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CMs should brush up on HIPAA regulations
A case in which a Lafayette, LA, case manager was arrested and charged with obstruction of justice should serve as a reminder to case managers that they must be familiar with the Health Insurance Portability and Accessibility Act (HIPAA) as well as their local and state patient privacy laws, says Elizabeth Hogue, Esq., a Burtonsville, MD, attorney in private practice specializing in health care issues.
"There are still a lot of misunderstandings about HIPAA and what hospitals must do to protect patient privacy. For their own protection and the protection of the people for whom they advocate, case managers should be familiar with HIPAA provisions," she says.
Hogue was referring to a case in which a federal judge recently threw out a false arrest lawsuit filed by Elizabeth Maier, RN, a case manager at Lafayette General Medical Center, who was charged with obstruction of justice when she refused to allow police officers to interview a woman who was being treated for domestic abuse injuries.
U.S. District Court Judge Tucker Melancon issued a summary judgment for the defendants, ruling that HIPAA does not block officers from obtaining information about a crime from a victim and doesn't prohibit hospital personnel from giving police access to a victim of a crime.
The incident, which took place April 9, 2005, occurred while a 66-year-old woman was being treated in the emergency department for injuries on the head, face, and forearm, and told a nurse that her husband pushed her down. The patient later told Maier that she did not want to report the abuse but a nurse already had called 911.
According to papers filed in the false arrest lawsuit, when the police arrived, Maier stood in the door of the treatment room and refused to let them talk to the patient, telling them they were called by mistake. The woman later left the hospital with her husband.
The police obtained a warrant from a judge and arrested Maier in May 2005. The Lafayette Parish district attorney's office declined to prosecute.
"The case manager said that she did not give police access to the woman to protect her confidentiality but HIPAA doesn't say that. It says that health care professionals should share information when someone may be in imminent danger," Hogue says.
"No doubt, this case manager thought she was doing the right things and had the best intentions, but her actions were based on a lack of understanding of the law," Hogue says.
In this case, rather than interposing herself between the patient and the police, Maier could have stepped aside and let the woman tell police she didn't want to pursue the matter, Hogue points out.
"In her lawsuit, Maier claims that she did not block the entry of the police in a way that amounted to obstruction. She says she stood at the door of the exam room and told the police that if they forced access, she would sue them under HIPAA," she says.
Louisiana domestic abuse statutes require police to notify victims that they can get a protective order against their abuser and to escort them to a shelter if they request it, Hogue says.
"The court's point of view was that even if the patient didn't want to talk to the police, they had an obligation under Louisiana law to make her aware of her rights and to give her an opportunity to exercise those rights. Because Maier did not give the police access, they were unable to inform the victim of her options and choices," Hogue says.
The judge issued a summary judgment in the case, pointing out that Maier's suit is not supported by the law, Hogue adds.