This does not
include psychotherapy notes.
This information does not
include psychotherapy notes.
OCR's investigation revealed that the Center provided the complainant with an opportunity to review her medical record,
including the psychotherapy notes, with her therapist.
In this case that was settled with the Office of Civil rights, the provider was a mental health center that was accused of refusing to provide a patient with a copy of her medical record,
including psychotherapy notes.
We resolve this inconsistency by clarifying in § 164.508 (b)(4) that, with certain exceptions, a covered entity may not condition the provision of treatment, payment, enrollment in a health plan, or eligibility for benefits on an authorization for the use or disclosure of any protected health information,
including psychotherapy notes.
Comment: One commenter noted that the public mental health system is increasingly being called upon to integrate and coordinate services among other providers of mental health services and they have developed an integrated electronic medical record system for state - operated hospitals, part of which
includes psychotherapy notes, and which can not be easily modified to provide different levels of confidentiality.
OCR's investigation revealed that the Center provided the complainant with an opportunity to review her medical record,
including the psychotherapy notes, with her therapist.
In this case that was settled with the Office of Civil rights, the provider was a mental health center that was accused of refusing to provide a patient with a copy of her medical record,
including psychotherapy notes.
Not exact matches
Uses and disclosures that would have been permitted without individual authorization
included uses and disclosures for national priority purposes such as public health, law enforcement, and research (see proposed § 164.510) and uses and disclosures of protected health information, other than
psychotherapy notes and research information unrelated to treatment, for purposes of treatment, payment, and health care operations (see proposed § 164.506).
Examples that were provided
included a mental health care provider with first hand knowledge of a health plan improperly requiring disclosure of
psychotherapy notes and an occupational health nurse with knowledge that her human resources manager is improperly reviewing medical records.
We anticipate these authorizations will rarely be necessary, since
psychotherapy notes do not
include information that covered entities typically need for treatment, payment, or other types of health care operations.
Response: For the reasons explained above, we retain in the final rule a requirement that a separate authorization must be obtained for most uses or disclosures of
psychotherapy notes,
including those for treatment, payment, and health care operations.
These commenters asked that we make clear that
psychotherapy notes, at least in summary form, should be
included in the medical record.
To use or disclose
psychotherapy notes for most purposes (
including for treatment, payment, or health care operations), a covered entity must obtain specific authorization by the individual that is distinct from any authorization for use and disclosure of other protected health information.
Examples of invalid compound authorizations
include: an authorization for the disclosure of protected health information for treatment, for research, and for determining payment of a claim for benefits, when the covered entity will refuse to pay the claim if the individual does not sign the authorization; or an authorization for the disclosure of
psychotherapy notes combined with an authorization to disclose any other protected health information.
A covered entity that receives
psychotherapy notes must adhere to the terms of this rule —
including obtaining an authorization for any further use or disclosure.
His presentations are recognized around the world
including key
note addresses at ISSD, EMDRIA, EMDR Europe, American Group
Psychotherapy, and the International Association of Group
Psychotherapy.
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