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Skagit Valley Hospital

Understanding the New 2013 HIPAA Healthcare Privacy Rules



On January 25, the Department of Health and Human Services published its modifications to the HIPAA (Health Insurance Portability and Accountability Act) Privacy Rule. The new guidelines (called Final Rule) clarify some of the previous regulations that will allow development professionals working in healthcare-related philanthropy to better communicate and engage with potential donors.

In 2003, several critical aspects of the original 1996 HIPAA law went into effect to protect patient privacy and apply limitations on what information would be available to fundraisers. Some of the rules were vague and led to great deal of interpretation about what was permissible. The new guidelines offer clearer definitions about what information fundraisers can gather from hospital records and offer expansive opt-out options for patients.

In a nutshell, the new guidelines will allow development professionals to receive and use the following information in fundraising communications, donor segmentation, and interactions with patients and patient families:

  • Department of service (new)
  • Treating physician (new)
  • General outcome (i.e successful, deceased, etc.) (new)
  • Name
  • Address
  • Guarantor contact information
  • Date of birth
  • Insurance status
  • Date(s) of service (previously limited to one date of service)
  • Location/site of service

As always, organizations must be able to demonstrate a specific need to use this information, protect the data as confidential health information, and limit access to staff members who don’t need to the information for their job function.

The second most important update is to clarify opt-out language in fundraising information.

  • Patients and patient families must receive clear language indicating they may opt-out of fundraising communications through any combination of low-cost, low-burden methods such as email, a toll-free phone number, and/or through the organization’s website.
    • The low-burden clause is critical. Requiring patients to write a letter is not acceptable as it imposes too much burden on the patient.
  • The opt-out rule applies to verbal as well as written communications.

The bottom line for anyone in healthcare fundraising is to know the new rules and make a plan about what to do next. These modifications go into effect on March 26, 2013 and enforcement begins September 23, 2013. The link to the full guidelines is here.


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About the Author

Anne Clark

Anne Clark

Consultant, Strategic Information Services

Anne’s training as a librarian benefits Collins and clients alike as she researches the latest nonprofit trends and statistics.


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