Attention medical professionals: Don’t be a “HIPAA-crite!"

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Attention medical professionals: Don’t be a “HIPAA-crite!"

Encourager-In-Chief: May 3rd, 2022

Compassion counts!

I recently needed to call the Aetna insurance company to let them know about suspected fraudulent activity being perpetrated on them by the Lancaster Rehabilitation Hospital. I called on behalf of my wife, who was stuck there for four weeks. In that time, both of us experienced multiple examples of the hospital trying to bilk the insurance company for unnecessary services and equipment.

When I called Aetna, I spoke with someone about the issues. I started off by saying that my wife had recently stayed at that hospital and I wanted to go into some of the abuses we experienced. At that point, the Aetna agent went on autopilot and started saying that she couldn’t answer any questions about my wife’s medical condition because of the HIPAA laws. For those of you who may not be familiar with this, it stands for the Health Insurance, Portability, and Accountability Act. It’s supposed to protect patient’s privacy; however, I find that it is often being misused by some medical personnel as a reason not to do their jobs or listen.

I could tell that the woman was not listening and so I needed to break her pattern. I explained that I didn’t need any of my wife’s medical records because she was already at home. I wasn’t calling to discuss any of them. I was calling to discuss the fact that the Lancaster Rehabilitation Hospital kept my wife there an extra two weeks longer than she needed to be because they delayed her physical therapy activities. For example, her occupational therapist was just showing my wife her pictures of her daughter on her phone instead of helping my wife regain mobility in her fingers. When Kim arrived, she couldn’t walk at all. The hospital didn’t order the equipment she needed to get results until the third week of her stay. Within three days of receiving the equipment, she was walking. I also explained to the Aetna rep that Lancaster Rehabilitation Hospital was tacking on unnecessary services by scheduling speech therapy for my wife even though there was nothing wrong with her speech. Even the speech therapist admitted that she did not know why it had been scheduled because my wife didn’t need it.

It took a while before the bureaucrat at Aetna could understand why I was calling. Fortunately, the call was recorded so that the appropriate people could investigate the fraud allegations.