October 4, 2011
I received notification from the IRS that they will be conducting an on-site review at my practice and they are going to request information. Can they view my patient records?
Dr. P, this is a very general question and lends itself to today's title, "appropriate response to request for information." Before I address what an appropriate response to a request may be, I recommend that you hire a competent attorney immediately to work with you on your matter with the IRS.
To answer what is an appropriate response, begs the question of what was in the request? And, whether the request itself was proper. When dealing with any third party, whether a patient, the government, an agency, etc., your response is only as proper as the request that has led to a disclosure. If any such disclosure from your practice does contain protected health information, this information is heavily protected by HIPAA and applicable state laws governing patient privacy. Without having additional information on your situation, I cannot comment as to whether a proper request from the IRS could/would be issued to see patient medical records. I have a hard time imagining that would be the case. Patient protected health information may only be disclosed under certain protected and authorized circumstances, and even under those circumstances, only to the degree necessary for a response. So, to address what is an appropriate response to a request for information - the first response should be to question the appropriateness of the request. The second response would be to tailor any disclosure to provide only that information that is expressly authorized - whether by court order, explicitly by a patient, or otherwise. Because requests are required to be tailored as per purpose, anything more than a general answer is inappropriate. If you have a specific situation arise where you think you have received an overly broad request, I recommend you contact an attorney to review.
Instances where our office has been contacted to review requests for information other than payors include requests from the Office for Civil Rights, Workers Compensation, Division of Human Rights, EEOC, NYS Tax Department, IRS and other agencies. For many of our clients, we recognize its difficult to fight the urge to respond and cooperate with a request from one of the listed agencies or other authorities, however, providing a hurried response may result in opening you up to more liability as opposed to having you categorized as a "cooperative" individual.
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