Pursuant to a Subpoena by a HIPAA Compliant Authorization: New York's Civil Practice Law and Rules (CPLR) at §3122(a) has created requirements for the subpoena of medical records that are more stringent than HIPAA's rules. Thus, a health care provider must continue to provide the required medical information in order to be paid. This exemption can be found in the Privacy Rule at 45 CFR §164.502(a)(1)(ii) and §164.501 definition of "payment." WCL §13-f requires that medical records be provided to the Board and the carrier or employer before they will be required to pay for any medical services.
For the health care provider's own payment operations. As with Item 1 above, the WCL requires the filing of medical reports Thus, filing a C-4 with accompanying narrative is a "lawful process" in compliance with Workers' Compensation Law and health care providers may continue to file this information with the Board and the carrier or employer in compliance with the WCL. This Notice informs claimants that their health care providers are required to regularly file medical reports. The Claim for Compensation ( C-3) and the Notice of Indexing ( EC-64) have been modified to include a HIPAA Notice on the reverse side. Furthermore, WCL §13-(g) requires hospitals to provide all related medical records within twenty days of receiving a request. WCL §13-a(4)(a) and 12 NYCRR §325-1.3 require health care providers to regularly file medical reports of treatment with the Board and the carrier or employer. This exemption can be found in the Privacy Rule at 45 CFR §164.512 (e) and (l). In compliance with Workers' Compensation Law with reasonable assurances from the requesting party that the claimant has been notified. Thus, if a WCLJ directs the taking of medical testimony or depositions, health care providers are not restricted by HIPAA and under New York State Law must comply with the WCLJ's direction.įailure to comply with an order of a WCLJ is a violation of New York State Law and has severe penalties. This exemption can be found in the Privacy Rule at 45 CFR §164.512. Pursuant to an order of a Workers' Compensation Law Judge (WCLJ). No Authorization Required: The Privacy Rule permits health care providers to submit health information, without an authorization, to the Board and the carrier or employer in three situations:. The following are some guidelines regarding health care providers' continuing obligation to provide medical records to the Board: For a binding interpretation of the law, you must contact the regulating federal agency, the Office of Civil Rights. Therefore, the New York State Workers' Compensation Board has no authority over the method and manner in which the new legislation and regulations will be implemented. However, HIPAA and the Privacy Rule are federal legislation. Important: This guideline reflects the Board's understanding of HIPAA and its application to New York's workers' compensation process. 
Therefore, health care providers may continue to provide the Board and carriers with reports of treatment ( C-4s) and health care providers may continue to testify at hearings and depositions. If you are a “covered entity,” such as a health care provider, the Privacy Rule specifically exempts health information that is required as part of a lawful process, including a workers' compensation proceeding, from HIPAA restrictions concerning use and disclosure of protected health information.
Under HIPAA’s Privacy Rule, the Workers' Compensation Board, workers' compensation carriers and employers are not covered entities and therefore may continue to use medical information concerning claimants in their customary manner.
The Privacy Rule changes the way that “protected health information” may be used and disclosed by covered entities. On Apthe Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 went into effect.
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