Isn't my rx mine to have?

[Irene P.]

I called my doctor's office yesterday to ask that they fax my rx to cpap.com and also prepare a paper one for me to have. They called this morning to say the dr. is off until next Tuesday, so they couldn't fax my rx until then. I guess I can't do anything about that, although there is another sleep dr. in the office who could sign it if they really wanted to help me. I then asked her about a paper rx written for me for a machine and mask that I could have on hand in case something else came up when I needed it. She hesitated, then said he'd probably give me one for a mask, but not for a machine. I said why not, and she replied that I only get one machine every five years. I said I know that's insurance policy, but what if I want to get an extra one. She said, well, the dr. wants to see you every year anyway, so you could talk to him then about it. My year will be up next May. I got kind of ticked off and said, "Well, it's my prescription. Don't I have a right to it?" She said no. I asked why. She said it's against the rules. I said I don't think that's the law. She said, well, it's their policy.

What are my rights?

Irene

[Autopapdude]

Your rights are to have a copy of the prescription, pursuant to HIPAA laws, and other Federal and State statues, regarding the Freedom of Information and medical treatment. I'd be insistent that you need a copy of your prescription for ALL aspects of your treatmet--including machine, mask and humidifier. Doctors often want to make it difficult, but the information is yours, and you do have a choice as with whom to deal. Sounds like the receptionist is being a "screen" for the doctor--preventing you from making any contact with him. I'd ask for the doctor, and insist that he contact you and file a WRITTEN request for a copy of your prescription.

Obstructive Sleep Apnea is a disability under the ADA, given certain circumstances, so failure for a medical person to comply with a request in WRITING can constitute a violation of Federal Law.

[Irene P.]

Thanks, Autopapdude. Your response validates what I sort of already knew, and empowers me to act on it. And I will. Irene

[leejgbt]

You need a copy of your CPAP Rx as it is necessary when any repairs are done. I think your mistake is in asking for a new Rx instead of a copy of your original Rx.

[Irene P.]

I never thought of asking for the original rx. However, it was for a specific unit and a specific mask. So it might be better is I can get a more generic one.

[mdintx]

If you continue to get resistance, contact the HHS Office of Civil Rights:

http://www.hhs.gov/ocr/

As a provider, I receive routine reviews of HIPAA laws. This is the office my trainings refer to for help in these types of situations.

[cinco777]

Irene P wrote

I got kind of ticked off and said, "Well, it's my prescription. Don't I have a right to it?" She said no. I asked why. She said it's against the rules. I said I don't think that's the law. She said, well, it's their policy.

From reading this forum, you will quickly realize that you are getting "the runaround" from your Drs office (his staff is just doing what he has told them). When you talk to your Dr., he will tell you the same thing, "it is our policy not to give you the RX, or he will tell you that you really don't need it as he will take care of all your needs". The reason Why he is not providing you with a copy of the RX is that you, without a copy, are still within his control - you can't do anything, even get a new mask, without his involvement. If he allows you to go it alone, he won't be getting as many $$$s from you. Knowing this, I recommend that you write a letter to your Dr. (him, not his office or one of his staff) requesting a copy of your machine/mask/... prescription. He or his staff will likely not respond to your first letter (they may claim later that they did not receive it!). You will wait a week or two without getting a response and you will then mail a 2nd letter, referencing the first and including a copy of the first letter, and this one you will mail as certified and/or registered. You may want to consider sending it via FedX as their tracking/receipt system is better documented than USPS. The 2nd letter did get results for me and I did receive a copy of my RX (but not from the sleep Dr. who had told me No but from another Dr. in the same department). It doesn't matter who signs, just as long as it is a Dr. and contains the correct RX information.

If your 2nd letter and follow-ups do not get you the requested RX, your next step is to go to Member Services (if one exists) and, if not, contacting your State Health agency/commissioner's office via phone and also mail (with copies of all your letters to the Dr.).

It is a sorry state of affairs that you/we/others need to follow this process to get your RX. Please post your experiences so others will know what worked and what didn't.

[LinkC]

Obstructive Sleep Apnea is a disability under the ADA...

Not always. Diagnosis alone is not the determining factor. There must also be evidence that it significantly impairs a major life activity in order to qualify for protection under the ADA. Further, ADA has nothing to do with any right to a copy of prescriptions.

Neither does HIPPA. That "right" is subject to laws of the various states, not Federal, and they vary widely.

[Autopapdude]

Not always. Diagnosis alone is not the determining factor. There must also be evidence that it significantly impairs a major life activity in order to qualify for protection under the ADA. Further, ADA has nothing to do with any right to a copy of prescriptions.

Neither does HIPPA. That "right" is subject to laws of the various states, not Federal, and they vary widely.

Wrong on both. I have a best friend who is a compliance officer for the ADA. It DOES give you rights to "informed medical treatment," including prescriptions. The 'Disability" portion is subject to one's ability to work at their "highest and best" function, or total inability to work. Thus, OSA can be a disabling condition.

State laws can impact HIPAA, but they cannot "modify" it. State jurisdiction extends to the "informed consent" aspects of HIPAA, and it is NOT to circumvent or modify Federal mandates.

[LinkC]

Wrong on both. I have a best friend who is a compliance officer for the ADA. It DOES give you rights to "informed medical treatment," including prescriptions.

If that's true, you should have no trouble quoting the portion of ADA giving one the right to a copy of his prescription. (Good luck! Neither the phrase "informed medical treatment" nor "prescription" appears anywhere in the document.)

Not always. Diagnosis alone is not the determining factor.

Thus, OSA can be a disabling condition.

What part of "Not always" is confusing you? Sure, it CAN be. But OSA isn't automatically covered by ADA. It's on a case-to-case basis. (You say I was "wrong" and then agree with me!!! Got a best friend who's an English teacher?)

[GumbyCT]

I called my doctor's office yesterday to ask that they fax my rx to cpap.com and also prepare a paper one for me to have. They called this morning to say the dr. is off until next Tuesday, so they couldn't fax my rx until then. I guess I can't do anything about that, although there is another sleep dr. in the office who could sign it if they really wanted to help me. I then asked her about a paper rx written for me for a machine and mask that I could have on hand in case something else came up when I needed it. She hesitated, then said he'd probably give me one for a mask, but not for a machine. I said why not, and she replied that I only get one machine every five years. I said I know that's insurance policy, but what if I want to get an extra one. She said, well, the dr. wants to see you every year anyway, so you could talk to him then about it. My year will be up next May. I got kind of ticked off and said, "Well, it's my prescription. Don't I have a right to it?" She said no. I asked why. She said it's against the rules. I said I don't think that's the law. She said, well, it's their policy.

What are my rights?

Irene

Certainly YOU do have a right to anything in your records also. It is a stall to say the doc wasn't in - he has already written the script and it IS part of your records. You can also get it from the DME.

As mentioned this tactic is used so you don't spend your money any place but with them and who they choose for you. It is ALL about control.

Remember when a doc gave you a prescription (in your hand) to take to the pharmacy of your choice?
This should be handled the same way. Except many have seen this as a money mill control feature.

"Well, it's my prescription. Don't I have a right to it?" She said no. I asked why. She said it's against the rules.

Many providers want you to believe that HIPPA is to protect you from You - Not so.

1st you need to contact the licensing authority in your state, talk to them to find out what they suggest you do and follow their advise. Generally that is part of the Health Dept. in your state. They have to be licensed in your state, not town or city. Some states have an online search feature so you can stay clear from those with problems.

They will likely tell you to hand deliver a written request and let the staff know what you found out. That should get you everything you want.

If you don't know how to contact the licensing authority - contact the Attorney General for your state and follow their advise. Too many times people let this pass and then this happens again to the next person. Filing a complaint will document this problem and if it continues will be resolved correctly.

What does the HIPAA Privacy Rule do?
For patients – it means being able to make informed choices when seeking care and reimbursement for care based on how personal health information may be used.

*It enables patients to find out how their information may be used, and about certain disclosures of their information that have been made.

*It generally limits release of information to the minimum reasonably needed for the purpose of the disclosure.

*It generally gives patients the right to examine and obtain a copy of their own health records and request corrections.

*It empowers individuals to control certain uses and disclosures of their health information.
More here - http://www.hhs.gov/ocr/privacy/hipaa/faq/about/187.html

If patients request copies of their medical records as permitted by the Privacy Rule, are they required to pay for the copies?
http://www.hhs.gov/ocr/privacy/hipaa/fa ... e/353.html

How To File a Complaint
http://www.hhs.gov/ocr/privacy/hipaa/co ... index.html

HIPAA - Frequently Asked Questions
http://www.hhs.gov/ocr/privacy/hipaa/faq/index.html

Good Luck and do keep us posted as to how you make out.

[Autopapdude]

Autopapdude wrote:
Wrong on both. I have a best friend who is a compliance officer for the ADA. It DOES give you rights to "informed medical treatment," including prescriptions.


If that's true, you should have no trouble quoting the portion of ADA giving one the right to a copy of his prescription. (Good luck! Neither the phrase "informed medical treatment" nor "prescription" appears anywhere in the document.)

LinkC wrote:
Not always. Diagnosis alone is not the determining factor.

Autopapdude wrote:
Thus, OSA can be a disabling condition.


What part of "Not always" is confusing you? Sure, it CAN be. But OSA isn't automatically covered by ADA. It's on a case-to-case basis. (You say I was "wrong" and then agree with me!!! Got a best friend who's an English teacher?)

_________________

EDITED BY AUTHOR
Most important, I was giving a newbie advice on obtaining her prescription. It is her right to do so. I didn't write my comments to you, so I shall continue to stand by my advice to her that she may, under Federal and State laws, obtain her prescription. No need to debate you, Link. You have your wise cracks, and I have my intentions to try and help a newbie. So, I shall stay on topic here.

[LinkC]

Yes, and giving a "newbie" bogus info really isn't helping. She clearly asked "What are my rights?" Referring her to HIPAA without the specifics does not help. Calling out ADA is also of no value UNLESS she can establish her OSA as a "disability". Even then, it doesn't address her right to have her prescription...which is what she was asking about.

The helpful (and correct) answer is "It depends on Tennessee law." I've been trying to research that the last couple of hours to give her a substantive answer. I've had no luck. It MAY be that TN law does not require the release of a prescription to the patient, and her Dr's office was correct.

Since you quoted unequivocally that HIPAA and Freedom of Information Act provide for that, I was hoping you could give us all more specifics.
Apparently not.

Fortunately, Gumby was able to provide some more detail.

[GumbyCT]

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule

The HIPAA Privacy Rule for the first time creates national standards to protect individuals’ medical records and other personal health information.

This is Federal Law and cannot be weakened by ANY state laws even in TN.

[RN Ricky]

Yes you do have a right to your script. You and your insurance co. PAID for it! If you go to Sears you get to keep the shoes you paid for. The other advice from the forum is good.
Hey you 2 guys lay off each other and be friends -- nothing is worth this tussal.