PADI Policy Re Medical Releases

[RJP]

The latest law, The Health Insurance Portability and Accountability Act of 1996 (HIPAA) [1], has even strictor rules on handling health information.

DIVE OPS, take note! -- better have this stuff locked away, not in some accessable filing cabinet.


[1] Understanding Health Information Privacy

Please let's not go down the HIPAA road again; it does not cover dive shops.

Please follow the link you provided and you'll see:

The Privacy and Security Rules apply only to covered entities. Individuals, organizations, and agencies that meet the definition of a covered entity under HIPAA must comply with the Rules' requirements to protect the privacy and security of health information and must provide individuals with certain rights with respect to their health information. If an entity is not a covered entity, it does not have to comply with the Privacy Rule or the Security Rule.

A Covered Entity is one of the following:
- A Health Care Provider
- A Health Plan
- A Health Care Clearinghouse

Are you a covered entity?

Dive shops, dive instructors, training agencies, etc are NOT covered entities; therefor do NOT have to comply with HIPAA.

Am I saying that they should therefore release your records to the world? No. But misapplication of laws that are very specific and very clear is not a great way to bolster your position, it only weakens it.

 

[Mike Boswell]

Mike, the Privacy Act of 1975, as amended, covers this completely. The firm is required to tell you why they are requesting information, and what will be done with it. They must get your permission for anything they do with it.

The latest law, The Health Insurance Portability and Accountability Act of 1996 (HIPAA) [1], has even strictor rules on handling health information.

DIVE OPS, take note! -- better have this stuff locked away, not in some accessable filing cabinet.


[1] Understanding Health Information Privacy

Hi Jax,

Whether HIPAA covers US dive ops is one thing (some say not), but what I am addressing is more the "foreign dive vacation" sort of thing.

If you are on an expensive dive vacation, and they tell you that you need a local doctor's signoff, you are kind of stuck. This leads many to just lie on the form, but as AndyNZ points out, lying may ultimately make things worse for everybody.

It just seems to me that the dive industry needs to be proactive and address this issue, before local poobahs are given the excuse to step in with a bewildering hodge-podge of half-assed legal gibberish and venality which hurts both divers and the dive industry.

 

[Crowley]

Hi Jax,

If you are on an expensive dive vacation, and they tell you that you need a local doctor's signoff, you are kind of stuck. This leads many to just lie on the form, but as AndyNZ points out, lying may ultimately make things worse for everybody.

It just seems to me that the dive industry needs to be proactive and address this issue, before local poobahs are given the excuse to step in with a bewildering hodge-podge of half-assed legal gibberish and venality which hurts both divers and the dive industry.

Exactly right Mike!

and have you ever experienced some of these local doctors in remote tropical locations!? Some of them barely know anything about medicine, never mind diving! One of the locals in Thailand used to ask as part of his "diving medical": "have you ever had AIDS or elephantiasis?" I mean, whay do you say to that? "Well, I had a small touch of AIDS a few years back but I took a couple of Aspirin and it cleared right up, then I rubbed some tiger balm on my grapefruit sized testicles and woop, next morning they were back to normal!"

Many, many dives do not occur in places where there is access to quality medical care, and where HIPAA is a large water dwelling beast. The RSTC form goes some way to addressing that, I think. We don't want to disappoint divers by saying no, and we don't want to hurt divers either. In most cases, we're just doing our best to help everybody, given the resources that are available to us at the time.

Cheers,

C.

 

[rstofer]

Before I could take the NAUI program at Dive Asia, Singapore, in '88, I had to have an upper respiratory and ENT exam by a diving doctor. This included a chest X-ray. And yes, the doctor specialized in hyperbaric medicine. This was a really big deal.

One fellow slipped through the process and didn't get the chest X-ray. He also failed to mention some kind of bronchial infection. As a result, when he surfaced from the first dive, he was bleeding from his mouth.

The diver surfaced on the starboard side of the boat, forward of the stern and the instructor was forward of the stern on the port side. I was sort of in the middle. "Hey, Paul, Bill is bleeding from his mouth!". At first Paul thought I was joking; and then he didn't!

I think more interesting questions would be:

1) For those of you currently diving, how many think their doctor would be willing to sign the release?

2) How many think that the signature implies that they are fit to dive?

3) How many, over 50, really believe they are fit to dive?

Richard

 

[Mike Boswell]

3) How many, over 50, really believe they are fit to dive?

Richard

Smile when you say that, Grasshopper. 75 is the new 50!

 

[TeriLeonard]

First, in our shop, we do treat medical releases as confidential. Next, I have turned away a prospective student even though he had a signed medical release. In fact, he ended up with THREE releases signed by the time we were done.

I did take him into the water at first. However, I ended up towing him in to shore before we even dropped down because he was so short of breath that I thought he was going to have a heart attack. I turned him away after he went through my entire bottle of oxygen and then strolled down to the beach and smoked a cigarette! He kept bringing me new releases, but I never would take him back into the water.

 

[Octopusprime]

Mike, the Privacy Act of 1975, as amended, covers this completely. The firm is required to tell you why they are requesting information, and what will be done with it. They must get your permission for anything they do with it.

The latest law, The Health Insurance Portability and Accountability Act of 1996 (HIPAA) [1], has even stricter rules on handling health information.

DIVE OPS, take note! -- better have this stuff locked away, not in some accessible filing cabinet.


[1] Understanding Health Information Privacy

I think this is a very interesting question. Every course I have ever taken has been started with the PADI NEW STUDENT RECORD folder. This has the medical on one side of the folder. Often then sitting on a picnic table or in a dive bag while you are underwater.

Under HIPAA only the people required to authorize the activity should have access to it. This data is required to be protected from anyone to even see it. I talked to a medical insurance professional That is also a PADI instructor and well versed in HIPAA and he explained to me that DiveShop/instructor is NOT a covered entity but often instructors are independent contractors which unless someone gives authorization the information should not be shared.

Very interesting. I have heard that PADI has started to do online forms are they taking the medical form online? That sounds like a nightmare.

Here is a great resource...
HIPAA Privacy Rule and Its Impacts on Research
Under the covered entities a dive shop would not be covered under HIPAA however it is probably a good idea to keep them under lock and key and confidential

The Privacy Rule applies only to covered entities; it does not apply to all persons or institutions that collect individually identifiable health information. It may, however, affect other types of entities that are not directly regulated by the Rule if they, for instance, rely on covered entities to provide PHI. It is important that researchers be aware of how the Rule might affect them in the various types of organizations in which they operate, and what they may have to do in order to continue their research or begin new research efforts on and after the compliance date for the Privacy Rule.

 

[Seaweed Doc]

Without getting into whether HIPAA or any other privacy law specifically applies, I wonder if the following might apply:

PADI is based in the US.
A tourist is (let's assume) from the USA.
Perhaps the owner of the diver operation, or a DM, or an instructor, or whomever is a US citizen or resident.

I suspect a diver might be able to make a case that US law applies because 2 or more of the above apply.

(Or substitute BSAC, British tourist, British-owned shop in a former colony. I don't know if BSAC does track medical stuff, but humor me for the example.)

Any lawyers or sea-lawyers care to comment?

 

[tursiops]

This is a useless discussion.
(1) HIPAA in inapplicable, in part because....
(2) No student need reveal ANY medical information; they only need to provide a doctor's signature, no matter how many YES answers they might have put on the form. The form is a questionnaire, its purpose is to ascertain if the student needs to get a doctor's OK. So just provide the Doctor's OK.

This has been the subject of many threads. No point in starting over again, on a 7-year old thread.

 

[BlueTrin]

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