Is this Legal?

YOU, miss the point. Chart Mining is illegal. You are not a Dr. and it is NOT up to you to decide who gets a bone stimulator. Add to the Fact, that chart mining is a major HIPA violation. It's different when a Dr. writes a script for you to deliver service. It is ILLEGAL for you to "mine"
the charts. Period.
 






Hey Perry Mason. If the patient has signed a consent, then HIPA doesn't apply. Why dont you point us to the HIPA Section that 'Chart Mining is Illegal'. At the same time, why dont you also provide some links or references to support your assertion that recent publications say bone stims 'simply don't make much of a difference in the healing process'. Why dont you just save the world and call your congressman.

Oh Waiter, I'll have some of what ^ Perry Mason's havin'..
 






Hey Perry Mason. If the patient has signed a consent, then HIPA doesn't apply. Why dont you point us to the HIPA Section that 'Chart Mining is Illegal'. At the same time, why dont you also provide some links or references to support your assertion that recent publications say bone stims 'simply don't make much of a difference in the healing process'. Why dont you just save the world and call your congressman.

Oh Waiter, I'll have some of what ^ Perry Mason's havin'..

Frequently asked questions about the HIPAA privacy

FAQs Information
May a physician or hospital "fax" a patient's medical information to other physicians or to an insurer?
What is the "minimum necessary" standard?
What can a physician say to another covered entity if the covered entity will not fax information on the belief that the "fax" would not be allowed under the Privacy Rules?
May a physician discuss information about a patient's treatment with other physicians using e-mail?
What steps should a physician take to protect oral communications with or about patients?
If a patient's family members call to ask how their loved one is doing, what can the treating physician disclose?
Question regarding physicians' difficulty with gathering patient information
Physicians report a concern the Privacy Rules may create a barrier to effective communication about patients. How should a physician evaluate whether a particular communication is acceptable or is restricted by the Privacy Rules?
May a physician send out appointment-reminder postcards? Leave messages on answering machines? Verify appointment times with the patient's spouse or other living companion?
May a physician use a sign-in sheet? Call out names in the waiting area? Place charts outside a patient's room while the patient is waiting to see the physician?
May a hospital provide information, including a patient's room number, to a patient's family or friends or to the clergy?
May a physician send protected health information overseas for transcription?
May a physician or hospital release information to the police to assist with an investigation?
Do the Privacy Rules prevent 911 dispatchers, emergency medics, or police or fire departments from using patient's names and other identifiable information?
How is the government enforcing the Privacy Rules?
The family of a deceased patient is requesting the patient's original medical records. Can my office refuse?
Are there any physicians or groups exempted from the HIPAA privacy requirements?
What is a Notice of Privacy Practices?
What are the requirements for a physician to distribute a Notice of Privacy Practices to patients and seek an acknowledgement that each patient has received a copy?
Do the Privacy Rules require a physician to get the patient's consent for uses and disclosures?
May a physician obtain a consent instead of providing the Notice of Privacy Practices?
Are physicians required to have pharmaceutical sales representatives sign Business Associate Agreements?
Do the Privacy Rules require physicians to have pharmaceutical sales representatives sign any type of confidentiality agreement, even one that is not a Business Associate Agreement?
Although the Privacy Rules do not require physicians to have pharmaceutical sales representatives sign any type of confidentiality agreement, may a physician ask sales representatives to sign them anyway?
May a physician continue to make adverse event reports to pharmaceutical manufacturers and/or the FDA?
May a sales representative sit in on a patient's exam or treatment?
May a physician share protected health information with a sales representative as part of a discussion about the physician's experiences with the manufacturer's product?
May a physician disclose protected health information to a pharmaceutical sales representative or directly to a pharmaceutical manufacturer for purposes of enrolling a patient in a patient assistance program?
May a physician provide a sales representative with patients' names and addresses so the sales representative can send follow-up mailings?
No. This would require the physician to obtain a valid authorization from each patient giving the physician permission to disclose the patient's protected health information to the pharmaceutical manufacturer for this purpose.
What tools and resources does the AMA have available to assist physicians to understand and implement the Privacy Rules?
Does the AMA recommend other resources that a physician might find helpful to learn more about the Privacy Rules?
Where can a physician learn more about the HIPAA Transaction and Code Set Rules and the Security Rules?
Is HIPAA ever preempted by state law?
Related Links
How to HIPAA: The Top 10 Steps
Related Articles
Articles on Billing and Coding
From American Medical News
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The Privacy Rule sets out both civil and criminal penalties for covered entities that breach the Rule.66 The civil penalty provision allows a $100 fine per violation for disclosure made in error, with a maximum fine of up to $25,000 per year. The criminal penalties for persons who knowingly obtain or disclose personally identifiable information include fines of up to $50,000 and imprisonment for up to 1 year. If the crime is committed under false pretenses, the individual or organization faces fines up to $100,000 and 5 years of imprisonment. Penalties for the sale or use of PHI for commercial advantage, personal gain, or malicious harm are fines of up to $250,000 and 10 years of imprisonment.

The Privacy Rule does not provide for a private right of action by patients or research participants.67 Thus, an individual whose privacy is violated under the Privacy Rule cannot sue the covered entity or individual who breached his or her privacy. Rather, an individual can file a claim with HHS’s Office for Civil Rights (OCR). OCR is in charge of enforcement and decides whether and when to pursue a regulatory investigation and penalties against a covered entity (Stevens, 2003). In addition, it is important to note that this does not prevent an individual from pursuing a private right of action under state law (Pritts, 2008).

The Compliance and Enforcement regulations stress cooperative compliance over the imposition of penalties (reviewed by Pritts, 2008). The regulations specifically provide that the Secretary will, to the extent practicable, seek the cooperation of the covered entity in obtaining compliance.68 If an investigation indicates a failure to comply, the regulations provide that the Secretary will first attempt to resolve the matter by informal means.69 Such informal resolutions include demonstrating compliance, a completed corrective action plan, or a resolution agreement (HHS, 2007).70 Only if a covered entity does not take action to resolve the noncompliance will HHS contemplate imposing civil monetary penalties on the covered entity.71
 






yep, I'd say it's done for "personal advantage", rather than "saving the world".

Could you imagine how angry a patient would get, say a minister in your town who was HIV positive which was disclosed in the notes?

Chart mining is not cool. If you have promoted your product well, a surgeon will know when to use it, in patients who haven't healed in 90 days. DME reps are so Greedy.
 






ooooo copy the FAQs that's deep.

I think ministers with aids are scarier than greedy DME reps.

But then I don thave an agenda like y'all seem to....

really, you dont know ho's signed what, you're just in it for the 'payback' for being fired.

You'll never get to appreciate how many patients' feet have been saved by the greedy reps.
 




































Then you have the Exogen reps, mulling through charts to find ACUTE Fxs that are covered by commercial insurance. When will all this madness stop??? Most of those fxs are going to heal without 3 grande tagged onto their tab! If I were a commercial insurance company, I would want to know about this crap!

If I were a commercial insurance company, I might want to know that I am overpaying for the Orthofix device by the tune of around $1500-2000 _per_patient_, when you set up your buy and bill schemes with the clinics ( since the clinic of course buys it @1600 from Ofx and bills the insurance company for >3000, sometimes over $4000!!)
 






they are going to pay that regardless, so what difference does it make? I'd rather get PO's any day and let the clinics do the paperwork and fit the patients. Nothing illegal about it. Clinics do buy and bill on many products.
 






Can you not agree, even if the company has stripped you of your remaining shreds of ethics, that a clinic profiting $1500-2000 off prescribing one single physiostim should raise some serious red flags? and that perhaps clinics are prescribing solely on the profit they receive, and not on clinical aspects?

And are you really OK with the rest of that insurance co's subscribers paying for that in their premiums?
 






Personally, I hate it. It represents the travesty of our health care system. The companies are raping the system. Not just this company but EVERYTHING connected with health care. A nail for a house may be just 5 cents, but a nail for a human body is marked up obscenely because the system allows it by "paying" for it.

Personally, I am repulsed by "Medical Gouging" in this country. And yes, if I were BCBS or United I would void our contract for selling at a lower price to the clinics.
 


















Unless it's in the payers contract that we cannot sell at a reduced, direct price to clinics then it's fair game. Unless, I guess, if it's a government payer.

The law provides the patient a choice to rent or purchase, and this basic right was not given to bone stim patients. Medicare and others believe the patient will make the most economical choice, which is why they don't decide, the patient does. When no choice is provided, the abuses start. Giving away free product to patients that don't qualify, paying doctors staff to assist at whatever, fixing CMN's, and numerous other billing scams to divide up the very profitable bone stim dollar which gets overbilled every time as a purchase. Price fixing by the few manufacturers insisting it can only be purchased even tho there is a rental code, keeps in a "routinely purchased category", costing the system more money. This is a very serious crime, but nobody can figure out the antitrust game, especially Medicare and the DOJ.
 












The law provides the patient a choice to rent or purchase, and this basic right was not given to bone stim patients. Medicare and others believe the patient will make the most economical choice, which is why they don't decide, the patient does. When no choice is provided, the abuses start. Giving away free product to patients that don't qualify, paying doctors staff to assist at whatever, fixing CMN's, and numerous other billing scams to divide up the very profitable bone stim dollar which gets overbilled every time as a purchase. Price fixing by the few manufacturers insisting it can only be purchased even tho there is a rental code, keeps in a "routinely purchased category", costing the system more money. This is a very serious crime, but nobody can figure out the antitrust game, especially Medicare and the DOJ.


Simple. It's "overpayment" . The bone stimulator companies created a situation where as Medicare overpays for Bone Stimulators. Period. Who puts in "12 months" and WHY? You know who and we all know "why".

These products could easily be rented for three months. But it's not as profitable.

If Medicare was smart, they would elliminate the Stark Law for these devices and leave it up to the companies to come up with a rental version for three months at a time or just divide the total current contract rate by three. Let the clinics dispense them and if the clinic notes aren't up to par, then refuse payment. These devices shouldn't cost any more than 900 bucks ANYWAY.

These devices should be dispensed by the clinics. The companies could have a few reps per state and do away with all of this BS.