Posted by employee on 1/27/07

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A Medical Director, (employed by a hospital) of a specialty
clinic has the the responsibility of the overall running
and building of a this clinic which is located inside the
hospital building- an integrated health care facility. It
came to the Medical director's attention that the clinic
was not being used to capacity, as some docs (also
employees of the hospital) were referring patients other
institutions. To investigate one such case, the Medical
director reviewed the records of a patient who was referred
to a similar specialty clinic of another institution, to
ascertain the reason for the referral and underutilization
of the services of the specialty clinic located within the
hospital. The patient had not been seen by the medical
director of this clinic for treatment or consult. When no
valid reason was found for such a referral (eg, patient
request, continuity of care if previously seen at other
facility for the smae problem), the Medical Director raised
the concern of under-utilization of the specialty clinic in
a internal meeting so that this problem would cease if the
issue of under-utilization was ackowledged and corrected.

HIPAA provides for exceptions to the privacy rules for
clinical treatment and certain healthcare administrative
functions. Did the Medical Director commit a HIPAA
violation?

Re: A case of HIPAA VIOLATION, but by the client's attorney, 5/26/09, by Curmudgeon.

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