HIPAA: WHEN A MINOR BECOMES AN ADULT

When a minor becomes an adult, they become the owner of their medical record.  Here are a couple of things to consider: When does a minor become an adult; What does the practice need to do to ensure proper handling of the record according to HIPAA.

A minor can become an adult in several ways.

• They reach the age of 18. One good way to keep aware of this is to post a sign at the front desk or break room that states “Patients born in 2003 turn 18 this year”.
• They join the military. Federal law states that all members of the military are adults even if they are below the age of 18.
• They get married. In this case, they need to inform the practice if they are under 18 and produce the paperwork.  It is not the responsibility of the practice to ask and discover this on their own.
• The state can declare them emancipated. The patient is responsible for informing the practice by providing a copy of the court documentation.
• They MAY become an adult if they have a child. This is controlled by state law. In some states, the underage mother has ownership of the child’s records but is still considered a minor when it comes to her own record. In other states, the mother is immediately considered an adult. In yet other states, both parents are considered adults. You need to know what your state dictates. This information is available on your state’s website. Your medical/dental board or business lawyer may also be a good resource.
• There are state laws that give the minor ownership over certain aspects of their records. For example, if a minor is seeking treatment for an STD some states have declared the minor owns that information, not the parents. This does not make the minor an adult.

Tax law often creates an area of confusion. A person who is 18 – 23 years old may still be considered a dependent of the parents if they are in school. This does not change the fact that they are considered an adult and fully in control of their records and treatment.

When your patient becomes an adult, several things need to happen.

Provide them with a Notice of Privacy Practices and get them to sign any HIPAA authorizations needed. All contracts are now the responsibility of the new adult and any old authorizations, restrictions, and access requests are no longer in effect. Be sure to have this conversation with the new adult alone even if they are accompanied by a parent. This can prevent getting the practice involved in potentially volatile or embarrassing situations.

Here are some frequently asked questions.

Do the parents of the new adult still have any rights or access to the patient’s information? No, unless authorized by the new adult.

Can the parent still accompany the new adult? Yes. Anyone can accompany any patient. HIPAA considers that the patient’s consent is implied in this circumstance.

Can the parent still take financial responsibility for the new adult? Yes. Anyone can pay but the ultimate responsibility is with the new adult as it is with any other patient.

Can the parent still make appointments for the new adult? Yes. Once again, anyone can make an appointment unless your practice has a policy against it.

Can the parent still confirm appointments? This is a little more complicated. If they call and have all the information, then yes, you can confirm. If someone calls and says I need to know when Mr. X has his next appointment, I advise caution. The key is not to give out protected information.

TMC HIPAA service clients are encouraged to call Client Services if you need help on this or other HIPAA issues at 1-888-862-6742 or e-mail your question to Service@TotalMedicalCompliance.com.