Health Insurance Portability Accountability Act (HIPAA)

Client Rights & Therapist Duties

This document contains important information about federal law, the Health Insurance Portability and Accountability Act (HIPAA), that provides privacy protections and patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. The terms “client” and “patient” are used interchangeably and mean the same thing in this document.

HIPAA requires that you are provided with a Notice of Privacy Practices (the Notice) for use and disclosure of PHI for treatment, payment and health care operations.  The Notice explains HIPAA and its application to your PHI in greater detail. 

Once you become an active patient, the law requires your signature acknowledging that you have been provided with this.  If you have any questions, it is your right and obligation to ask so that further discussion can be had prior to signing the document.  When you sign the document, it will also represent an agreement between you and your therapist.  You may revoke this Agreement in writing at any time.  That revocation will be binding unless action has been taken in reliance on it. 

LIMITS ON CONFIDENTIALITY

The law protects the privacy of all communication between a patient and a therapist.  In most situations, information can only be released about your treatment to others if you sign a written authorization form that meets certain legal requirements imposed by HIPAA.  There are some situations where your therapist is permitted or required to disclose information without either your consent or authorization. If such a situation arises, the disclosure will be limited to what is necessary.  Reasons your information may need to be released without authorization include:

1.  If you are involved in a court proceeding and a request is made for information concerning your diagnosis and treatment, such information is protected by the psychologist-patient privilege law.  Your therapist cannot provide any information without your (or your legal representative’s) written authorization, or a court order, or if your therapist receives a subpoena of which you have been properly notified and you have failed to inform your therapist that you oppose the subpoena.  If you are involved in or contemplating litigation, you should consult with an attorney to determine whether a court would be likely to order your therapist to disclose information.

2.  If a government agency is requesting the information for health oversight activities, within its appropriate legal authority, your therapist may be required to provide it for them.

3.  If a patient files a complaint or lawsuit against their therapist, the therapist may disclose relevant information regarding that patient in order to defend themselves.

4.  If a patient files a worker’s compensation claim, and their therapist is providing necessary treatment related to that claim, the therapist must, upon appropriate request, submit treatment reports to the appropriate parties, including the patient’s employer, the insurance carrier, or an authorized qualified rehabilitation provider.

5.  A therapist may disclose the minimum necessary health information to related business associates that perform functions on behalf of the therapist and agency, or that provide them with services if the information is necessary for such functions or services.  Business associates sign agreements to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in your contract with your therapist.

There are some situations in which your therapist is legally obligated to take actions, which are necessary to attempt to protect others from harm, and your therapist may have to reveal some information about your treatment:

1.  If it is known, or there is reason to suspect, that a child under 18 has been abused, abandoned, or neglected by a parent, legal custodian, caregiver, or any other person responsible for the child’s welfare, the law requires that a report is filed with the State of Michigan Abuse Hotline.  Once such a report is filed, your therapist may be required to provide additional information.

2.  If your therapist knows or has reasonable cause to suspect that a vulnerable adult has been abused, neglected, or exploited, the law requires that a report is filed with the State of Michigan Abuse Hotline.  Once such a report is filed, your therapist may be required to provide additional information.

3.  If your therapist believes that there is a clear and immediate probability of physical harm to the patient, to other individuals, or to society, your therapist may be required to disclose information to take protective action, including communicating the information to the potential victim, and/or appropriate family member, and/or the police or to seek hospitalization of the patient.

CLIENT RIGHTS AND THERAPIST DUTIES

Use and Disclosure of Protected Health Information:

●          For Treatment – Your health information is used and disclosed internally in the course of your treatment.  If your therapist is to provide information outside of the practice for your treatment by another health care provider, your therapist will have you sign an authorization for release of information.  Furthermore, an authorization is required for most uses and disclosures of psychotherapy notes.

●          For Payment – Your health information may be used and disclosed to obtain payment for services provided to you as delineated in the Therapy Agreement.

●          For Operations – Your therapist may use and disclose your health information as part of internal operations.  For example, this could mean a review of records to assure quality.  Your therapist may also use your information to tell you about services, educational activities, and programs that your therapist feels might be of interest to you.

CLIENT RIGHTS

●          Right to Treatment – You have the right to ethical treatment without discrimination regarding race, ethnicity, gender identity, sexual orientation, religion, disability status, age, or any other protected category. 

●          Right to Confidentiality – You have the right to have your health care information protected.  If you pay for a service or health care item out-of-pocket in full, you can ask your therapist not to share that information for the purpose of payment or operations with your health insurer.  Your therapist will agree to such unless a law requires your therapist to share that information.

●          Right to Request Restrictions – You have the right to request restrictions on certain uses and disclosures of protected health information about you.  However, your therapist is not required to agree to a restriction that you request.

●          Right to Receive Confidential Communications by Alternative Means and at Alternative Locations – You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations.

●          Right to Inspect and Copy – You have the right to inspect or obtain a copy (or both) of PHI.  Records must be requested in writing and release of information must be completed.  Furthermore, there is a copying fee charge of $1.25 per page.  Please make your request well in advance and allow at least 2 weeks to receive the copies.  If your therapist refuses your request for access to your records, you have a right of review, which your therapist will discuss with you upon request.

●          Right to Amend – If you believe the information in your records is incorrect and/or missing important information, you can ask your therapist to make certain changes, also known as amending, to your health information.  You have to make this request in writing.  You must tell your therapist the reasons you want to make these changes, and your therapist will decide if it is appropriate, and if your therapist refuses to do so, your therapist will tell you why within 60 days. 

●          Right to a Copy of This Notice – If you receive your paperwork electronically, you will have a copy in your patient portal.  If you completed this paperwork in the office at your first session a copy will be provided to you per your request, or at any time.

●          Right to an Accounting – You generally have the right to receive an accounting of disclosures of PHI regarding you.  On your request, your therapist will discuss with you the details of the accounting process.

●          Right to Choose Someone to Act for You – If someone is your legal guardian, that person can exercise your rights and make choices about your health information; your therapist will make sure the person has this authority and can act for you before your therapist takes any action. 

●          Right to Choose – You have the right to decide not to receive services with your therapist.  If you wish, your therapist will provide you with names of other qualified professionals. 

●          Right to Terminate – You have the right to terminate therapeutic services with your therapist at any time without any legal or financial obligations other than those already accrued.  It is important that you discuss your decision with your therapist in session before terminating, or to at least contact your therapist by phone letting your therapist know that you are terminating services.

●          Right to Release Information with Written Consent – With your written consent, any part of your record can be released to any person or agency you designate.  Together, you and your therapist will discuss whether or not releasing the information in question to that person or agency might be harmful to you.

THERAPIST DUTIES

●          Your therapist is required by law to maintain the privacy of PHI and to provide you with a notice of their legal duties and privacy practices with respect to PHI.  Your therapist reserves the right to change the privacy policies and practices described in this notice.  Unless your therapist notifies you of such changes, however, your therapist is required to abide by the terms currently in effect.  If your therapist revises their policies and procedures, your therapist will provide you with a revised notice in office during your session.

COMPLAINTS

If you are concerned that your therapist has violated your privacy rights, or you disagree with a decision your therapist has made about access to your records, you may contact your therapist, the State of Michigan Department of Health, or the Secretary of the U.S. Department of Health and Human Services.