Copy – You have the right to inspect or obtain a copy (or both) of Protected Health Information contained in the CAPS psychological records that are used to make decisions about your treatment for as long as the PHI is maintained in the record. CAPS may deny your request to inspect and copy in certain circumstances as defined by law. For example if it is determined that your psychological well-being is fragile or will be negatively affected, a denial or delay in pursuing this request may occur. If you are denied access to your health information, you may request that the denial be reviewed. On your request, CAPS will discuss with you the details of the request process.

    Right to Amend – You have the right to request an amendment of Protected Health Information for as long as the PHI is maintained in the record. Your written request must include the reason or reasons that support your request. CAPS has the option of denying your request for an amendment if we determine that the record that is the subject of the request was not created by CAPS, is not available for inspection as specified by law, or is accurate and complete. On your request, CAPS will discuss with you the details of the amendment process.

    Right to an Accounting – You generally have the right to receive an accounting of disclosures that occur regarding your Protected Health information PHI. For example if we consult with the Health Center physician or nurse practitioner in regards to your medication or related health issues we will note that contact in your records. At your request, CAPS will discuss with you the details of the accounting process.

    Right to a Paper Copy – You have the right to obtain a paper copy of this notice from CAPS; in fact the copy that you are currently reviewing is your copy. CAPS also has availability of additional copies by requesting one from the secretary or downloading it from the CAPS website at www.fit.edu/caps/.

    Good luck to all,
    Linda




  2. Engel

    Engel New Member

    ((((((((( thank you ))))))))
  3. crystal72

    crystal72 New Member

  4. joeb7th

    joeb7th New Member

    Dear Crystal...


    I had never seen a psychiatrist in my entire 50+ year long life until a chronic and acute colitis attack and subsequent panic attack sent me to our local hospital maybe 3 or 4 years ago. This psychiatrist came in and talked to me for a few minutes and left and said I might want to see a therapist for post traumatic stress and current stress.

    Then, never again did I ever see a psychiatrist until 1 and 1/2 years ago when I was hit with a powerful flu, fainted and crushed my face and knocked myself out in the middle of this, and was prescribed a super powerful broad spectrum antibiotic called Levaquin within hours of this fainting and head crushing blow and with an electrolyte imbalance as well as high white blood cell count, fever, bronchitis , dehydration and swallowing nothing but blood and flem for 10 days.

    Within 30 minutes of taking these two Levaquin pills I fainted in my wife's car on the ride home after they discharged me from this ER within 2 to 3 hours after my fainting/ head crushing/septum breaking arrival.

    And this was after I pleaded with the ER doctor to not send me home as I clearly stated that I had never been so weak and physically traumatized in my entire life. I was literally like a person who just went through a bloody, head crushing, knocking out car accident while in the middle of the worst, most weakening and dehydrating flu I had ever experienced.

    Sorry, hospital's too full. See you.

    I would think most people would consider it reasonable and normal that someone might just feel "a little anxious" through all this ?

    Then within 24 more hours after this "second" fainting I was back in an ambulance from home again with body pain and "weakness" so unbelievably powerful I couldn't breath and was passing out again and with crazy haywire and painful symptoms in every other inside and outside part of my body.

    My Gad I thought what in the world is happening here!

    Immediately, I lost 40 lbs in 2 to 3 months from unbelievable GI tract pain and going into shock every time I ate and I developed brady cardia and fainted in the hospital later and had a 3 and a 1/2 second pause in my heart beat there and I developed tendonitis and incredible weakness through out my body as well as middle intestinal damage and now I have bronchial asthma and sinusitis and scarring in my left lung and so many other horrific first time breakdowns and painful symptoms all over my body you wouldn't believe.

    But through all this, I was being told so many times that because I was so anxious and actually shaking with tremors when I would race to the ER with these mind blowingly painful and scary body failings ( you'd think losing 40 pounds in 2 and 1/2 months might have made them take me a little more seriously? ) and because the ER wasn't finding any problems on their basic 3 tests ( urine, heart, blood ) that my problems were more psychological than phsyical!

    They eventually started calling the psyche ward people to interview me before they would admit me anymore to this ER.

    I now have so many psyche department calls after going to the ER in the last year and half like this and that finally culminated with a first time two day stay in their psyche ward because I came in in tears a couple of months ago...that my medical record reputation has been ruined here.

    And this has also definitely affected my personal reputation among family and friends who never doubt a doctors take on things.

    In regards to this first time psyche ward self-commiting I was told that if I volunteered to be admitted to this mental health wing that they would promise that doctors would "re-look" at the physical pain symptoms that I always said were driving me into this completely exhausting anxiety state. That was the only reason I agreed to do this.

    One doc came in that first day while I was in this ward, asked some questions about my physical problems and I never heard from him or had any more phsyical tests done after that! So much for their offered main incentive to me to commit myself.

    They then discharged me on the morning of the third day saying my insurance wouldn't cover anymore the $5000 a day charges in that department.

    That's right...five thousand dollars a day! And I have to tell you, almost all that time was spent laying on a bed reading magazines with no interaction from staff. I had two interviews and a "group" therapy meeting and my meals. That was it.

    But now this psyche ward stay is on my medical record. And this and all those other psyche referral calls in the ER is hurting my every visit to other doctors.

    The first thing doctors mention now when I see them is my extensive record of psyche anxiety calls when they look up my hospital records on their lap tops.

    When I went to my ER so many times during this crisis ( and I never ever went to ER's or even doctors like this the previous 54 years and I am a lifetime resident here ) I went there for pain and suffering and weakness so great I honestly felt like I was dying or in the least on the verge of fainting.

    But because I was so frantic with anxiety and my basic 3 tests of urine, blood and heart would come out okay, they would always just load me up with ativan and keep me for a couple of hours after they had called the psyche people to interview me and then just send me home.

    And I am certain that my last three visits to the ER were partly because I was going through Lorazepam withdrawals and didn't even know this! I was new to Lorazepam and didn't know how to manage this very well.

    Do you have any idea how rough a lorazepam withdrawal is? Dear Lord.

    And these ER docs never gave my situation enough thought or questions to even consider this! It was just " Oh no, that psycho-somatic nut is back ) Their irritated tone, dismissive non-treatment and humiliating go home comments made this so obvious.

    I cannot tell you how humiliated and devastated I have been through all of this psych diagnosis and treatment and dismissing stuff. I am afraid to go to our ER anymore out of shame and humiliation and embarrassment. And I still feel bad enough to go all the time!


    The last ER doc I saw came in, looked at my chart, commented on my last visit to the psyche ward and then said " Mr ----- I'm going to give you some ativan, you are going to call your wife to come and get you, so get dressed and I don't even want to talk about your situation anymore... I've got more important patients to attend to."

    Now that's what I call an incredibly unethical bias and treatment. But that's the way it is for me now here in this grand luxury hotel of a hospital on the fabulous Monterey Peninsula in California.

    All this has really happened as I say it has. And all because they don't believe my complaints that I feel like I am dying ( systemically feeling like some gland or organ is super malfunctioning ) and with other unbearable body pain and weakness.

    Thanks for the long read. But I always feel the need to expose the nightmarish but all too real psyche gulag shunting that goes on with this auto immune damaging class of ailments we generally call CFS/FIBRO. At least my true experience with this.
    [This Message was Edited on 05/04/2007]