Administrivia

Here is the law giving you a right to your medical records: http://edocket.access.gpo.gov/cfr_2002/ ... 64.524.htm

There's a good overview of HIPAA here: http://www.hhs.gov/ocr/privacy/hipaa/un ... index.html

In particular:

What Rights Does The Privacy Rule Give Me Over My Health Information

Health Insurers and Providers who are covered entities must comply with your right to:

Ask to see and get a copy of your health records

That includes your prescription.

LinkC wrote:

M.D.Hosehead wrote: An attempt to force you to use a particular provider is illegal.

M.D.Hosehead wrote: You are entitled to a written prescription from the doctor

Could you lead me to a source for those? I've heard both before, but never been able to verify either one. I know that rarely do you get a "hard copy" of a 'script these days. Most often they are sent electronically. I'd love to see a legal requirement for that!

I'm thinking maybe it varies by state? Thanks!

LinkC, you're right to question those statements, and I may have overstated the facts.

There's no question HIPAA guarantees patients the right to copies of their medical records. Those records always document tests ordered and the treatment prescribed, whether that treatment is a drug, a procedure, or equipment. The recorded prescription for a drug, or for a CPAP, which the patient can have a copy of, may not be in the form of a separate slip of paper suitable for carrying to a pharmacy or DME. It could, for example, be a statement in the physician's notes.

That said, it's a physician's ethical duty to act in the patient's best interest. It's hard to imagine an ethically valid reason reason for a physician''s office to refuse to provide a patient a written prescription if asked.

Many times a sleep doc has a financial interest in the DME and steers you that way. As you see above, I've HEARD that's illegal, but never been able to verify that.

That is illegal. It's called the "Stark Law"

http://www.starklaw.org/stark_law.htm

Section 1877 of the Social Security Act (the Act) prohibits physicians from referring Medicare patients for certain designated health services (DHS) to an entity with which the physician or a member of the physician's immediate family has a financial relationship--unless an exception applies. Section 1877 also prohibits an entity from presenting or causing to be presented a bill or claim to anyone for a DHS furnished as a result of a prohibited referral.

The law applies to the sleep doc who ordered the PSG and to the physician affiliated with the sleep lab. The law also applies to other kinds of "providers."

I'm not alleging the OP's sleep lab violated Stark, but OTOH what benign motive would there be for applying pressure tactics to the OP to force her to patronize a particular DME? Even if there's technically no violation of Stark, If it isn't in the patient's best interest, it's unethical.

Ah! Thank you for the info on the Starke Law. Interesting read...I'd bet that one is routinely violated!! Too bad that, as Feds, they can only apply it to Medicare/aid patients!

As you implied, forcing a 'script is a bit trickier...

Good info!

Thank you so much for the reference info. I'm aware I have a right to my records, and I'm glad to have the specific cites. Good to know that CPAP.com accepts copied scripts too.

This is a very rural area, and the Sleep Clinic is a one-person operation in a small semi-converted house near the small hospital. The sole staff person presented himself by his first name only in all contacts - don't know credentials (RT?). When I asked for a copy of the study, he said I must get that from my dr. Apparently, the area pulmonologist, who serves two hospitals, usually only provides oversight, so the records go to one's primary care provider, and because mine had just left the area, that left me in the lurch. By the time of the CPAP trial in December, I had seen another dr a couple times in November, but did not want to identify him as my primary care provider, as I wasn't yet sure (have not been back or to anyone else - busy with specialists for the time being). I will be seeing the pulmonologist now on another matter and will ask him to provide the followup as well as a copy of the study. I doubt they get many such requests here, although they are busy enough that an appt takes awhile.

Although the Sleep Clinic staff person would not let me take the prescription myself (I specifically asked why not take it and decide later - not the best timing - thought it very odd) and also insisted I must identify a particular DME on the spot, he did not actually specify which DME. He did, however, tell me certain DMEs in the area did not provide the equipment specified, and when I asked if the local one did, he said yes. The DME asked in advance by phone for a copy of the Rx for billing, and I had the original from the doctor who'd by then left the area, which I copied (with no VOIDs ) and promptly sent them. Yet, at the very end of the session some weeks later with the DME RT, he barked that Dr X is your dr (the dr I saw on a tentative basis in November) and handed me the script from him with the VOIDs on it. I never identified this dr to the DME as my physician, in fact, I specifically told the person who called for the script I did not want to do that. I think that IS a HIPAA violation... and more of a mess for me. Either I have to return to him or get a new Rx from the pulmonologist, if he will see do the follow-up (directly, I mean, rather than as a consultant to a primary care provider).