Moonlighting, HIPAA, and Risk Management

A. The Psychiatrists’ Program is a national program, providing coverage in all 50 states and the District of Columbia. Thus, your medical malpractice coverage is portable—in other words, you can take it with you. Prior to your move, just be sure to contact your underwriter with the updated information regarding your new practice location. You may be required to complete a change request form and provide a copy of your medical license for the new practice state. The underwriter will provide you with coverage options as well as premium discounts available to early career psychiatrists. As insurance rates vary per state, your premium will be adjusted to reflect the Florida rate.

A. No. Only covered entities are subject to enforcement by HHS, and the only way for a provider to be covered is to engage in at least one of the specific transactions electronically for which HHS has developed standards. HHS has developed standards for the following electronic transactions: (1) claims, (2) payment/remittance advice, (3) coordination of benefits, (4) claims status, (5) enrollment/disenrollment, (6) eligibility, (7) premium payments, and (8) referral certification/authorization. HHS is reportedly finalizing standards for the first report of injury and claims attachments and has authority to promulgate standards for additional transactions.

All psychiatrists, even those not covered by or subject to HIPAA, may want to at least be aware of the privacy rule’s requirements for protecting the confidentiality of patient information. All psychiatrists, of course, have a very strong independent duty to protect patient confidentiality based on ethical and other legal obligations. The privacy rule’s minimum confidentiality protections may be viewed as a national standard by which all psychiatrists may be judged if faced with a breach of confidentiality claim in state court or a licensing-board complaint. This point can best be illustrated by the fact that in 2001, two years prior to anyone having to comply with the privacy rule, the court in the Sutherland case (143 F. Supp. 2d 609) used the privacy rule’s standards for disclosing patient information as guidance for its decision.

Additional information about the privacy rule is posted on the Program’s Web site at www.psychprogram.com. Furthermore, participants in the Program can download a complimentary copy of the HIPAA Help Manual in the “For Participants Only” section.

A. Participants of the Program who attend an approved, accredited risk management seminar are eligible for a 5 percent premium discount. The Program can be the sponsor of the seminar or you can attend one sponsored by other organizations (be sure to check with your underwriter first to make sure the seminar meets the guidelines for the discount).

Risk management seminars are presented by the Psychiatrists’ Program each year. Nationally recognized specialists and experienced clinical, legal, insurance, and claims professionals reinforce basic risk management skills and techniques and present current psychiatric professional liability trends.

Here’s the schedule of national risk management seminars sponsored by the Program:

• “Risk Management for the Ages: Special Child and Adolescent Topics”

March 26, 2004: New York City

April 16, 2004: Syracuse, N.Y.

June 5, 2004: Hartford, Conn.

July 16, 2004: Philadelphia, Pa.

September 17, 2004: Oak Brook, Ill.

Details on registration, meeting facilities, and agendas will soon be available on the Web at www.psychprogram.com.

This column is provided by PRMS, manager of the Psychiatrists’ Program, for the benefit of members. More information is available by visiting the Program’s Web site at www.psychprogram.com; calling (800) 245-3333, ext. 389; or sending an e-mail to [email protected]. ▪