HIPAA and Massage Therapy


HIPAA and Massage Therapy

HIPAA and Massage Therapy go together… most likely. In this posting we will walk through the relevant parts of the Health Insurance Portability and Accountability Act (HIPAA) to test whether HIPAA does apply.

First, HIPAA applies to Covered Entities and Business Associates. For our purposes here, we will focus on Covered Entity. What is a Covered Entity according to HIPAA? According to the regulations that implement HIPAA (CFR 45 § 160.103 Definitions):

Covered entity means:

(1) A health plan.

(2) A health care clearinghouse.

(3) A health care provider who transmits any health information in electronic form in connection with a transaction covered by this subchapter.

From this we now need to determine two things:

  1. Are Massage Therapists considered health care providers?
  2. Do Massage Therapists transmit any health information in electronic form in connection with a HIPAA covered transaction?

Health Care Provider… does that include Massage Therapists?

There is a definition of Health care provider in CFR 45 § 160.103 Definitions that basically says anyone who “furnishes, bills, or is paid for health care in the normal course of business” is a health care provider. That may still be a bit vague. Luckily, HIPAA also requires healthcare providers to register for a National Provider Identifier (NPI) to assist with administrative and financial transactions (for more information click here). The Health Care Provider Taxonomy Code Set offers very specific classifications for health care providers, including massage therapist:

Massage Therapist – 225700000X: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

So Massage Therapists are healthcare providers, by definition and taxonomy.

Health Information

So what constitutes “health information” is the next logical question. There are two conditions that must be met in order for something to qualify as “health information”:

(1) Is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and

(2) Relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual

We know already that Massage Therapists are health care providers from the preceding section so that takes care of the first condition. For the second condition, anything recorded by the practice is health information unless the patient dropped by just to talk about the weather.

From the HIPAA definition of Covered Entity we have focused on: (3) A health care provider who transmits any health information in electronic form in connection with a transaction covered by this subchapter.

We know that Massage Therapists are health care providers and it is most likely that they discuss health information with patients. The remaining piece to determine whether HIPAA and Massage Therapists go together is transmits any health information in electronic form in connection with a transaction covered by this subchapter.

Transactions Covered by HIPAA

Again, turning the definitions contained within HIPAA (CFR 45 § 160.103 Definitions)

Transaction means the transmission of information between two parties to carry out financial or administrative activities related to health care. It includes the following types of information transmissions:

(1) Health care claims or equivalent encounter information.

(2) Health care payment and remittance advice.

(3) Coordination of benefits.

(4) Health care claim status.

(5) Enrollment and disenrollment in a health plan.

(6) Eligibility for a health plan.

(7) Health plan premium payments.

(8) Referral certification and authorization.

(9) First report of injury.

(10) Health claims attachments.

(11) Health care electronic funds transfers (EFT) and remittance advice.

(12) Other transactions that the Secretary may prescribe by regulation.

Rather than slog through each of these (and whatever #12 may entail), unless the practice is completely cash and paper (i.e., no credit cards), HIPAA and Massage Therapists go together.

HIPAA and Massage Therapy?

Yes. Massage Therapists are healthcare providers.

Yes. Massage Therapists create and receive health information as healthcare providers that relates to the past, present, and future condition and care of individuals.

Yes. Unless the practice is completely cash and paper based, there are HIPAA covered electronic transactions.

Yes. Massage Therapists must comply with HIPAA

Yes. HealthCare Too can help your Practice comply with HIPAA as well as improve its use of Health Information Technology to drive down costs and improve performance… and would enjoy the opportunity to so.

HIPAA and Massage Therapists -- HealthCare Too Service Catalog

 

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