Update on Mailing the Notice of Privacy Practices to Patients in an Emergency Services

 

We have received a recent opinion from our EMS attorney regarding the practice of mailing NPP’s (Notice of Privacy Practices) as a sole procedure of providing NPP’s to patients in emergency situations. 

 

What are the requirements of providing the NPP? 

  1. The requirement of providing the NPP is a HIPAA requirement that is regulated through the Office of Civil Rights.
  2. The specific regulation governing the NPP is 45 CFR 164.520 https://www.law.cornell.edu/cfr/text/45/164.520.  This regulation requires health care providers to provide a copy of their NPP to each patient at the time of first service delivery.  However, the regulation contains an exception to this rule for emergency services, in which it permits the notice to be delivered "as soon as practicable" thereafter.  
  3. Unless the provider changes its NPI, there is no requirement to provide a new copy of the NPP for subsequent trips.
What are the benefits of mailing the patient’s copy of the NPP? 
  1. Clients are insuring that every patient they transport is being sent an NPP by US postal mail.
  2. If this record can be stored, as in the case with Comstar’s practice, then clients can pull the record of the notice being sent if requested by the patient or in the case of an audit by Office of Civil Rights.
  3. By automating the delivery of the NPP, clients will be able to verify which patients have received a copy and therefore, do not need to be sent any additional NPP’s for future transports with their service.

Due to the exception noted in 45 CFR 164.520, regarding “emergency” situations, is it advisable for clients to use a mailing as the sole delivery of NPP’s? 

The Office of Civil Rights hasn’t officially opinioned on this matter.  When asked, they fall back on the fact that an exception does exist for emergency situations.  Technically speaking, it could be argued that due to the nature of the 911 service our clients provide, this exception applies to them.  However, there could be potential risk  if a patient issues a formal complaint to the Office of Civil Rights stating they didn’t receive their NPP at the time of service. In our EMS attorney’s opinion; under this scenario the question would be whether the Office of Civil Rights would take issue with the fact that providers aren’t making a case by case determination as to whether an emergency exists, but rather are basing the existence of a medical emergency on the nature of their service. According to our EMS attorneys, best practice would be for our clients to develop a workable solution to provide the form at the time of transport when possible.  That could be done by having multiple copies in the vehicle or leaving a stack with hospitals they frequently transport to for patients who are fully aware/able to be handed the NPP. If clients proceed in this manner with a case by case determination and mailing NPP’s, they will be minimizing their risk in terms of HIPAA compliance. 

 

Please feel free to contact Kathy Martin, co-owner, with any questions or concerns regarding this information. Kathy can be reached by email at Kathy.martin@comstarbilling.com or on our dedicated client phone line: (800) 742-3001.