HIPAA Question

[UTLonghorn_1979]

I made a congressional inquiry about my medical status, and the FAA replied to my Congress person basically outlining my diagnoses and why it was taking so long.

Is the FAA allowed to spell out my personal diagnoses to 3rd parties without my consent?

You’d think they would just say “ this person’s case is complex and will take some time,” not list each diagnosis, almost looking intentionally like they want to make it look as bad as possible and that’s why it’s taking so long.

Is the FAA immune to HIPAA rules?

 

[mandm]

Have you signed away your rights anywhere to allow data sharing? I mean yes, that’s crappy, I’m sorry to hear that.

 

[mcmanigle]

Yes, the FAA is immune to HIPAA rules. HIPAA applies specifically to entities that bill medical insurance companies, which includes practically all health providers, but does not include the FAA.

There was a time not so long ago when HIPAA didn't apply to the VA or the NIH hospital or similar either, because they did not bill health insurance companies. However, they were covered by the Privacy Act of 1974. It's a different set of rules that applies to federal agencies, but I'm not sure specifically what the rules are or how it applies here. I wouldn't be surprised if there was a specific carve-out for a congressional inquiry or something.

 

[UTLonghorn_1979]

Have you signed away your rights anywhere to allow data sharing? I mean yes, that’s crappy, I’m sorry to hear that.

Not that I’m aware of. When you make a congressional inquiry, you just fill out an email inquiry thing asking for help with a govermen agency. I didn’t sign any release.

 

[UTLonghorn_1979]

Yes, the FAA is immune to HIPAA rules. HIPAA applies specifically to entities that bill medical insurance companies, which includes practically all health providers, but does not include the FAA.

There was a time not so long ago when HIPAA didn't apply to the VA or the NIH hospital or similar either, because they did not bill health insurance companies. However, they were covered by the Privacy Act of 1974. It's a different set of rules that applies to federal agencies, but I'm not sure specifically what the rules are or how it applies here. I wouldn't be surprised if there was a specific carve-out for a congressional inquiry or something.

I’m making some other inquiries…thank you!

 

[mandm]

Yes, the FAA is immune to HIPAA rules. HIPAA applies specifically to entities that bill medical insurance companies, which includes practically all health providers, but does not include the FAA.

There was a time not so long ago when HIPAA didn't apply to the VA or the NIH hospital or similar either, because they did not bill health insurance companies. However, they were covered by the Privacy Act of 1974. It's a different set of rules that applies to federal agencies, but I'm not sure specifically what the rules are or how it applies here. I wouldn't be surprised if there was a specific carve-out for a congressional inquiry or something.

If you are a service provider that only accepts cash, then would HIPAA not apply? I didn’t know that was the rule (billing insurance).

Ask your congressman why the FAA shared your personal medical history and if that’s normal?

 

[172andyou]

I made a congressional inquiry about my medical status, and the FAA replied to my Congress person basically outlining my diagnoses and why it was taking so long.

Is the FAA allowed to spell out my personal diagnoses to 3rd parties without my consent?

You’d think they would just say “ this person’s case is complex and will take some time,” not list each diagnosis, almost looking intentionally like they want to make it look as bad as possible and that’s why it’s taking so long.

Is the FAA immune to HIPAA rules?

Is the faa a covered entity?

 

[UTLonghorn_1979]

Is the faa a covered entity?

Looks like no, but they are still subject to the Privacy Act of 1974. Just annoying that they would feel the need to spell all that out, make it look like “this guy is a mess and it will take time” vs. the facts that I’ve done everything asked of me, all specialists have recommended SI, as has my HIMS AME.

I REALLY wish they would just push these back to the AME…sigh.

 

[mcmanigle]

If you are a service provider that only accepts cash, then would HIPAA not apply? I didn’t know that was the rule (billing insurance).

Ask your congressman why the FAA shared your personal medical history and if that’s normal?

Correct, if you were a cash-only provider who never touched insurance billing, HIPAA would not apply. There are a slew of other privacy regulations that would, but not HIPAA.

I suspect some of this was intentional -- they weren't necessarily looking to make every independent massage therapist start using a secure method to book their appointments.

 

[Lindberg]

What were you hoping to happen here? Your Congressman isn't going to take on the FAA for you without knowing all the facts unless he really owes you one. And the FAA isn't going to go along with that and not fully explain to a Congressman why he inquires. You asked him to inquire, he did, and the FAA responded. If you didn't want your Congressman to get the details from the FAA, why did you ask him to inquire?

 

[RussR]

What were you hoping to happen here? Your Congressman to take on the FAA for you without knowing all the facts unless he really owes you one. And the FAA isn't going to go along with that and not fully explain to a Congressman why he inquires. You asked him to inquire, he did, and the FAA responded. If you didn't want your Congressman to get the details from the FAA, why did you ask him to inquire?

That's pretty much the same thought I had. Legal or not, I don't know. But effectively, you asked Congress to act as your agent. They asked the FAA for information as your agent, which you authorized them to do. The FAA responded to them as if they were your agent, so Congress can act upon your request with all appropriate information. Seems like the FAA responded as I would have expected.

I am not a lawyer and have no idea if all this meets HIPAA or Privacy Act or anything like that, but as a layman, the FAA did pretty much what I'd expect, and what I'd hope they'd do. After all, if the FAA just responds with "it's complicated, it'll take a while", how does that help Congress help you? That accomplishes nothing.

 

[Fiveslide]

Your Congressman to take on the FAA for you without knowing all the facts unless he really owes you one.

In a country of nearly 350 million people, the amount of people in the stack of SI files isn't even a drop in a bucket. Even if every person in line for an SI banded together in some form of protest, it would barely be enough to qualify as a nuisance to those in the federal level of American politics.

I wouldn't expect change, ever, with the number of people affected being so low. Any loosening of regulations will be a welcome surprise for the few that just want to fly their family and friends around in 50 year old planes. However, those people will not be the reasons behind any changes.

 

[172andyou]

Correct, if you were a cash-only provider who never touched insurance billing, HIPAA would not apply. There are a slew of other privacy regulations that would, but not HIPAA.

This is the key for this specific question, I think.

I think most people outside of the medical industry (and many within it also, I suppose) think of HIPAA as respresenting *the* medical privacy rules, instead of knowing that there are many regulations. So they use "HIPAA" as a throwaway for "is this legal".

HIPAA is both shockingly broad and shockingly narrow.

It's broad because it touches insurance related things and electronic records. In the US "insurance related things" consists of very nearly every health care transaction.

It's narrow because it really was intended to stop insurers from using a persons medical information to jack up rates and exclude them from being insurable, thus creating a tier of patients that need insurance, but can't afford it and another tier that don't need it because they are healthy, and can get it super cheap as a result.

 

[UTLonghorn_1979]

What were you hoping to happen here? Your Congressman to take on the FAA for you without knowing all the facts unless he really owes you one. And the FAA isn't going to go along with that and not fully explain to a Congressman why he inquires. You asked him to inquire, he did, and the FAA responded. If you didn't want your Congressman to get the details from the FAA, why did you ask him to inquire?

I made the inquiry to ask where it was in the process, timeline. Not divulge my personal medical conditions with a congress person and their staffer.

 

[MauleSkinner]

I made the inquiry to ask where it was in the process, timeline. Not divulge my personal medical conditions with a congress person and their staffer.

It seems you made an assumption about privacy and the government that probably hasn’t been true for decades.

 

[Lindberg]

I made the inquiry to ask where it was in the process, timeline. Not divulge my personal medical conditions with a congress person and their staffer.

That sounds like an inquiry that could have gone directly to the FAA. You know your case is complex and will take a long time, so I fail to see why asking the FAA to tell a congressperson that would have any benefit. Probably the congressperson and the FAA felt the same way and didn't assume you'd intended to waste their time with that.

 

[UTLonghorn_1979]

That sounds like an inquiry that could have gone directly to the FAA. You know your case is complex and will take a long time, so I fail to see why asking the FAA to tell a congressperson that would have any benefit. Probably the congressperson and the FAA felt the same way and didn't assume you'd intended to waste their time with that.

I was honestly just hoping it might help push things along. Been several posts here with somewhat similar cases/timelines where after a congressional inquiry the SI was issued.

 

[wellknow]

Generally a Congressional office insists on a privacy release before inquiring

 

[Clip4]

I made a congressional inquiry about my medical status, and the FAA replied to my Congress person basically outlining my diagnoses and why it was taking so long.

Is the FAA allowed to spell out my personal diagnoses to 3rd parties without my consent?

You’d think they would just say “ this person’s case is complex and will take some time,” not list each diagnosis, almost looking intentionally like they want to make it look as bad as possible and that’s why it’s taking so long.

Is the FAA immune to HIPAA rules?

When a person puts the FAA in a position they have to defend a delay in your medical approval, Reporting facts such as a history of alcohol abuse, dropping out of an alcohol program, and conditions requiring SSRIs seems fair play to me.

 

[UTLonghorn_1979]

When a person puts the FAA in a position they have to defend a delay in your medical approval, Reporting facts such as a history of alcohol abuse, dropping out of an alcohol program, and conditions requiring SSRIs seems fair play to me.

Okay, but is it legal? That’s my question.

 

[TCABM]

Okay, but is it legal? That’s my question.

Here is Wingman Med’s thoughts.

HIPAA and Your FAA Exam - Wingman Medical

HIPAA helps protect health information, but not at public safety's expense. You don’t have tell the FAA; they don’t have to let you fly.

wingmanmed.com

Since they’re in the business, I would expect they more closely can answer your question.

 

[UTLonghorn_1979]

Here is Wingman Med’s thoughts.

HIPAA and Your FAA Exam - Wingman Medical

HIPAA helps protect health information, but not at public safety's expense. You don’t have tell the FAA; they don’t have to let you fly.

wingmanmed.com

Since they’re in the business, I would expect they more closely can answer your question.

I’ll ask them, thank you. I briefly scanned and didn’t see my situation addressed.

I don’t have any issue with them having my records, of course that’s needed to evaluate my medical issuance. The question is are they allowed to disclose that to parties that are totally uninvolved in the decision making AND when I didn’t authorize it.

 

[schmookeeg]

I made the inquiry to ask where it was in the process, timeline. Not divulge my personal medical conditions with a congress person and their staffer.

The congresscritter did not get involved.

Their staffer forgot you in however long it took to forward the reply and moved onto the next in the never-ending pile.

I'm all for medical privacy, but HIPAA isn't it for many reasons, and it's not like they posted your case to Insta with a "lawl lookit hemmorhoids so bad we grounded this pilot" heading.

 

[MauleSkinner]

I’ll ask them, thank you. I briefly scanned and didn’t see my situation addressed.

I don’t have any issue with them having my records, of course that’s needed to evaluate my medical issuance. The question is are they allowed to disclose that to parties that are totally uninvolved in the decision making AND when I didn’t authorize it.

So what, exactly, did you expect?

“How’s Longhorn’s medical coming along?”
“Gonna be a while.”
“OK, We’ll pass that along.”

 

[UTLonghorn_1979]

So what, exactly, did you expect?

“How’s Longhorn’s medical coming along?”
“Gonna be a while.”
“OK, We’ll pass that along.”

Same thing I already said in post #17. If nothing constructive to add…you know…

 

[MauleSkinner]

Same thing I already said in post #17. If nothing constructive to add…you know…

“Push things along” is not “totally uninvolved.” You can’t have it both ways.

 

[UTLonghorn_1979]

“Push things along” is not “totally uninvolved.” You can’t have it both ways.

Congressional office isn’t making the medical decision, so they don’t need to know the specifics.

All they needed to say was it’s “it’s in queue, we’re extremely backlogged because we don’t delegate anything to regional FAS or the HIMS in this area of review. Everything is reviewed by 3 people in DC.”

One would hope that it would prompt the Rep to ask: “why is it handled that way?”

My main goal is to bring attention to the process and hope that it would help move things along. Not that my Rep would now have my personal medical conditions saved in their email inbox.

 

[Lindberg]

Congressional office isn’t making the medical decision, so they don’t need to know the specifics.

All they needed to say was it’s “it’s in queue, we’re extremely backlogged because we don’t delegate anything to regional FAS or the HIMS in this area of review. Everything is reviewed by 3 people in DC.”

One would hope that it would prompt the Rep to ask: “why is it handled that way?”

My main goal is to bring attention to the process and hope that it would help move things along. Not that my Rep would now have my personal medical conditions saved in their email inbox.

Longhorn: "Can you ask the FAA why my medical application is taking so long?"
Congressman: "Sure thing."

Congressman: "Why is this guy's medical application taking so long
FAA: "It takes what it takes."
Congress: "It seems to take an unacceptably long time."
FAA: "We don't have the resources."
Congressman: "Can't you just get this one guy hooked up?"
FAA: "Well, he told us about the one thing, but he didn't tell us about the other thing, and then he had a relapse of the other thing, and he's better now, he says, but the record is really unclear, so we're thoroughly reviewing everything to give him the best shot. We could just deny it because he doesn't meet the standards of you want a quick result."
Congress: "Alright then."

Congress: "Wow, you've got a complicated history. The FAA is taking it's time to make sure they get it right."
Longhorn: "How do you know that?!"

 

[flyingron]

Of course, the FAA doesn't believe the Privacy Act applies to them. THey've gotten called out on this a couple of times and frankly, if I had more time, I'd burn them over their blatant disregard concerning the airman database.

 

[Fiveslide]

Okay, but is it legal? That’s my question.

If I'm reading between the lines correctly, you'd like for it to be illegal, because them violating your privacy may mean leverage with FAA to get what you desire?

I would not proceed down path, even if it was. Your name is on the radar of an overworked, likely underpaid, FAA employee. There are some pots of **** you just don't stir up.

 

[UTLonghorn_1979]

If I'm reading between the lines correctly, you'd like for it to be illegal, because them violating your privacy may mean leverage with FAA to get what you desire?

I would not proceed down path, even if it was. Your name is on the radar of an overworked, likely underpaid, FAA employee. There are some pots of **** you just don't stir up.

I want them to play by the same rules they expect everyone else to and are legally supposed to. Is that so audacious?

 

[Brad Z]

That's pretty much the same thought I had. Legal or not, I don't know. But effectively, you asked Congress to act as your agent. They asked the FAA for information as your agent, which you authorized them to do. The FAA responded to them as if they were your agent, so Congress can act upon your request with all appropriate information. Seems like the FAA responded as I would have expected.

I am not a lawyer and have no idea if all this meets HIPAA or Privacy Act or anything like that, but as a layman, the FAA did pretty much what I'd expect, and what I'd hope they'd do. After all, if the FAA just responds with "it's complicated, it'll take a while", how does that help Congress help you? That accomplishes nothing.

This is the correct answer. When you seek assistance through your member of Congress online, there is typically a checkbox that authorizes the rep’s staff to inquire on your behalf. Below is an example from Congressman Breyer, my representative. I’m sure the other 534 members are the same.

Constituent Authorization*
To be able to assist you, we must have a signed privacy release form that clearly outlines your problem and the remedy you are seeking. By checking the box below you are giving our office permission to look into the matter on your behalf. Please make sure to attach below any relevant identifying information and supporting documents which relate to your inquiry.

I hereby request the assistance of the Office of Representative Don Beyer to resolve the matter described below. I authorize the Office of Representative Don Beyer to receive any information that they might need to provide this assistance. The information I have provided to the Office of Representative Don Beyer is true and accurate to the best of my knowledge and belief. The assistance I have requested from the Office of Representative Don Beyer is in no way an attempt to evade or violate any federal, state, or local law.

 

[Fiveslide]

I want them to play by the same rules they expect everyone else to and are legally supposed to. Is that so audacious?

It is not. We've all seen your justifiable frustrations as you've been posting on the medical topics board these past months. It had me thinking me you might try something drastic if you did get that leverage. I would have to restrain myself from using leverage if I were in your situation.

 

[UTLonghorn_1979]

This is the correct answer. When you seek assistance through your member of Congress online, there is typically a checkbox that authorizes the rep’s staff to inquire on your behalf. Below is an example from Congressman Breyer, my representative. I’m sure the other 534 members are the same.

Constituent Authorization*
To be able to assist you, we must have a signed privacy release form that clearly outlines your problem and the remedy you are seeking. By checking the box below you are giving our office permission to look into the matter on your behalf. Please make sure to attach below any relevant identifying information and supporting documents which relate to your inquiry.

I hereby request the assistance of the Office of Representative Don Beyer to resolve the matter described below. I authorize the Office of Representative Don Beyer to receive any information that they might need to provide this assistance. The information I have provided to the Office of Representative Don Beyer is true and accurate to the best of my knowledge and belief. The assistance I have requested from the Office of Representative Don Beyer is in no way an attempt to evade or violate any federal, state, or local law.

Thank you, mine doesn’t have that wording or anything like that, just a Box to check to be added to their email list.

 

[UTLonghorn_1979]

It is not. We've all seen your justifiable frustrations as you've been posting on the medical topics board these past months. It had me thinking me you might try something drastic if you did get that leverage. I would have to restrain myself from using leverage if I were in your situation.

if that means bringing a broader eye to the FAA and and getting them more functional and accountable, sure. If it’s leveraging my own specific stuation, that’s not my goal.

 

[Kenny Phillips]

Looks like no, but they are still subject to the Privacy Act of 1974. Just annoying that they would feel the need to spell all that out, make it look like “this guy is a mess and it will take time” vs. the facts that I’ve done everything asked of me, all specialists have recommended SI, as has my HIMS AME.

I REALLY wish they would just push these back to the AME…sigh.

Yeah, turns out there are enough sketchy AMEs to prevent the FAA from doing just that. (One at Spruce Creek Fly-in some years back was bad enough that the FAA required a new medical for all that he approved.)
Certainly I'd be OK with PCP approval for most everything; my doctor would be quite picky.

 

[455 Bravo Uniform]

I think the case manager at FAA and your Senator/Congressman are Aggies.

 

[Wheresmychute]

Yeah, turns out there are enough sketchy AMEs to prevent the FAA from doing just that. (One at Spruce Creek Fly-in some years back was bad enough that the FAA required a new medical for all that he approved.)
Certainly I'd be OK with PCP approval for most everything; my doctor would be quite picky.

Or just HIMS AME's. Anything would be better than some dude reading a few pieces of paper to determine someone's fitness to fly.

 

[bbchien]

This is the correct answer...

Brad, as you likely know, prime righteous complainants will always be complaining that his or her, "rights were violated", even when a someone was attempting to help. It is a "cannot win" situation. (Now I'm not saying anything directly as to anyone who participates in this string....)

 

[Brad Z]

Brad, as you likely know, prime righteous complainants will always be complaining that his or her, "rights were violated", even when a someone was attempting to help. It is a "cannot win" situation. (Now I'm not saying anything directly as to anyone who participates in this string....)

I'm not too concerned about people's feelings per se, but if they ask a question I hope they get the correct answer. It may not be the answer they want, but if someone wants to complain, I'd rather they complain from a position of knowledge rather than incorrect assumptions.