Acupuncture Continuing Education

Ethics In Acupuncture #2

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This course presents an overview of medical ethics and then examines ethical and legal patient privacy considerations. Topics include:

  • Sign-In Sheets
  • Consent
  • Maintenance of Records
  • Disposal of Medical Records
  • Marketing & Media Coverage
  • Legal Authorization For Release
  • Sharing Patient Information
  • Workers Compensation
  • Disability, Abuse, and Neglect Exemption
  • Confidential Conversations & Answering Machines
  • Collection of Payment

 

Medical Ethics
Ethics are moral principles that act as guidelines for behavior. They act as a guiding philosophy, impart moral importance and help discern right from wrong. Although ethics correlate to legality, ethical obligations are often greater than what is legally required. Conversely, simply because something is legal does not necessarily make it ethical. The following is an . . .

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Access To Care, AMA Code of Ethics
Access to care involves issues of transportation, disability, knowledge, referral, and finance. Item #9 reads, “A physician shall support access to medical care for all people.” This item raises many questions:

• Who or what entity pays for medical care?
• What types of medical care are covered by insurance and government programs?
• When is a referral to another type of health care provider appropriate?
• What limits are placed on access to medical care?
• Who or what entity is responsible for providing or ensuring . . .

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NCCAOM Code of Ethics
The NCCAOM has a code of ethics for all diplomates:

  • Respect the rights, privacy and dignity of my patients and maintain confidentiality and professional boundaries at all times.
  • Treat within my lawful scope of my practice and training and only if I am able to safely, competently and effectively do so.
  • Allow my patients to . . .

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Health Insurance Portability and Accountability Act (HIPAA)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, sets national standards for healthcare related electronic health care transactions and code sets, unique health identifiers, and security. Patient records and information of licensed acupuncturists . . .

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Disposal of Medical Records
If using an external company to shred your patient PHI, ensure that they are HIPAA compliant. Often, shredding companies are certified by the . . .

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Marketing
Licensed acupuncturists do not have the ability to share patient information with marketing companies without prior authorization. HHS notes:

When is an authorization required from the patient before a provider or health plan engages in marketing to that individual?

Answer:
The HIPAA Privacy Rule expressly requires an authorization for uses or disclosures of protected health information for ALL marketing communications, except in two circumstances:

  • When the communication occurs in a face-to-face encounter between the covered entity and the individual; or the communication involves a promotional gift of nominal value.
  • If the marketing communication involves direct or indirect remuneration to the covered entity from a third party, the authorization must state that such remuneration is involved.

As a result, hiring a third party to send information directly to patients such as brochures, pamphlets, and coupons without prior patient authorization is a violation of the privacy rules.

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Media Coverage
HIPAA protections apply to using media coverage. The press may want to do a highlight of your practice. Be sure to obtain authorizations from the patients involved in . . .

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Legal Authorization For Release
Acupuncturists are advised to seek legal counsel to obtain the appropriate authorization paperwork for purposes of marketing and media coverage. The same applies to information about patients supplied to research projects. In addition, it is advisable to consult with your comprehensive liability insurance carrier (malpractice insurance company) to ensure compliance. It may seem harmless to interview a patient about the benefits of acupuncture and to post it on Youtube or a website. However, prior authorization is necessary. Care must be used when engaging in community outreach, advertising, and social media. Although informal verbal consent from a patient may seem ethical, it is not the required legal protection required by HIPAA. The following is an example of what a simple release form may look like . . .

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Answering Machines
The general idea is to keep it simple and short when leaving messages on an answering machine. Confirming an appointment time is permissible, but limit the inclusion of. . .

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Collection of Payment
Acupuncturists can disclose PHI for purposes of collecting a bill. Use reasonable restrictions to protect information. HHS notes . . .

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