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How does HIPAA apply to a minor of divorced parents where insurance information is concerned?

New York, NY |

I am the legal custodial parent with sole decision making rights for matters that are not deemed "important medical" or "important educational" to my child. The child's providers refuse to give any information regarding claims such as if a claim was filed, and what the status of a claim may be quoting HIPAA. I am the primary financially responsible party via court order for my child as well. I do not and never have requested personally identifiable information for those claims.

My question, do I have a right under HIPAA to request and receive information pertaining to my child regarding his financial account from his providers? If so, how do I go about enforcing this to them.

Attorney Answers 3

  1. Your question is confusing. Are you saying you have joint legal custody and shared physical custody and are the non-custodial parent, but have "sole" authority when it comes to normal dat-to-day "non important" medical/educational decisions when the child is in your custody (for instance, whether the child is sick enough to stay home from school, as opposed to what school your child is going to be enrolled in).

    Who is not giving you this health information citing HIPAA privacy? The health provider? The health insurance carrier? Is this because the other parent has the obligation to insure the child and the child is insured under an employer's "family coverage" and you are not listed as the primary insured policyholder or the child's emergency contact.

    Assuming this is not a battle with the other parent for you to get this information, I would assume a certified copy of the Family Court order awarding you some shared legal custody, together with a release or consent signed and notarized by the other parent would be sufficient to get the providers or insurers to give you access to this information.

    If this is not the case, you should petition for a modification of the Custody Order in Family Court which explicitly raises the issue of your need to have access to this information and amending the order in this regard as well as requiring the other parent to execute any consents to disclosure the carrier or provider is requiring.

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  2. HIPPA, to my knowledge, usually applies to actual medical information (not insurance information), to which you would clearly be entitled to. The Doctor MAY be refusing to give the information because the insurance in in the non-custodial parent's name & the file has been marked accordingly on their request. The only "insurance" information you'd be entitled to in that event is the Statement of Benefits, to the degree the non-custodial parent wants to make you liable for your share of the unreimbursed portion of the Doctor bill. Thus, request same of the non-custodial parent.

    * If you found my answer to be "HELPFUL," or the "BEST ANSWER," please feel free to mark it accordingly.

  3. I'm also a little confused by the question - are you simply trying to confirm that the child has insurance or that the bills are being paid? Are you not being told about day-to-day health matters? You may need to take your court order or divorce agreement to an attorney to get clarification.

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