#hipaa

[justinspoliticalcorner]

Christopher Wiggins at The Advocate:

A Houston-based surgeon stands accused of betraying the privacy of transgender kids who weren’t under his care by stealing their medical information and handing it over to a far-right extremist who vehemently opposes transgender rights. The federal indictment, unsealed on Monday, details Dr. Eithan Haim’s alleged unauthorized access and disclosure of sensitive patient information at Texas Children’s Hospital. Haim, 34, completed his residency at Baylor College of Medicine and reportedly reactivated his access to the hospital’s electronic records system in April 2023. He is accused of illicitly obtaining patient names, treatment codes, and attending physician details, which he then shared with conservative activist Christopher Rufo. Rufo, known for his hardline stance against transgender rights, used the information to publish an exposé claiming the hospital continued to provide gender-affirming care for minors despite a public announcement to halt such services.

The indictment alleges Haim accessed this sensitive information under false pretenses and with malicious intent, aiming to harm Texas Children’s Hospital. Haim’s actions followed a 2022 opinion from Republican Texas Attorney General Ken Paxton, labeling gender-affirming care for minors as a form of child abuse. Gov. Greg Abbott, a Republican, subsequently directed the Texas Department of Family and Protective Services to investigate parents seeking such care for their children. In response, Texas Children’s Hospital announced it would pause all gender-affirming services for minors to comply with these directives and protect its staff and patients from potential legal consequences.

Dr. Eithan Haim, who leaked the health records of trans kids to far-right anti-LGBTQ+ extremist Christopher Rufo, is facing charges of violation patient privacy.

[h0d4g]

Reminder to everyone using thisisnotawebsitedotcom.com that you are violating HIPAA by viewing Bill’s medical records.

:D

[geekysteven]

[rapeculturerealities]

Biden moves to shield patients’ abortion records from GOP threats - The Washington Post

https://www.washingtonpost.com/health/2024/04/22/abortion-medical-records-patients-biden-hipaa/

The Biden administration on Monday announced new rules intended to protect the privacy of patients seeking abortions, and the health workers who may have provided them, from Republican prosecutors who have threatened to crack down on the procedure.

The rules strengthen a nearly 30-year-old health privacy law — known as the Health Insurance Portability and Accountability Act, or HIPAA — to offer more robust legal protections to those who obtain or provide reproductive health care in a state where it is legal to do so. The final policy prohibits physicians, insurers and other health-care organizations from disclosing health information to state officials for the purposes of conducting an investigation, filing a lawsuit or prosecuting a patient or provider. It covers women who cross state lines to legally terminate a pregnancy and those who qualify for an exception to their state’s abortion ban, such as in cases of rape, incest or a medical emergency.

Under previous rules, organizations were allowed to disclose private medical information to law enforcement in certain cases, such as a criminal investigation. Officials at the Department of Health and Human Services said they had heard from patients and providers who were confused about their legal risks or had even deferred care amid GOP threats in the nearly two dozen states with abortion restrictions.

[hyperlexichypatia]

The problem with most identity verification systems is that they're designed to prevent financial fraud by strangers, rather than privacy violations (and resulting interference/abuse) by family members, partners, and acquaintances. You let me pick up my prescriptions by giving my name and phone number? Do you think my abusive husband doesn't know my phone number? You let me verify my bank account with my name and birthdate? Do you think my controlling parents don't know my birthdate? You confirm my doctor's appointment with my name and address? Do you think my meddling daughter doesn't know my address? Other people have written about the sexism inherent in "mother's maiden name" as a verification question (the assumption that everyone's mother is married, that every married woman changes her name, that every child has their father's and not their mother's surname), but the bigger problem is: Do you think my abusive mother doesn't know her own name? This is why I like photo ID requirements -- my response to "Not everyone has or can afford photo ID" is "Then fix THAT, and make state ID unrelated to driving." We should all demand universal, free state ID cards. In the meantime, of course, we should support policies that offer alternative ID options for things like voting and healthcare -- but we should not compromise on mandatory individuation. Before my father passed away, his motor disabilities left him with limited abilities to write or type or speak, so he signed over power of attorney to me (which wouldn't have been necessary if he'd had access to universal design forms of communication, but that's another day's topic). I was horrified to discover that he needn't have bothered, because no one (with one exception) ever asked for the power of attorney paperwork. I signed documents for him, took money from his bank account, and consented to surgery on his behalf, and through all of it, no one ever asked for evidence that I was acting with his consent. I was horrified by how easy it was. No one questioned me. They assumed that as his daughter and caregiver, I had a right to control him. Most people, by default, are ableist, ageist, and sexist. Most people, by default, assume that people have a right to make decisions on behalf of their family members, especially if those family members are disabled. Most receptionists, doctors, nurses, bankers, and other professionals will, without a second thought, share information about a client to the client's family member, especially if the client is disabled. It doesn't occur to them to question it. Of course you can tell a wife's information to her husband -- he's her husband. Of course a woman can make an appointment for her disabled elderly father -- she's his daughter. Of course a mother can ask if her 23-year-old disabled son has picked up his medication -- she's his mother. If the decision is left to the individual professionals, most of them will, unquestioningly, defer to their own ableist, ageist, sexist biases. Individuation has to be enforced. Intra-family privacy has to be enforced. And identity verification requirements that don't protect against family members don't do that.

[never-not-ever]

I just got a text message in a group chat with my therapist and 8 of her other clients. Like am I just being an asshole and criticizing everything??? But isn’t that some kind of HIPAA thing?!? Like I now have the phone numbers of all your other clients… not that I know their names or any other information but like still… it just feels weird.

Like am I being a nit-picky asshole or is this just weird?

She said she was sending an email out tonight about her medical leave but this was a surprise 😅

[grits-galraisedinthesouth]

Poor Catherine 💔

So sad 😥

Correction: The unfortunate prank was NOT after giving birth, but rather during Catherine's hospitalization for hyperemesis gravidarum.

[religion-is-a-mental-illness]

By: Madeleine Rowley

Published: Jun 25, 2024

The fragile facade of transgender ideology has cracked over the past year. Whistleblowers from within the medical profession have emerged to provide damning evidence that doctors are performing procedures based on shoddy scientific evidence under the label of “gender-affirming care,” as outlined in the WPATH Files and the Cass Review. Former patients who received “gender-affirming” care as adolescents have now detransitioned and are suing the doctors who cut off their breasts and put them on hormones that permanently damaged their bodies. Businesses ranging from Target to NFL teams are scaling back or eliminating Pride-themed merchandise and promotions. The public, too, is increasingly turning against transgender ideology. The tide is shifting.

The Left has adopted a new approach in response: political persecution of those speaking out against trans dogma. Earlier this month, the Department of Justice indicted Eithan Haim, a surgeon at Texas Children’s Hospital (TCH) who exposed the hospital’s secret continued use of irreversible sex-change procedures on minors after having publicly stated that it had stopped. By indicting Haim, the DOJ is seeking to silence future whistleblowers and to signal its disregard for the mounting evidence that gender-affirming care is harmful, and often irreversible.

Haim had anonymously sent City Journal’s Christopher Rufo documents proving that doctors at TCH were still prescribing hormone replacement therapy drugs and implanting puberty blockers in minor-age patients more than a year after the hospital announced it had stopped its pediatric gender-affirming care program. A month after Rufo published his article in May 2023, federal agents from the Department of Health and Human Services knocked on Haim’s door to let him know that he was a “potential target” in an investigation of alleged violations of the Health Insurance Portability and Accountability Act (HIPAA). This week, an unsealed indictment revealed that the U.S. Attorney’s Office for the Southern District of Texas is charging Haim with four felony counts of violating HIPAA. A press release on the indictment alleges that Haim accessed patient information “under false pretenses and with intent to cause malicious harm to TCH.”

According to a letter written by Haim’s lawyers, Assistant U.S. Attorney Tina Ansari admitted that she hadn’t reviewed the purported evidence against Haim and was instead relying on what FBI agents told her. In the same discussion, Ansari insisted that the documents Haim sent to Rufo included children’s names, but nothing in the documents Rufo saw identified any individuals. All were redacted. The prosecutor then asked Haim to admit wrongdoing, telling him that he should apologize to the families of the children who received transgender medical interventions at TCH if he wanted her to help him avoid a felony prosecution. When this tactic failed, Ansari intimated that the families would sue if she didn’t bring criminal charges.

Roger Severino, vice president of domestic policy for the Heritage Foundation and a former HIPAA regulator at the Department of Health and Human Services, called Haim’s prosecution “outrageous.” As Severino notes, Haim blew the whistle in good faith in a state “where it’s illegal to do these experimental surgeries on minors.” (In September 2023, Texas attorney general Ken Paxton announced that SB 14, a new law banning gender-transition procedures for minors in Texas, had gone into effect.)

Ansari’s zeal to prosecute Haim is especially strange, given her lack of knowledge of HIPAA law, as noted in a letter from Haim’s lawyers. In the past, Ansari has prosecuted cases involving doctors who falsified patient-care documents to receive higher insurance payouts, a health-center owner who scammed Medicare out of millions based on fraudulent claims, and a pharmacist who submitted false claims to Tricare and other federal insurance programs while pocketing $22 million. Yet she moved to indict Haim in this case, despite his having no profit motive, and despite the Texas Attorney General’s Office declining to act on the case for six months.

Dan Epstein, vice president of America First Legal, a conservative public-interest law group, calls the Haim indictment an overreach of epic proportions. “The fact that Texas state attorneys decided not to bring action on this case says that there wasn’t much public concern over it,” Epstein said. “This is a policy matter, and as a prosecutor if you’re enforcing legal policy and statute, you have to exercise some level of discretion.”

Paragraph 19 of the indictment alleges that Haim’s disclosures to Rufo resulted in “financial loss” to TCH, and that Haim blew the whistle out of “malicious intent.” Haim, for his part, observes that he swore an oath to “do no harm” and believed he had a duty to disclose alleged TCH’s secret gender clinic to prevent further harm to children undergoing procedures for which there is a lack of long-term evidence of efficacy (or safety).

This week, Vanessa Sivadge, a former registered nurse at TCH, came forward as a second whistleblower, alleging not only that the hospital was running its gender clinic in secret but also that doctors were illegally billing Texas’s Medicaid program to pay for the transgender medical interventions. Sivadge had spoken with Rufo for an article last year as an anonymous whistleblower, denouncing TCH’s gender-affirming care treatments for minors. Shortly after she did that, two FBI agents knocked on her door and, according to Sivadge, told her that she was a “person of interest” in the investigation involving Haim. They threatened to “make her life difficult” if she tried to protect him.

Unfortunately, these examples of politically motivated prosecutions aren’t new and will likely continue. Case in point: the U.S. Attorney’s Office for the District of Columbia has chosen to prosecute cases like that of 75-year-old Paulette Harlow, recently sentenced to two years in prison for a demonstration at an abortion clinic. Meantime, pro-Hamas demonstrators who violated D.C. law by covering their faces with masks and keffiyehs and defaced statues near the White House run free, and anti-Israel protesters who barricaded themselves in Columbia University’s Hamilton Hall have seen criminal charges against them dropped.

Texas Children’s Hospital is a flashpoint. Haim faces up to a decade in prison and a $250,000 fine. What happens next could discourage future whistleblowers in the health-care industry.

“When it comes to health care fraud, you prosecute those that are going to have a strong deterrent effect and where prosecutorial resources justified spending taxpayer dollars on the matter,” says Epstein. “And here, I think, this is a clear case of prosecutorial overreach.”

[sophieinwonderland]

Today We're Talking About Ethics and Dual Relationships!

One more thing that bothered me was an anecdote DIDadoseofreality mentioned where they engineered a scenario that allowed their student, who they were also the therapist of, to talk about trauma in front of the whole class.

Now, in this anecdote, they're sure to make it clear that they asked their student if he was okay participating in this exercise. And the student had allegedly expressed a desire before to be able to talk about his trauma in a way that wouldn't make him feel foolish. So they present this as doing the student a favor.

And maybe that is how the student perceived it.

But... this is also a really uncomfortable power dynamic where your therapist who you share privileged information with is using that privileged information in your classroom to pressure you into sharing traumatic events with all your classmates.

And while the student allegedly gave consent for his teacher/therapist to blog about it the incident later, his therapist is his teacher.

There is a huge power dynamic in play there for pressuring a patient into waiving their HIPAA rights.

And while I sure do hope the teacher/therapist had the presence of mind to at least use a pseudonym for their student/patient and that their student/patient's name isn't actually Zac, it really doesn't matter because anyone in that class or told what happened by people in the class could stumble upon the blog post and now know that Zac's in therapy with their teacher.

Because after describing this event in the class in detail they also thank Zac for letting them tell everyone what Zac did Monday. Which, for a post made 4 days ago, places this incident multiple people know about on October 30th.

Unless some of the details were falsified beyond the name of the students, I'm going to hazard a guess and say that there was only one class anywhere where a student participated in an exercise that followed the exact sequence of events described on that blog, including Zac's specific trauma, on October 30th 2023.

...

I tried doing further research to find out if this was common or if it was even ethical. What I found first was a Quora thread with a bunch of different opinions. Well, the same opinion mostly but from different people.

I wasn't clear on dual-relationships or how they worked, so I decided to do further reading and came across this article. (Since I'm not one to just trust Quora at its word when there are better sources to be had.) Here are some excerpts.

This is not a simple "all dual relationships are bad." There is clearly nuance to this.

But if this relationship could impair their objectivity or competence in their role as a therapist, then they're supposed to avoid that relationship.

Now, one answer in that Quora thread described an example of a therapist-professor relationship working well for them with proper precautions and going to extraordinary lengths to keep those lines separate.

This is clearly not how DIDadoseofreality behaved though.

They used privileged information to influence how they treat their student in the classroom, got their student to open up about a traumatic event in front of everyone, then while having power over their client in their dual relationship as a teacher, they got their client to waive their HIPAA rights and allow their story to be posted on the internet for all to see. And potentially reveal to their classmates that the student is seeing their teacher as a therapist.

These are massive ethical violations.

I frankly would not trust them as a therapist OR a teacher.

If I were Zac, I would be shopping for a new therapist because mine could clearly not be trusted to keep their dual relationships separate.

If I were DIDadoseofreality, I would be looking for a colleague I could recommend Zac to for the same reason. I would also promptly delete my post describing the events of October 30th before a student or someone connected to me in real life identifies me and reports me for what are obviously ethics violation as both a therapist and a teacher.

[justinspoliticalcorner]

Trudy Ring at The Advocate:

Planned Parenthood must turn over some records on transgender health care to Missouri Attorney General Andrew Bailey, a judge has ruled. Bailey, a Republican, is investigating providers of gender-affirming care in the state, which has outlawed the provision of such care to minors and certain adults. His demand for information from Planned Parenthood of the St. Louis Region and Southwest Missouri came in March 2023 as part of his investigation of whether Washington University’s Pediatric Transgender Center or other health care entities in Missouri “have engaged in or are engaging in any practices declared to be unlawful,” as he stated in a letter to Planned Parenthood. The Planned Parenthood affiliate then sued Bailey in an attempt to block his demand, saying it was unauthorized and that the attorney general hadn’t shown how Planned Parenthood is directly involved in his investigation. Bailey argued that his request “should stand because he has an affidavit that alleges intentional dishonesty in Plaintiff's medical and billing practices,” St. Louis Circuit Judge Michael Stelzer wrote in his ruling. Ruling in Bailey’s favor, Stelzer said the AG’s office has “broad investigative powers” and that Bailey has the right to obtain any documents that aren’t protected by the federal Health Insurance Portability and Accountability Act, which provides for patient privacy.

Missouri AG Andrew Bailey (R) has been granted snooping powers on Planned Parenthood of St. Louis Region and Southwest Missouri's records for transgender health services.

[nonenosome2]

Watch "No 2A If You Take THIS LIST of Medications!" on YouTube

Wow.

"We can't violate HIPAA to get the information we want, so we will just force you to sign away your HIPAA rights if you want to be able to fill your prescription."

"Also, if you are taking a medication we don't like then you will lose the Right to protect yourself."

[leebrontide]

That Most Intimate of Thrones

The most recent edition of Shed Letters is available!

I fell down a rabbit hole about the ethical, legal, and existential issues (and potential!) of smart toilets and now I'm making it everyone's problem! Please I stayed up too late researching this. Please read it.

(the pic of Scribble is there because I start almost all my newsletters with pictures of my cats. Because obviously why wouldn't I?)

[opramachine]

Build your medical exam chart @ OPRAmachine Medical Hub.

Step 1: Fill out the attached "OPRAmachine Intake and consent form".

Step 2: Make you medical chart, photos and PII public @ OPRAmachine Medical Hub.

Who's first?