A member of the hospital’s medical staff has been accused of improperly billing

Question

A member of the hospital’s medical staff has been accused of improperly billing Medicare for treatments done in his office that were not medically necessary. A subpoena for copies of patient records was received but the subpoena does not include a patient authorization for release of the records. In addition, the subpoena requests all “peer review committee” records pertaining to this physician. Consider the following questions: What must you check before releasing the patient records? What legal concept described in this chapter will determine admissibility of the hospital records into evidence? The defendant’s lawyer objects to the subpoena, arguing that the patient records are “hearsay.” To resolve this issue, identify at least one element that will likely be required in your testimony (or certification of the records). Your hospital attorney objects to the subpoena of the peer review committee materials, citing state law that protects peer review records from discovery. What legal concept describes this protection? In the course of acting on the subpoena, you discover that one of the patient records (which are electronic) has had major sections deleted. Your review of the audit trails determine that a hospital staff member was responsible for the deletions. Under what legal concept could the hospital be subject to liability for the deletions? What should have been done to protect the records?

Explanation / Answer

Release of information must comply with state and federal guidelines.All the following things must be checked before releasing any medical records.Records can be released to patients above 18 years of and not less than that.Under 18 years requires a legal guardian. A person requesting medical records must submit a written consent with the following information: Patient name, date of birth, contact information and last four digits of SSN Information being requested and dates of service The name and address of the person the information is being released to The signature of the patient, signed within one year If a patient wants to look at their medical record or get copies of their record, they may submit a written request to the Health Information Department. If the patient comes in person, they must bring government-issued, picture identification, such as a driver’s license, passport, military card. If a third party (friends, family members, other) requests to see or copy a patient’s health information, they must either have the patient with them and follow these instructions, OR they must present a notarized authorization signed by the patient to health information and present government-issued, picture identification. A notarized authorization, signed by the subject of the records, which identifies the specific records hospitals are authorized to release. If the patient appears in person and presents identification, no notary is required. If the request is submitted by mail or FAX, the signature must be notarized to ensure verification of requestor identity. A valid subpoena from a court of competent jurisdiction accompanied by a completed, notarized affidavit is needed. Due to time limit,remaining questions can be asked as another question,they will be answered,thankyou for your cooperation

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