He is a specialist on healthcare industry legal and regulatory affairs, and has several years of experience writing about HIPAA and other related legal topics. Because PHI is any combination of health information and PHI identifiers, when health information or PHI identifiers are maintained separately from each other, the identifiers alone are not considered protected health information under HIPAA. Webof LGBT persons remains legally permitted. Importantly, this also includes any data relating to a family member, friend, or employer that could identify the individual. We offer a range of rooms, and with the support of our Event Production & Reservations team youll be sure to find the space to meet your event needs. Journal of Youth and Adolescence, 41, 544560. Some undergo surgery as well. Badgett, M. V. L. (2012). The impact of a higher minimum wage on poverty among same-sex couples. WebThis umbrella term includes people who have nonbinary, gender-fluid, or gender nonconforming identities. Under HIPAA regulations, hospitals may use or disclose a patients protected health information to a family member, other relative, close personal friend or any other person the patient identifies. HHS The adjective describes a person who does not experience sexual attraction. It is important to note that these definitions only apply to health care providers, health plans, and health care clearing houses that qualify as HIPAA Covered Entities, and only to Business Associates while they are performing a service for or on behalf of a Covered Entity. First, it depends on whether an identifier is included in the same record set. 4QyIyYEe]JQZ]Q)= TLFZU%b\2Z;~;9z=_+z>klyW'OOg}^?~=]^nZc(NP Studies have shown that 42 percent to 68 percent of LGBTQindividuals report experiencing employment discrimination (Badgett, 2012; Fassinger, 2007). Specifically, the rules create limited safeguards for all protected health information, which includes any information that relates to (1) a patients past, present or future physical or mental health or condition, (2) the provision of healthcare to the patient, or (3) payment for the patients healthcare. What kind of information is covered by the privacy rules? 84 0 obj <>stream This definition is followed by a footnote that explains a record can be any item, collection, or grouping of information that includes Protected Health Information and is maintained, collected, used, or disseminated by or for a Covered Entity. While this may be a little confusing to follow and likely difficult to make clear to patients unfamiliar with the terminology of HIPAA an explanation of what information is protected by HIPAA could be explained thus: This explanation of what information is protected by HIPAA can help reduce patients misunderstandings about what is considered Protected Health Information under HIPAA and reduce the volume of complaints to HHS Office for Civil Rights. Therefore, the answer to questions such as is gender a HIPAA identifier, is gender considered PHI, and is LGBTQ status considered PHI is that is can be depending on who is maintaining or transmitting the information and whether it is maintained or transmitted with health information. Retrieved from http://williamsinstitute.law.ucla.edu/research/workplace/testimony-s811-061212/, Badgett, M. V. L., Durso, L. E., & Schneebaum, A. 200 Independence Avenue, S.W. WebWithout this information, lesbian, gay, bisexual, and transgender (LGBT) patients and their specific health care needs cannot be identified, the health disparities they experience cannot be addressed, and important health care services may not be delivered. HIPAA Journal's goal is to assist HIPAA-covered entities achieve and maintain compliance with state and federal regulations governing the use, storage and disclosure of PHI and PII. WebHowever, when a provider discloses information about a patient, the provider usually must try to reveal as little private information as possible. A HIPAA violation of this nature is usually considered to be a data breach; and, depending on the consequences of the violation, may have to be reported to HHS Office for Civil Rights. Socioeconomic status as context for minority stress and health disparities among lesbian, gay, and bisexual individuals. 5. Retrieved from http://www.endhomelessness.org/library/entry/national-recommended-best-practices-for-serving-lgbt-homeless-youth, Rosario, M., Schrimshaw, E. W., & Hunter, J. Washington, D.C. 20201 Before explaining these terms, it is useful to first explain what is meant by health information, of which protected health information is WebThe regulations provide protections for the privacy of certain individually identifiable health data, referred to as protected health information, and establish rules balancing patient rights with the need to protect public health. Nineteen percent of transgender individuals in one study reported having been refused a home or apartment and 11 percent reported being evicted because of their gender identity or expression (Grant, Mottet, & Tanis, 2011). When do medical providers have to tell patients about their privacy rights? If the patient files a complaint with HHS, and HHS agrees that the rules have been violated, HHS may impose a fine on the provider or, in rare cases, pursue criminal charges. These barriers, including workplace and housing discrimination, can result in increasing SES disparities for LGBTQ persons and families. All geographical subdivisions smaller than a State, including street address, city, county, precinct, zip code, and their equivalent geocodes. Information about sexual orientation and gender identity is an essential part of any medical history. The following 18 HIPAA identifiers will qualify as PHI if included in any written or electronic document or spoken conversation: Names. Gamarel, K. E., Reisner, S. L., Parsons, J. T., & Golub, S. A. WebThe core legal obligations of States with respect to protecting the human rights of LGBT people include obligations to: Protect individuals from homophobic and transphobic violence; Prevent torture and cruel, inhuman and degrading treatment; Repeal laws criminalizing same sex relations and transgender people Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Keisling, M. (2011). A lack of acceptance and fear of persecution can lead many LGBTQ youth to leave their homes and live in transitional housing or on the streets. Do not confuse having an intersex trait with being transgender. Under the Privacy Rule, if a state provides legally married spouses with health care decision making authority on behalf of one another, a covered entity is required to recognize the lawful spouse of an individual as the individuals personal representative without regard to the sex of the spouses. Those who identify and express their gender outside of the gender binary. We are constantly inspired by the passion, creativity and pride of the LGBT community. No permission required:> In a variety of other circumstances, a healthcare provider may disclose information about a patient without the patients consent. For example, a personal representative of an individual is able to review and obtain a copy of the individuals medical record or authorize disclosures of protected health information. Author: Steve Alder is the editor-in-chief of HIPAA Journal. Under HIPAA, PHI is considered to be any combination of health information and PHI identifier(s) created, received, maintained, or transmitted by a covered entity. If information relating to a patients Emotional Support Animal is maintained in a record set, it assumes the same protections as the patients health information. People who are transgender or gender diverse include: Those who have a gender identity that differs from the sex assigned to them at birth. The Human Rights Campaign reports on news, events and resources of the. First, it depends on whether an identifier is included in the same record set. Serving our youth: Findings from a national survey of service providers working with lesbian, gay, bisexual, and transgender youth who are homeless or at risk of becoming homeless. In one study, 90 percent of surveyed transgender respondents reported experiencing harassment, mistreatment or discrimination at work due to their gender identity (Grant et al., 2011). %%EOF A Covered Entity may maintain multiple record sets about an individual (i.e., a patient or plan member), but individuals only have the right to access and request amendments to information maintained in designated record sets. National recommended best practices for serving LGBT homeless youth. (2015, July 16). The term spouse includes all individuals who are in lawful marriages without regard to the sex of the individuals. hb`````Z $e@@,&gY1e*b>|9! Covered entities are allowed to disclose PHI for treatment, payment, and health care operations. The following 18 HIPAA identifiers will qualify as PHI if included in any written or electronic document or spoken conversation: Names. For more information about when the Protected Health Information definition may not apply to a health care provider or health plan, please see The HIPAA Definition of Covered Entities Explained. In conclusion, there is no doubt that understanding what is considered Protected Health Information under HIPAA can be complicated; but, by identifying what is Protected Health Information and what isnt and knowing when protections are applied to non-health information and when they are not Covered Entities and Business Associates can accelerate the flow of information and reduce the number of unjustified complaints by patients to HSS Office for Civil Rights. Fassinger, R. (2007, September). From insurance enrollment to program-specific resource areas such as Recovery, Wellness, Family and Youth, find a compilation of LGBT-focused organizations and opportunities to connect. The term HIPAA information can relate to any standard in the text of the Health Insurance Portability and Accountability Act inasmuch as the term could mean information about a pre-existing condition for insurance purposes, information contained in a Medicare claims transaction, or the right to withhold information from an insurance provider when treatment has been paid for privately. www.hipaadvisory.com GAY It can also accelerate the flow of information within a health care facility when members of the workforce understand that not every piece of information relating to a patient has to be locked down behind access controls. 137 0 obj <> endobj (2009). Therefore, it is not necessarily be the case that Covered Entities, Business Associates, and members of their respective workforces have a lack of understanding about what is considered Protected Health Information under HIPAA, but rather that patients need better educating about what HIPAA Protected Health Information is. This umbrella term includes people who have nonbinary, gender-fluid, or gender nonconforming identities. With regards to written authorizations, it is important to be aware that individuals have the right to revoke their authorizations at any time. The U.S. legal system does not prohibit discrimination on the basis of sexual orientation and gender identity in several states, including workplace discrimination. Despite the value of such frank discussions, studies have shown that many gay, lesbian, bisexual, and transgendered (LGBT) persons are reluctant to discuss their sexual orientation or gender identity with their health care providers out of fear of ridicule, abandonment of care, or improper disclosure of their sexual orientation or health status to third parties. WebThe regulations provide protections for the privacy of certain individually identifiable health data, referred to as protected health information, and establish rules balancing patient rights with the need to protect public health. HIPAA is a 1996 federal law that is intended to improve the portability and continuity of health insurance coverage and to establish national health information privacy standards. Among women 18-44 years of age, 29 percent of bisexual women and 23 percent of lesbians are living in poverty, compared to 21 percent of their heterosexual counterparts. Discrimination against LGBTQ persons in the workplace is a significant factor in socioeconomic differences for LGBTQ persons (McGarrity, 2014). All other requests for access to information under HIPAA must be accompanied by a written authorization from the patient. Because a single data breach can affect many thousands of individuals, it is not surprising to see impermissible uses and disclosures at the top of the list. Association between socioeconomic position discrimination and psychological distress: Findings from a community-based sample of gay and bisexual men in New York City. Subject to limited exceptions, the Privacy Rule at 45 CFR 164.502(g) requires covered entities to treat an individuals personal representative as the individual with respect to uses and disclosures of the individuals protected health information and for purposes of exercising the individuals rights under the Privacy Rule. 5221 Paramount Parkway Aside from the confidentiality and disclosure of health information, the new federal rules describe a few related rights that patients may exercise: How can a patient complain if a provider has violated the privacy rules? Discrimination against LGBT persons in the workplace is a significant factor in socioeconomic differences for LGBT persons (McGarrity, 2014). LGBTQIA+ is an abbreviation for lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and more. WebHIPAA Identifiers. The Center remains committed to addressing these challenges by providing you and your loved ones with LGBT-specific recovery services and support. The FAQ, while applicable in a variety of circumstances, was developed in large part to address confusion following the 2016 Orlando nightclub shooting about whether and when hospitals may share protected health information with patients loved ones. WebHIPAA Identifiers. To learn more, please read our Privacy Policy. Protected Health Information can be any information relating to an individual that is maintained in the same record set as the individuals health information. Wells, K. (2009). However, it is important to be aware that HIPAA provides a federal floor of privacy protections. Many LGBTQ youth may also be rejected by their family of origin or caregivers and forced to leave the home as minors. LvIK`(&HC R0d`vL_@q$[+"_H@T&30:?0 * This field is for validation purposes and should be left unchanged. This list does not include organizations that self-define as co-educational; although such groups may well be gender-inclusive in practice, they have yet to modify their policies and language to be inclusive at the institutional level. Please report privacy incidents promptly using the online reporting tool (link below) or the Hotline phone number at, Auditing Access to Electronic Medical Record, Employee Access to Protected Health Information, Fundraising, Marketing, Informational Newsletter Guidelines, Surprise Billing and Good Faith Estimate Notices, Avisos de facturas mdicas sorpresas y avisos de presupuestos de buena fe, All geographical subdivisions smaller than a State, including street address, city, county, precinct, zip code, and their equivalent geocodes, All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death, and all ages over 89 and all elements of dates (including year) indicative of such age, Vehicle identifiers and serial numbers, including license plate numbers, Biometric identifiers, including finger and voice prints, Full face photographic images and any comparable images, and, Any other unique identifying number, characteristic, or code. Lesbian, Gay, Bisexual, and Transgender Office on Socioeconomic Status (OSES) website. Eighteen states have no laws prohibiting workplace discrimination against LGBTQpeople (Human Rights Campaign, 2015). This standard defines designated record sets as a group of records maintained by or for a Covered Entity that is the medical records and billing records about individuals [] or the enrollment, payment, and claims information maintained by or for a health plan that is used in whole or in part by or for the Covered Entity to make decisions about individuals.. Evidence has shown that gay and bisexual men who earned higher incomes were significantly less likely to report discrimination compared to those of lower socioeconomic position. For example, the Privacy Rule allows covered entities to share information about the patients care with family members in various circumstances. The definition of designated record sets appears in the introduction to the Privacy Rule in 45 CFR 164.501. However, most Notices of Privacy Practices already contain more information than most patients are prepared to read; and, as will become evident in later sections of this article, explaining what is covered under HIPAA and what is not will likely raise more questions than answers for patients wishing to exercise their Privacy Rule rights. The law respects the patients wishes on matters of privacy and confidentiality. (2014). LESBIAN Under Executive Order 11246 and its implementing regulations, federal contracting agencies must include sexual orientation and gender identity as prohibited bases of discrimination in the Equal Opportunity Clause in federal contracts. It pains me to have to clarify that no, the LGBTQ community does not embrace pedophilia, and LGBTP is not an acronym used or supported by the LGBTQ community. LGBTQhomeless youth are more likely than their homeless heterosexual counterparts to have poorer mental and physical health outcomes, including major depressive disorders, PTSD and substance abuse (Keuroghlian, Shtasel, & Bassuk, 2014). The following 18 HIPAA identifiers will qualify as PHI if included in any written or electronic document or spoken conversation: Privacy If the threats could be reasonably anticipated, covered entities and business associates have to implement measures to protect against the threats, or mitigate the consequences if the threats were to materialize. OCR has issued a FAQ explaining that, under the HIPAA Privacy Rule, disclosures to a loved one who is not married to the patient or is not otherwise recognized as a relative of the patient under applicable law generally are permitted under the same circumstances and conditions as disclosures to a spouse or other person who is recognized as a relative under applicable law. WebProtected Health Information (PHI) is an individuals health information that is created or received by a health care provider related to the provision of health care by a covered entity that identifies or could reasonably identify the individual. Not all intersex folks identify as being part of the LGBTQIA+ community. In both quality and quantity, a patients description of his or her medical history can be far more important than any physical exam, laboratory tests, or other diagnostic tools in helping determine the patients health status. See below for a more detailed definition of each term, from GLAADs LGBTQ Media Reference Guide. Our Resource Center is a comprehensive guide connecting you to a wide range of personal resources and professional opportunities. (2013). From time to time, the Health Insurance Portability and Accountability Act is incorrectly cited as an obstacle to hospital visitation rights and decision making authority for LGBTQ families. Sometimes lesbian is the preferred term for women. Human Rights Campaign. Bisexual people need not have had specific sexual experiences to be bisexual; they need not have had any sexual experience at all to identify as bisexual. Most health care providers in the U.S., including private physicians offices and hospitals, must provide each patient with a description of the patients privacy rights during the patients first doctors visit after the rules became effective in mid-April 2003.