HIPAA The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects health care consumers’ privacy and stipulates certain rules be adhered to on the part of health care providers (HHS, 2016b). Massage therapists may need to follow HIPAA guidelines. The U.S. Department of Health and Human Services’ definition of a health care provider is “any person or organization that furnishes, bills, or is paid for health care in the normal course of business,” and any health care provider who transmits client records electronically in relation to any health care claim does need to be HIPAA compliant (HHS, 2016b). The following checklist may determine whether the massage therapist or bodywork professional must be compliant with the HIPAA Privacy Rules if they answer, “yes” to the following questions: ● Do you work for someone who files insurance claims, or do you file insurance claims? ● Do you complete an intake form for clients? ● Do you write session notes on clients? ● Do you work in a massage establishment with more than ten employees? ● Do you file claims with any clearinghouses, such as Availity or Office Ally? ● Do you have general liability insurance or malpractice insurance? ● Do you want to be covered if your session notes are subpoenaed for legal reasons? ● Do you want protection if your client decides to sue you for any reason? (Neeley, 2016) The client records maintained in the practice are the clients and the practitioner is merely the keeper of the information according to HIPAA regulations (Neeley, 2016).
The U.S. Department of Health and Human Services has created different kinds of standards for submitting insurance information electronically. These are: 1. Electronic claims submission. 2. Enrollment checking. 3. Eligibility verification. 4. Health care explanation of benefits. 5. Health plan premium payment. 6. Health claims status. 7. Referral certification and authorization. 8. Coordination of benefits. If the practice conducts any of these eight actions electronically, they qualify as a “covered entity” under HIPAA. Covered information includes anything that can uniquely identify a client, such as his or her Social Security number, phone number or even an IP address that identifies the client online (Neeley, 2016). In 2014, a new law was added, stipulating that if a health care provider or his company is required to be HIPAA compliant, then anyone he releases information to must also be HIPAA compliant. This includes any subcontractors who work for the employer or agency. For further clarification, contact the employing agency, review state board requirements and the official HIPAA website and documents. There is contact information on the HIPAA website to ask questions directly. State boards have requirements to protect client privacy, confidentiality, documentation and record retention. Codes of Ethics address these issues as well. Even if the practice is not a covered entity under HIPAA, it is important to keep client information private and confidential. Records should be secured in a locked cabinet and electronic files should follow encryption and password security protocols and accessed only by appropriate staff.
HEALTH AND SAFETY
● Never allow the client or anyone, even the client’s doctor, to dictate the therapeutic plan of treatment. Therapists are solely responsible for any injury sustained by the client during or after therapy, and any resulting medical and/or legal liability. The therapist is responsible for the health, safety, and welfare of the patient, even if a physician prescribed the massage or bodywork treatment. ● Therapists must be aware of health concerns outside of their scope of practice and must suggest the client visit a healthcare professional if necessary. It is important to document this information with specific details regarding the health concern(s). ● Never give medical advice or make statements that could be taken as a diagnosis as this could be construed as practicing medicine without a license, which can be subject to legal action. ● Never discuss a client’s medical or health status with anyone without written, explicit consent from the client, including the client’s doctor, even if serious injury or illness is suspected. ● Assure that all ice and snow is cleared prior to your first appointment. ● Review and approve your building’s maintenance and cleaning plan. ● Keep stairways and hallways free of clutter. ● Check the stability of railings along stairways and hallways. ● Keep throw rugs to a minimum, and make sure they do not pose a safety risk ● Assure that your massage table is in good repair.
The following general guidelines should be followed to ensure the health and safety of clients and practitioners while upholding ethical standards: ● Review Occupational Safety and Health Administration (OSHA) and industry standards of health, safety and hygiene (Occupational Safety and Health Administration, 2016). ● Draping, towels, the massage table surface, and all items or materials must be cleaned according to accepted standards of sanitation, and must meet all legal health and safety requirements, including universal precautions relating to communicable diseases. ● Carefully assess a client’s condition before beginning professionally approved and appropriate therapy. ● Never apply techniques that are outside of accepted practice in the field. ● Continually assess verbal and non-verbal client feedback during the massage to ensure the technique is appropriate, effective, and tolerated by the client Safety, security and risk management In order to provide the critical and ethical element of safety to ensure client welfare, the practitioner must address safety and security precautions in all phases of the practice. According to the AMTA, the best safety measure is prevention (AMTA, 2016e). Awareness of the potential hazards is fundamental to creating a plan to address safety risks. One of the first steps should be to assess what areas of your business could provide potential safety hazards. The AMTA provides the following guidelines: Physical safety features ● Check the sidewalk and entrance to your office for obstacles and toe catches.
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Book Code: MLA1224
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