Confidentiality, Privacy and Security

Releasing records beyond the date of signature on an authorization

  • 1.  Releasing records beyond the date of signature on an authorization

    Posted 06-24-2014 10:53
    I am updating our Policy and Procedures and want to see how other entities are handling the releasing of records beyond the date of signature on an authorization. 

    HIPAA does allow us to recognize a properly signed authorization and apply such authorization to medical records / PHI subsequent to the date of the authorization but we are not required to do so.............

    HHS CMS FAQ: 

    Question:  May a covered entity disclose protected health information specified in an Authorization, even if that information was created after the Authorization was signed?

    Answer:

    Yes, provided that the Authorization encompasses the category of information that was later created, and that the Authorization has not expired or been revoked by the individual. Unless otherwise expressly limited by the Authorization, a covered entity may use or disclose the protected health information identified on the Authorization regardless of when the information was created.

    Currently we do not release records beyojnd the date the patient signed the authorization because our thinking is that the patient cannot know why they may be seen at our facility beyond that date, and we do not know if they would like those records released to the requestor.  What is anyone else doing with this?

    Kimberly Moore, RHI
    SCL System Release of Information Manager








  • 2.  RE: Releasing records beyond the date of signature on an authorization

    Posted 06-25-2014 09:19
    So this came up recently at Truman.  We have only ever released records past the signed date in rare circumstances.  A patient complained to the OIG and they contacted us about it and cited the FAQ below, however, in our rebuttal, we explained why we don't release past the date and how we are ultimately protecting the patient (who could not know what may be written in their record in the future and may not have wanted said records released) and they accepted it

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    Seth Katz
    Assistant Administrator, Information Management and Program Execution
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  • 3.  RE: Releasing records beyond the date of signature on an authorization

    Posted 06-26-2014 09:23
    That has also been our policy for the same reasons cited.  The patient at the time the authorization was signed does not know what future care he will receive and therefore can't make an informed deicsion as to whether that inforamtion should be relawsed..  Also of note is the fact that faciliteis "may" release not are required to release which leaves it up to the facility policy.  We are very careful to educate our pateints (and often times legal practices) on this very point.  Our only exception is cases like disability where the authorization signed by the patient specifically states that it is good for future episodes of care.

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    Wauleah Larson
    Director, Medical Records
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  • 4.  RE: Releasing records beyond the date of signature on an authorization

    Posted 06-25-2014 10:26
    We do not release records created after the date of the signature on the authorization.  We get a little push back as well but when we explain our reasoning it usually satisfies the requestor.  Our reason is the same as stated in these postings. 

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    DeAnn Tucker
    Director, HIM & Privacy Officer
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  • 5.  RE: Releasing records beyond the date of signature on an authorization

    Posted 06-26-2014 07:45
    We only release records past the date signed when the authorization clearly states that it is allowed. We have to look in the authorization for a statement that say something like '...allow release of records past the date signed as long as authorization is still in effect' - and since this is what the patient is signing, we legally have to allow it. If this statement is not in an auth, records cannot be release after the date signed, no matter how long the auth is valid for. We even have the option on our authorization for this statement to be checked by the patient when they are requesting records, so they don't have to keep filing out a new auth every time they want records, they can just call and ask for the information (which is then documented in our tracking system)

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    Aimee Langman, RHIT 
    Release of Information Specialist
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  • 6.  RE: Releasing records beyond the date of signature on an authorization

    Posted 01-19-2015 10:45
    Kimberly ~

    Do you happen to have the FAQ # for this reponse?  I'd like to be able to find the actual citation to use in preparing a "canned" response to the many attorneys/insurance companies that insist that they get all records created after their original subpoena/request.

    Thanks so much,

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    Kimberley Hazelton, RHIA
    Records Manager
    Lincoln NE
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  • 7.  RE: Releasing records beyond the date of signature on an authorization

    Posted 01-20-2015 11:43
    This would also be of interest to me as well.  In our office we frequently have patients that sign a release of information on their first of a series of four appointments for the final report to be sent out to other facilities at a later time.  After seeing this post I am curious as to whether or not we need to revise our ROI forms to reflect it is for future information.

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    Susanne Baron, RHIT 
    Office Manager
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  • 8.  RE: Releasing records beyond the date of signature on an authorization

    Posted 01-21-2015 09:15
    So for so many years (10+) we never went past the date of signature even though the law says you can.  Our logic had always been that there is no way that a patient could know what could happen to them 8 months after they sign an authorization and so how could they knowingly be giving company X carte blanche to their records?  We said it was a patient protection piece.

    However, we've recently gone back on that because of patient complaints.  They get annoyed when a lawfirm or disability or whomever says they need to get them to sign a new authorization because the new records are past the date they previously signed.  So we now take them, but we're not happy with it.

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    Seth Katz
    Assistant Administrator, Information Management and Program Execution
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  • 9.  RE: Releasing records beyond the date of signature on an authorization

    Posted 01-22-2015 09:21
    We release beyond the date of signature for specific items such as recurring labs. For example,  patients come in each week or multiple days during the week and gets their INR checked and want a copy of it. It was frustrating to the patients having to sign a form with ID each time they came in so we have them fill out a form dated no longer than a year after their signature ( but typically 6 months) - and specifying ONLY labs related to their Coumadin therapy (INR/PTT) are covered with that one release. Any other release of information of subsequent visits not pertaining to the Coumadin therapy- they would fill out a new request.  Recurring labs is basically the only time we allow a release to be dated past the date of signature.

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    Kathryn Severson
    HIM Director
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  • 10.  RE: Releasing records beyond the date of signature on an authorization

    Posted 01-22-2015 09:35
    This continues to be misunderstood among patients and even other covered entities, and I can understand why others would not understand not releasing past the date of signature. It's just how people perceive things. However, since we also do not practice releasing past the date of signature we added on our ROI form the option to choose more than 1 purpose for the disclosure. One of those being "to maintain open communication for 365 days after date of signature, expiration of event, or revocation by patient."  Our HIM staff is trained to know how to apply this in situations that they foresee an ongoing disclosure of the patient's health information, i.e. attorney, work-related cases, fmla, etc...  This has cut down tremendously the need for the patient to sign when a new request is needed for an ongoing issue. Hope this helps!
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    Rasan Blevins
    Director of Support Services
    Third Street Family Health Services
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  • 11.  RE: Releasing records beyond the date of signature on an authorization

    Posted 01-22-2015 10:14
    At our facility, our authorization form states it will expire 90 days from the date it was signed, unless the patient lists a specific date on the form, which we also provide a blank line for the patient to write in their own date of expiration.



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    Audrey Faison
    HIM Operations Manager
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  • 12.  RE: Releasing records beyond the date of signature on an authorization

    Posted 01-23-2015 09:25
    Rasan ~

    I really like this idea and may look at incorporating it.

    More specifically, my staff was asking this week about subpoenas that are requesting additional records and whether or not we needed to see satisfactory assurances again if it's been months since we first responded to the subpoena and now there are new records.  My inclination is to say yes, unless the subpoena was very specific in stating that future records would also be included...  Sure wish things could be simple!

     

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    Kimberley Hazelton, RHIA
    Records Manager
    Lincoln NE
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  • 13.  RE: Releasing records beyond the date of signature on an authorization

    Posted 11 days ago
    I am curious to hear if this continues to be the standard among other facilities to not release records past date of signature unless authorization specifically allows for it.  This has been always been our standard/policy and want to ensure I'm not being too conservative. =)

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    REBECCA KILEN, MS, RHIA
    Privacy Officer
    Gundersen Health System
    rakilen@gundersenhealth.org
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  • 14.  RE: Releasing records beyond the date of signature on an authorization

    Posted 10 days ago
    our facility makes sure on every auth that it has a clear statement to allow past the date signed ....it has to be clear enough that the patient would understand that it does include future records, such at 'allows past, present, and future records', 'by signing this auth, I understand that records past the date I sign may be released' or our facility auth has a box that the patient/legal rep can check that states we can send records past the date signed as long as the authorization is valid. We will also go by the date range patients put on some auths because the patient is signing for that complete date range. We do get many calls when we refuse auths due to this because many think that as long as the auth is valid, they can request any information, but our facility is very strict on this and will not budge.

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    Aimee Barta , RHIT
    Sr. Release of Information Specialist
    barta.aimee@mayo.edu
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