Table of Contents
Isingeniso: Indima Ebucayi Yabashisekeli Ekuvikeleni Imfihlo Yezokwelapha
Kuwo wonke amarekhodi ezokwelapha, amarekhodi omthetho ngokuvamile akha obunye bobufakazi obunamandla kakhulu kodwa obukhona. I-paltiff efuna ukulimala komuntu siqu ingathembela kulamibhalo ukuze ibonise umonakalo, kuyilapho ummangalelwa osebenza ngecala elibi angase adinge ukuba afake ukwaziswa kokuzivikela. Nokho, lamaphepha afanayo anemininingwane ejulile eyimfihlo ((diagnoses), imikhakha yokwelapha, imikhakha yemithi, kanye nemininingwane yengqondo yezempilo yezempilo ekhona elindele ukuhlala iyimfihlo. Imvume yalezizithakazelo eziphikisanayo ibangele ukufinyelela komthetho onegunya eliqinile, isebenza njengomgcini wesango eliyinhloko. Ukuqonda uma kudingeka imvume, indlela yokuthola ukwelashwa, nemingcele yokufinyelela kwenkantolo esemthethweni ibalulekile kunoma iziphi izinqubo zomthetho ezihlanganisa ulwazi olungokwempilo (PI). Le ngxenye yokuhlola inikeza izimfuneko ezingokomthetho, futhi inqubo ezingokomthetho ezisemthethweni zomthetho.
Izisekelo Ezingokomthetho: IHIPAA Nomthetho Wangasese
I-Heal Inshorensispital Portability and Accounting Act (HIPAA) imisa isisekelo sokuvikela i-PHI. Engxenyeni yayo, i-HIPAAmfisfusion Application ivimbela izidalwa eziwumthetho eziwumthetho. Njengezimo ezithiwa odokotela, izibhedlela, amapharma, namapulani ezempilo, nezinhlelo zempilo ("i-Plosing PH [[FLT:]]] P [[FLT]]] [imvume egunyazweni [[FLT]]. Imvume, ekhishwe uma kuhlulelwa noma i-jajini.[3], ayisona nje isivikelo esisemthethweni kodwa isivikelo esiqinile sezekwesine.[FLT] futhi ihlola iNkakhulu leNkakhulu.[3] INkadebelo olubanzi liqaphele i-U-U.[3]
Ngokuqondile, 45 C.F.R. . . . . . 164.12 (e) ilawula ukusetshenziswa nokuvezwa okufunwa umthetho. Isho ukuthi into egqunyiwe ingase yembule i-PHI ngokusabela emyalelweni noma imvumeni, uma nje iveza ukwaziswa okugunyaziwe kuphela ngokusemthethweni ngomyalo. Imvume ivumela ukuvezwa kwe-pursudutu empompisweni, isicelo, noma enye inqubo engokomthetho, kodwa uma iqembu elifuna ukwaziswa kunikeza isiqinisekiso esanelisayo sokuthi imizamo enengqondo yenzelwe ukwazisa umuntu ngamunye noma ukuthola uhlelo oluvikelayo. Imvume inikeza lezi zimfuneko ngoba ikhupholwe isikhulu sokwahlulela esingathathiwe ngokomthetho noma ukubonisa ukufaneleka nokungabazeki. Lokhu kunikeza isivikelo esiqinile sesiqondiso sesineke.
Kunini Lapho Kudingeka Khona Umqhawe?
Imvume ayidingekile ngaso sonke isikhathi ukuze sithole amarekhodi ezokwelapha ngokuqatshelwa kwemithetho. Izici ezinqumayo zihlanganisa uhlobo lwamarekhodi, imvume yesiguli, ukuba khona kwezinqubo zomthetho ezihlukile, kanye nomthetho kahulumeni osebenzayo. Ngezansi sihlola izimo eziphoqelela isiqinisekiso.
Amarekhodi Aqashelwa Kakhulu
Ezinye izigaba zokwaziswa kwezokwelapha zithola isivikelo esikhudlwana ngaphansi komthetho wezwe nombuso. Amarekhodi empilo yengqondo, amarekhodi ezokusetshenziswa kabi kwezidakamizwa (aphawulwa ngu-42 C.F.R. ingxenye 2), ukuhlolwa kwe-HIV/AIDS, futhi ukwaziswa kwezakhi zofuzo kudinga imvume noma uhlelo olukhethekile lwenkantolo ngisho nalapho eminye imibhalo ingatholakala ngokubhekisa phambili kwe-subpoena. Imvume iqinisekisa ukuthi umahluleli ulinganise isithakazelo somuntu siqu nesidingo se-litigant se-o. Ngokwesibonelo, lapho i-preantff ifuna khona ukudalelwa okungokomzwelo, isivikelo singafuna ukufinyelelwa ngemivweliti yeze. Ngaphandle kwemvume, imibhalo enjalo isuke ingaphandle kwelungelo elicacile lesiguli.
Ukuvunywa Ngokuzithandela
Uma isiguli (noma ummeleli waso ongokomthetho) sinikeza imvume ebhaliwe ngaphansi kwe-HIPAA, imvume ayidingeki. Imvume kumele ichazwe ngokuqondile, ichaze amarekhodi afuna ukuvezwa, injongo yokuthunyelelwa, nowayamukelayo. Nokho, kuyi-advertarigarigigiption, iziguli ngokuvamile ziyenqaba ukugunyaza ukufinyelela kumarekhodi azo siqu, ikakhulukazi uma ukwaziswa kungalimaza icala lazo. Uma imvume i-partment imele iphendukela enqubweni engokomthetho engokomthetho. Imvume iba umzila ovamile uma amarekhodi engenakutholakala nge-spoena noma ngesaziso, ikakhulukazi uma izinto eziphikisayo zingalitholangasese.
Amarekhodi Aqopha Umlando Obuhlungu Futhi Angakholeki Ngezindlela Ezithile
Ngisho nasemaqenjini angaphansi, amanye ama-athomo awenqaba ukuveza amarekhodi angekho umthetho wenkantolo noma imvume ngenxa yokwesaba ukuphula i-HIPAA. Lokhu kuvame kakhulu kumapharma kanye nezimiso zesibhedlela ezinemithetho elandelwa ngokulandelana. Ama-Athorney kufanele alindele ukuthi kungadingeka imvume yokunqoba lemingcele yokuhlela. Ngaphezu kwalokho, uma amarekhodi edingeka ukuze kusungulwe isici esiyinhloko sezwi noma ukuzivikela (*) njengokuqinisekisa umlando wento elawulwayo ekhwameni lokuphamba noma ukunganakiwa (‘alugunyaza imvume yokugunyaza ukukhiqizwa ngaphandle kokwephula amalungelo ezindaba zomuntu siqu.
Izinhlelo Zokuthola Umqalisi: Isiqondiso Esilandelanayo
Inqubo yokuthola imvume yokubhala amarekhodi ezokwelapha ihilela izigaba eziningana ezihlukene, ngasinye sinezinqumo zaso ezingokomthetho nezikahle.
Ukuthungatha Imoto Nokusekela I - affidavit
Izinkantolo eziningi zifuna ukuba iqembu elifuna imvume yokuthumela umshini ocela uhlelo lokukhiqizwa kwamarekhodi ezokwelapha. Ukunyakaza kumelwe kuhambisane ne-affidavit noma isimemezelo esiqalayo:
- Incazelo eqondile yemibhalo egciniwe eyafunwa, kuhlanganise nohlu lwezinsuku, iziqiwi, nezinhlobo zezincwadi (isib., “yonke ikhemisi elikhipha imibhalo ye-oxycodone kusukela ngo-January 2020 kuya ku-December 2023”.
- Ukubaluleka kwengxenye ngayinye yemibhalo egciniwe kulokho okushiwo noma okuvikelwe kuyikhasimende, kuhlanganisa umbhalo ngamunye nomagazini oqondile oyiqiniso.
- Inkulumo etholakala ngezindlela ezimbalwa eziwukuvuma, njengemvume, ukufakwa kwemali, noma inxenye yesithathu.
- Uma imibhalo idingeka ngokuphuthumayo (ngokwesibonelo, ukuze kuvinjelwe ukubhujiswa noma ngenxa yezikhathi zovivinyo eziseduze), isicelo sokucabangela okungathí sina.
I - affidavit kumelwe isekelwe olwazini lomuntu siqu noma ebufakazini obungagudlw ’ ikhanda.
Izindlebe Eziphawuliwe
Kuzo zonke izigaba, isicelo sokugunyaza kumelwe sinikezwe wonke amaqembu, futhi uhlangothi oluphikisayo lunethuba lokuphikisa. Nokho, kunezimo ezilinganiselwe lapho uhlelo lwenxenye lungase lufaneleke khona [1] ngokwesibonelo, uma umceli efuna ukugcinwa kwangaphambi kokukhishwa kwemibhalo. Izigaba ziyahluka ngokuthi lemiyalo ihlelwe njengemvume noma njengemithetho yenkantolo ngaphansi kwemithetho etholakele. Noma kunjalo, umahluleli uyobukeza isicelo sokulalela izimfuneko ze-station futhi angaphatha ukuzwa emagumbini.
Ukulinganiselwa Kwesisebenzi
Imvume esemthethweni kumele ibhalwe ngokulayishwa. Inkantolo cishe izogunyaza ukuthatha uhambo lokudoba. Inkantolo izovala ama-redct noma ingawafaki amarekhodi angahlangene ngokuqondile, avikelwe yilungelo leziguli ezisebenza ngengqondo, noma aqukethe ukwaziswa okungaba izingxenye zesithathu (umz., amalungu omkhaya). Imvume izochaza isikhathi sokukhiqizwa kwezinhlanzi futhi ibeke izimo endleleni amarekhodi amelwe aphethwe ngayo ngemva kokuvezwa, kuhlanganise nokubekwa uphawu ngaphansi kokuhleleka okuvikela. Ama-Attorney kufanele alungiselele ukwenza uhlelo oluhlongoniswayo ukuze kulandele umthetho osebenzayo nemithetho kahulumeni.
Imibono Ebalulekile: Abashiyi Bempi, Abangaphansi Kwezwe, Neziqondiso Zenkantolo
Ama - attorney avame ukudida la mathuluzi amathathu, kodwa asebenza imisebenzi ehlukahlukene ngaphansi kwe - HIPAA nenqubo yomphakathi.
| Legal Process | Key Features | HIPAA Compliance |
|---|---|---|
| Warrant | Issued by a judge based on probable cause or a showing of relevance; requires affidavit; ex parte or noticed. | Automatic compliance under 45 C.F.R. § 164.512(e)(1)(i); no notice to patient required. |
| Subpoena | Issued by an attorney or clerk; does not require judge approval; may be challenged. | Requires either patient consent, a protective order, or satisfactory assurances of notification (45 C.F.R. § 164.512(e)(1)(ii)). |
| Court Order | Broader category that includes warrants; may be issued pursuant to a motion to compel. | Must be reviewed to ensure it meets the “order of a court” standard; similar to warrant but often less formal. |
Izenzo zenkantolo eziningi zibheka “umyalo wamacala” kanye ne-“ayisenzi” njengesebenza ngokwezinjongo ze-HIPAA, kodwa izimvume zivame ukuhlotshaniswa nomthetho olandelwayo. Uma kubhekiswa kumthetho, igama elithi“impicabadala” livame ukusetshenziswa ngokuvumelana ne-“uhlelo lwenkantolo olugunyaza ukuthululwa.” Ama-Atttorney kufanele aqinisekise imithetho yendawo kanye nokhetho lomthetho.
Ukushintsha Komthetho KaHulumeni Nokudelwa
Nakuba i-HIPAA ihlela isakhiwo sikahulumeni, izifundazwe zingabeka isivikelo esiqinile kumarekhodi ezokwelapha. Ngokwesibonelo, i-Iscrency of Medical Information Act yase California idinga uhlelo lwenkantolo noma imvume yesiguli yokuthulula ulwazi oluningi, ngokuphumelelayo ukuphakamisa ibhange elingaphezu kwe-HIPAA. Ngokufanayo, i-Mental Hygiene Law yase-New York idinga ukuqhubekela phambili okukhethekile ngaphambi kokuba amarekhodi empilo engqondo akhululwe. Uma umthetho wezwe unikeza isivikelo esikhulu sobumfihlo, awuphoxiwe yi-HIPAA (45.C.F.R. 16020). Ngakho, abameli kumelwe bahlole umthetho we-onqandaywo lapho imitapo ekhona noma lapho imiphakathi i-openssion ikhona khona noma lapho i-plupdia i-fix i-.
Kwezinye izinkantolo zikahulumeni, “igama eliqanjiwe” liyigama elikhethekile elibekelwe ukuqulwa kobugebengu, futhi ama-partigation kumelwe asebenzise“ uhlelo lwasenkantolo lokukhiqizwa” noma “umzwelo wokuphoqelela.” Iphuzu elibucayi liwukuthi lenqubo kumelwe ihlanganise ukubukezwa kokwahlulela. I-toppoena eyasayinwa unobhala ngeke yanele uma imelene nokungavunyelwa komthetho wezindaba zomuntu siqu. Abaqondisi-mthetho kufanele baqaphele izimpikiswano zezwe: uma umnakekeli wezempilo esezweni elihlukile, iqembu elicelayo lingadinga ukuhlanganisa imvume noma ukuhlelwa kwenqubo yeyunifomu noma izinqubo zobuphili.
Amasu Awusizo Ezilwane Ezinomsila
Ukuthola amarekhodi ezokwelapha nakadokotela ngempumelelo ngemvume kudinga ukuhlela ngokucophelela nokubulala.
Qala Ngokuhlaziya Umlando Obhalwe Ngokucophelela
Phambi kokuthatha imvume, sebenzisa izindlela ezithatha kancane ukuveza abazansi abafanele. Izinhlelo zokuhlola imilaliso zikhona emazweni amaningi futhi zingaveza ukuthi yiziphi izimemezelo ezilawulwayo eziye zanikezwa iqembu. Nakuba i-PDMP ngokwayo ingabhala ukuthi inemingcele yayo, inganciphisa izinga lokusebenza okusemthethweni, yenza ukuba kunikezwe ithuba lokunikezwa.
Bambisa Iseluleko Esijabulisayo
Ngokuvamile, ummeli wesiguli uyovuma kumthetho omisiwe ovikelayo ovumela lowo ocelayo ukuba abone amarekhodi kuyilapho evimbela ukusetshenziswa kwawo emalini. Umyalo omisiwe ungagwema inqubo yokugunyaza i-adversari futhi usheshe. Nokho, uma uhlangothi olumeleneyo lwenqaba, indlela egunyaza idinga.
Ukuhlela Indlela Ehlelwe Kancane
Qopha ekuhleleni kwakho uhlelo oluhlongozwayo olusho amarekhodi, isakhelo sesikhathi, amagama abagcini-zincwadi, nanoma yiziphi izimo (umzk., ukugcina imfihlo, ukubuya kwezincwadi ngemva kokuqulwa). Izinkantolo ziyakwazisa lokhu ngoba lubonisa ukuthi ucabangela ukukhathazeka komuntu siqu. Gwema ulimi olubanzi njengo- “yonke imibhalo yezokwelapha.” Kunalokho, yisho ngokunembile: “Yonke imibhalo yokwelapha noDkt. John Smith kusukela ngoJanuary 1, 2022, kuze kube manje ehlobene nokuxilonga nokuphathwa kwekhanda elinke ikhanda.”
Zilungiselele Ukubukeza Ngekhamera
Abanye abahluleli bayohlola amarekhodi asekhamerani (ezindaweni zokunyathelisa) ngaphambi kokuba banqume ukuthi bawadedele yini. Lokhu kuvamile emanothini ezempilo yengqondo.
Imiphumela Yokungaphikisani
Ukwehluleka ukunamathela ekufuneni izimfuneko kungaholela ekuvuselelweni okukhulu. Uma umkhakha othola amarekhodi ezokwelapha ngaphandle kwemvume efanelekile noma imvume, amarekhodi angase ancishiswe noma akhishwe ebufakazini. Okubi nakakhulu, umenzi wobubi angase abhekane nesijeziso, kuhlanganise nezijeziso zemali, izindleko zommeli, futhi ngisho nokukhishwa kwezindawo zokuvikela. Inhlangano embozweyo eda amarekhodi ngaphandle kwemvume engokomthetho ingaba ne-HIPAA yesijeziso somphakathi sezekwephulwa u-$50 000, kanye nesijeziso sobugebengu ezimweni zokusetshenziswa kabi kolwazi. Isimiso sezempilo esiphawulekayo sakhokha izindleko zediski noma i-PI eziyizigidi ezingu-R1 ngokungafanele ekusabelweni kwe-PI ekuhlanganeni okungahlangani kwezimfuneko ezingaphansi kwe-HIPA (bona [[FL:]] i-St.Foctive Active.[1]) futhi kuqinisekisa ukuthi inqubo yomthetho yokwamumo womabili.
Imithetho Yamuva Nemikhuba Yokuqulwa Kwecala
Izinqumo zamuva ezimbalwa zigcizelela ukugcizelela kwezinkantolo ukunamathela ngokuqinile ezindinganisweni zomthetho ezisemthethweni. Doe v. Ortho-Clinical Diagnotics, Inc. [2022], inkantolo yesifunda eMassachusetts yalahla umzamo ka-Prectaff wokuthola amarekhodi agunyaziwe ngesicelo somthetho 34 ngaphandle kwemvume yenkantolo, ikhipha ukuthi amarekhodi avikelwe yi-HIPAA futhi adinga imvume noma isilinganiso sawo. Inkantolo yagcizelela ukuthi umthwalo uwela eqenjini elicela ukubonisa isidingo esiphoqelelayo esidlula isithakazelo sendaba.
Ngokufanayo, Smith v. Johnson & Johnson (2023) wahlanganisa isenzo sokufaka icala lapho abahlahli be-pallatiff befuna amarekhodi ekhemisi ukuze babonise indlela yokubhalisa. Inkantolo yayala ukuba kubukezwe ikhamera futhi ekugcineni yakhipha ukwaziswa okungaqondakali, okungatholakali, ukwenqaba ukunikeza isiguli ngasinye isikhombi ngaphandle kwemvume. Lokhu kubonisa ukuzwela okukhulayo kwezomthetho wezindaba zokwelapha emongweni womphakathi, ikakhulukazi lapho amarekhodi engxenye yesithathu iboshelwa khona.
Ama-Attorney kufanele futhi aqaphele ukuthi incazelo ye- “yantswana” emarekhodini empilo kagesi ishintsha. Ngokunyuka kwemininingwane yokwaziswa kwezempilo (HIES) kanye ne-EHRs esekelwe emafwini, indawo engokoqobo yamarekhodi ingaba engacacile. Ezinye izinkantolo ziye zathi imvume ekhishwa kwenye i-odoli emotweni ingashukumisela ukukhiqizwa komnikezi kwenye uma umnikezi ekhona kuhulumeni ovela. Nokho, umkhuba ongcono ukufuna isiqinisekiso esifundayo kuhulumeni lapho amarekhodi ekhona noma ukuthola uhlelo lwenkantolo oluhambisana nomthetho womabili amazwe.
Amalungelo Eziguli Nendlela Yokubekela Inselele Ukusetshenziswa Okunganqamuki
Iziguli ezesaba ukuthi amarekhodi azo ezokwelapha azodalulwa ezindaweni ezichaziwe. Zingathatha indlela yokuhamba ukuze zithathe i-quash noma ukuze zivikelwe, ziphikisa ngokuthi uhlelo lokugunyaza ludlule kakhulu, azinalo ilungelo elanele, noma ziphule ilungelo elithile (umz., ilungelo lokusebenza kwengqondo lizokwenzelwa Jaffee v. Redmond[, 518 U.S. 1996). Ummeli wesiguli kufanele aqinisekise futhi ukuthi imvume, uma ivunyelwe, ihlanganisa ukuvalwa kwecala nokusetshenziswa kwemibhalo ebhalelweyo. Uma ingxenye ekhishwe i-oxpt, i-octive i-octive i-octive procep i-active i-octive i-active i-octive proception i-octive i-octive i-octive i-octive.
Ngaphezu kwalokho, iziguli zingacela ukuba ukwaziswa okusheshayo kwenkantolo okudinga ukuvuleka okunjengezinombolo ze-Social Security, umlando womkhaya, noma izimo zempilo ezingahlobene. Ezinye izinkantolo zimisa uchwepheshe okhethekile noma ongathathi hlangothi ukuze zibukeze amarekhodi ngaphambi kokuba zithululwe. Iziguli futhi kufanele ziqaphele ukuthi zingavuma ukuvubukulwa okulinganiselwe (ngokwesibonelo, zivumele ukuzivikela ukuba zibone kuphela amarekhodi ekhemisi kuyilapho zigobe amanothi engqondo.)
Isiphetho: Ukulinganisela Ukuthola Izinto Nesikhathi Sokuba Wedwa
Izimfuneko eziqinile zokuthola amarekhodi ezokwelapha nomthetho ogunyaziwe akuzona nje izithiyo ezingokomthetho ezingokwesiko; ziyizivikelo eziyisisekelo zemfihlo yesineke ezweni lemininingwane elokhu yanda. Ukusuka ku-HIPAA izimfuneko eziyisisekelo zokuthola isilinganiso sombuso kanye nokuthola impikiswano yomthetho, ukuma kwezwe kufuna ukuba abameli baqhubeke ngokuqapha nangokulunga. Ukuthi ungummeli ofuna ukufakazela incithaneko noma ummangalelwa ophendula izikhalo, ukuqonda uma imvume idingeka noma idingeka, futhi ungazi ukuthi ungawuthola kanjani umphumela wecala lakho. Ngokuhlonipha inqubo yokwahlulela namalungelo abantu, isimiso somthetho sigcina ukuthenjelwa okubalulekile ekuhlolweni okulungile noma okusebenzayo.
Ukuze ufunde ngokwengeziwe, hlola [ HHS HIPAA Amfihlo Umthetho, Cornell Information yolwazi lwezomthetho ekhasini erekhodini yezokwelapha[, kanye nesihloko ABABA shortal Law Treage short [].