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Andrea, Esq.
Andrea, Esq., Attorney
Category: Legal
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Experience:  25 yrs. experience in family law, estates, real estate, business law, criminal defense, immigration, and employment law.
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What are the laws in NYS regarding the sharing of a patients

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What are the laws in NYS regarding the sharing of a patient's medical records & specifically failed 'drug' tests with other doctors? My fiance has permanent nerve damage to her spine & lower body post 2 failed back surgeries, & has been on the same regiment of prescription of pain meds since 2008. She just got a letter from her neuro/pain management doctor's office that she failed a drug test, & they would not prescribe any controlled meds for her any longer, just acupuncture, or the like (which as a side note, her insurance won't even cover) : but they offer that since they recognize her condition requires continued care, if she chose to seek another doctor, she should do so asap, as she only has about a week's worth of her last month's prescriptions left. She just needs to provide the new doctor's name on a consent form that seems to require her to give blanket consent for the release of all her records (which would presumably include test results.) She has of course a physiologic dependence to these meds, after all this time on them & is in constant pain, but much worse w/out her meds. It seems criminal that she could be forced to go through hard withdrawal... If the records, tests inclusive are given to another doctor, it would seem unlikely she'd get help. I can explain the reason for her failure as a follow up if asked. Please advise! Can she request her records be released to her, & would the doctor's office be required to release them, so she can disseminate what she wants to to a new physician? Also can the doctor divulge the test result to our pharmacy? Thank you so much for any help!
Submitted: 1 year ago.
Category: Legal
Expert:  Andrea, Esq. replied 1 year ago.
Hello and Welcome to JustAnswer, My name is XXXXX XXXXX my goal is to provide you with Excellent Service

I can appreciate the pain your fiancee is in and it is very insensitive on the part of the doctor, not to mention painful for your fiancee to be forced to go through withdrawal when it is this same doctor who was probably prescribing them for her all these years,

1. You asked,

"Can she request her records be released to her, & would the doctor's office be required to release them ?"

Answer 1

Under New York law, a patient has a right to access and copies of their medical files. Although the Statute does not specifically state that the doctor can keep the originals, that is what the language of the Statute appears to imply. But, the important feature is that your fiancee is entitled to access, review, and have copies of her medical files. In this regard, I would not tell the former doctor the name of the new doctor. There is no reason for the new doctor to know his name since he will have all he needs in your fiancee's medical files;


2. You also asked,

" Also can the doctor divulge the test result to our pharmacy?"

Answer 2


The Health Insurance Portability Accountability Act ("HIPAA") prohibits a medical provider from disclosing the medical information of a patient to third parties unless the patient has consented in writing. However, if the third party is also a medical provider either directy or indirectly of the patient, no consent is necessary. For example, Doctor 1 is the primary medical provider for the patient. Doctor 1 examines the patient, after which he feels he needs to consult with Doctor 2, a specialist. The patient's consent is not necessary for Doctor 1 to discuss the patient's condition with Doctor 2; however , Doctor 1 is limited to disclosing only that part of the patient's condition which is necessary for the consultation. If Doctor 1 brings the patient's etire file and just opens it up for Doctor 2 to see, including parts of the file which are not necessary to the consultation, Doctor 1 has violated the HIPAA rules.

Therefore, in Answer to your question regarding the pharmacy, the doctor should disclose to the pharacist only the information which the pharmacist needs to fill any prescription for your fiancee and for that limited person only,

_________________________________________________________________________



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Customer: replied 1 year ago.
Hi Andrea, my fiance & I thank you for your time, & need more information please. We appreciate the answers you were able to give based on your understanding my somewhat somnambulistic, less than fully intelligible, 3:30 AM question. I'd sought out help online as I was having difficulty sleeping due to the stress I'm under, desperately trying to figure out how to help my beloved partner, who is in terrible pain, physically & logistically. We hope you're information will be a difference maker for us!
You were correct in the assumption that doctor (who is actually a NP working under a doctor at a large neuro/pain management practice) is the same 1 who has been prescribing these same meds to my fiance for years. Well, she is actually the 2nd of 2 NPs assigned to her as her primary caregiver/case handler at the practice since 2008, but the meds have been pretty consistent since the start.
Of note re : our ability to deal with the people at this practice, the office staff of this very large practice have become increasingly contrary & difficult to deal with, & this is well before the 'toxicology' test. We have become progressively aware that they are non-advocates of my fiance as a patient, & were soon strongly considering seeking new doctors for her if this incident hadn't occurred. However, given the delicate & sensitive nature of controlled meds & their application in the medical community, we have been somewhat apprehensive (to this point) to seriously look... but at this point it has clearly become necessary.
That leaves us with the issue of obtaining her up to date medical records, which would be required by any neurologist, or pain management doctor, or physician of any kind. Andrea, you suggested that as long as the new doctor doesn't know the identity of her former doctor, & we are just able to present the records, sans toxicology results, there should be no reason for the new doctor to seek out such results, & the former doctor has then no right to volunteer the information. However we are confused by this, as my fiance's medical records, with 5 years of diagnostics (EEGs, EMGs, MRIs, X-Rays & CAT Scans) are all tied to the facility that now says they can only offer her alternative forms of therapy. (the letter mentions acupuncture, injections, or manual therapy. All of which she either has had no success with & or are not covered by her health insurance...) So we have concern this may present a problem for us.
What can you suggest she could do to see another doctor & get treated medically for the pain she sadly & quite legitimately is in, with the same or similar controlled medications, without being haunted by this test result?
She received the letter Friday, & it is now going on Tuesday, we have as yet to contact the office. Given the trend in their behavior toward my fiance, & the subject matter at hand, we expect them to be as contrary & unhelpful as the law allows them to be, or more so if we are ignorant of my fiance's rights in these matters. We could use some advice as to where the practice's obstinance may be illegal. How much time do they have from when receiving the request for the records to be delivered to the patient are they allowed? Are they allowed to charge a fee for these records, & if so how much is the maximum allowable?
Are they allowed to abruptly (their letter was dated 5/8, & my fiance will be out of meds on 5/29 - 30... letter was received by us on 5/17, there would be no way in the best of scenarios she could see a new pain management/neuro doctor before the 29th of this month & continue her meds uninterrupted)cut her off from meds she has been prescribed from their practice since 2008? These are medications that cause physiologic dependency & relieve pain in a person with a major structural instability in her spine, & imperially provable nerve damage & nerve pain?
If there are statutes/laws on the books, (or whatever the legal jargon for such things you understand me to be layperson asking for)that you could direct us to that we could say print & be armed with at the doctor's office, to help my fiance not be forced through hard withdrawal, & to be able to seek medical care with her medical records given entirely to her, & not have to try to find medical care with a figurative 'Scarlet Letter' attached to her as a patient, this would be most helpful!
And to speak to the difficulty of withdrawal, & the lack of humanity in this medical practice, I'll cite to you an incident involving the weekend of 4/27 - 4/29. On the evening of Friday 4/26 I went to the doctor's office on behalf of my fiance to pick up her written scripts, as I have many times since 2008. She was due to run out of her meds between Friday evening & Saturday morning, as I told the young lady I dealt with at the front desk, who read a note & seemed genuinely sorry to tell me that my fiance would have to come in Monday morning for a test before the scripts could be released to her. It was too late that evening & she couldn't come in Saturday, despite the fact that they have hours then. I asked her if she could ask one of the many doctors still on call or in the facility still at that time if they could dispense a 2 or 3 day prescription for her, to avoid hard withdrawal, & was told (after the young lady consulted with a very dour expressioned woman who was of some lower order of office management in this large facility, but appeared to be 'in charge' at this time) that "This is [her] job & [she] couldn't risk it for my fiance," nor would any doctor be willing to. That weekend I did all I could to comfort my beloved, & she toughed it out as best she could, knowing that Monday morning there would be a light at the end of the tunnel... We never anticipated we'd find ourselves dealing with an even more exacerbated version of that situation staring us in the face a month later.
While we had considered taking her to the E.R. for her withdrawal & neuropathic pains that weekend, we were concerned about seeming to be "drug seeking/doctor shopping" so with the very finite (& we thought the last) time she'd have to deal with it, we decided to tough it out. That is not going to be a long term option, so on behalf of the love of my life, I ask for the legal advice that will help us overcome this nightmare situation.
Thanks So Much, in Advance!
Expert:  Andrea, Esq. replied 1 year ago.

Good Evening,

 

1. As I told you in my previous Answer, a patient is entitled to access as well as to copies of all their medical records and files. The Statute does not give any time frame for this, but where no time is specified in the law or in a document at hand, the law states that the act should be performed "within a reasonable amount of time", with "reasonable" depending on a particular set of circumstances. If I were you, I would not rely on a letter request. I would simply call the practice, ask to speak to someone in charge and saying that I will be at their office on such and such date and time for copies of my medical records, and just do not take "No" for an answer.

 

2. A charge may be assessed (and usually is) for making copies, but the charge must be "reasonable".

 

3. Regarding the medical records, I would redact the name wherever it appears and would not include the toxicology report at all.

 

4. It is completely irresponsible for any doctor who calls himself or herself a member of the medical profession to prescribe medication that they know is addictive, then suddenly cut the patient off. Get the address, telephone number, and the person in charge at the New York Medical Licensing Board and a copy of their Complaint form from them and from the American Medical Association, you will take these with you to the doctor's office. I was not aware that your fiancée was dealing with a Nurse Practitioner. The first step I would take is to call and ask for an appointment on an emerency basis with the doctor who was seeing your fiancée. If necessary, I would park myself in the doctor's office until I spoke with him. During the meeting, I would tell him that a Nurse Practitioner has no business making decisions of whether or not to give any additional prescriptions to a patient. I would also tell the doctor of her attitude with patients. Then, in a diplomatic way, but basically say, "Look, she did not ask for those drugs, you prescribed them for her for the last 4 years. Don't tell me that you're going to suddenly take her off of them, without even tapering them off." Then, if I got no satisfaction from the doctor, I would take out the Complaint forms and say, "We'll see what the Medical Licensing Board and the AMA have to say about the manner in which you and your office staff treat patients". Then, I would proceed to write a brief, concise statement, reporting the doctor to both offices and following up my letter with a telephone call two days later.

 

Unfortunately, there is no law or Statute to which I can direct you because there is no specific provision for these situations, although I believe that the law should be amended to make it mandatory for a doctor to taper patients off of addictive medications and to prohibit any doctor from doing this. The only document I can direct you to is the Hippocratic Oath which each doctor takes and in which they swear to alleviate suffering and you can bring that up during the meeting with the doctor. Ask him, "How seriously do you take the Hippocratic Oath ?" and "Can you tell me what it means to you ?"

 

___________________________________________________________________

 


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Thank you for allowing me the opportunity to be of service,

ANDREA

 

 

 

 

Andrea, Esq., Attorney
Category: Legal
Satisfied Customers: 11566
Experience: 25 yrs. experience in family law, estates, real estate, business law, criminal defense, immigration, and employment law.
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