We, psychotherapists and counselors, are already highly attentive to privacy issues and set high standards in regard to confidentiality and disclosures. As a result, our existing standards often exceed the minimum standards mandated by HIPAA. It is, however, critically important to stay abreast of changes in the law requiring increased vigilance in protecting our patients' right to privacy. The different provisions of the new Federal American Recovery and Reinvestment Act of 2009 have different effective dates. Some provisions take immediate effect, while others will not go into effect until 2010. Summary of some of the new Act's provisions relevant to psychotherapists: Expansion of individual rights: When patients, according to the new law, pay 100% out of pocket, they can direct their therapists to limit disclosure and specify that information cannot be provided to their health insurer (or others). As psychotherapists we are already required to obtain clients' disclosure in such situations. "Minimum necessary" rule: Previously, under HIPAA, the "minimum necessary" rule instructed covered entities to keep disclosures to the minimum amount necessary to accomplish the intended purpose. Therapists must always keep the "minimum necessary" rule in mind and reveal only what is truly necessary when communicating (always with clients' permissions) with medicating psychiatrists, GP's, etc. The new Act intends to tighten up what information may be disclosed. State attorneys general are now allowed to bring HIPAA enforcement actions: Another change is that now state attorneys general are allowed to bring HIPAA enforcement actions. Becoming HIPAA compliant is easy: Online HIPAA Course for 6 CE credits. Course includes the entire HIPAA text and HIPAA forms. Course fulfills law and ethics requirement. HIPAA Compliance Kit (includes Forms on CD) HIPAA Updates (free) Additional relevant online courses: Confidentiality Record Keeping (Course includes 59 Essential Clinical Forms) Informed Consent Over 20 Ethics Courses Guidelines (free) New California Laws Against 'Snooping' Reaffirm HIPAA's "Need to Know" Provision Under two new California medical privacy laws, AB211 and SB54, hospitals, clinics and psychotherapists in private practice could face stiff penalties for privacy breaches. These new CA laws are partly the result of 'snooping' or privacy breaches of high-profile celebrities, such as singer Britney Spears. AB211 and SB541 make it possible for institutions and individuals to be fined up to $250,000 for being lax when it comes to the medical privacy of CA residents. Therapists are liable not only for their own sharing of information, but for that of their staff as well. To protect the privacy of their patients, therapists, among other things, must make sure that staff members have access to information only on a "need to know basis." For example, billing staff should not have access to the entire clinical records, but only to billing-related information, such as names, procedures, DX, charges, and co-pay.

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