When it comes to HIPAA laws, it pays to know what information your sober living home needs to treat as protected health information (PHI) and what information can be transmitted without restrictions. Unlike addiction treatment centers—which almost always need to follow HIPAA laws to the letter—sober living homes have a little more variation in what they need to consider when it comes to resident privacy. Understanding where your organization falls in this spectrum is an important part of wise information management for sober living home operators.
Today, we’ll look into HIPAA laws as they apply to sober living homes in particular. We’ll answer questions like: “Is my sober living home subject to HIPAA laws?” and “What are the most common HIPAA violations at sober living homes?”
Read on to learn more about HIPAA laws at your sober living facility.
Is Your Sober Living Home a Covered Entity Under HIPAA Laws?
First thing’s first: Do HIPAA laws even apply to your sober living home at all?
It’s easy to assume that any organization dealing with addiction and recovery is subject to HIPAA laws, but that’s not actually the case.
Only organizations and individuals known as “covered entities” are subject to HIPAA laws. In general, a person, business, or agency is a “covered entity” under HIPAA laws if they are a health care provider that “furnishes, bills or receives payment” for health care AND if they send “covered transactions” electronically.
That means that if your sober living home is only billing for room and board—things that are often not considered to be “health care”—then you may not be subject to HIPAA laws.
If you’re still not sure, you can use this nifty tool to determine if your sober living home is a covered entity.
When Might Your Sober Living Home be Considered a “Covered Entity?”
There are some circumstances where your sober living home might be considered a covered entity.
For example:
Your sober living home provides and bills for addiction treatment counseling in addition to room and board
Your sober living home coordinates care with other health care providers
Your sober living home bills public or private health insurance providers for services
What About HIPAA Laws and Florida Model Sober Living Homes?
HIPAA’s interaction with sober living homes becomes even more complicated under the Florida model of addiction treatment.
Under the Florida model, business owners operate both a sober living home and an addiction treatment facility. In many cases, patients attend outpatient programs at the addiction treatment facility during the day while residing in the sober living home at night. Often, the patient’s insurance is billed for the day treatment but the resident (or the resident’s family) is responsible for room and board payments at the sober living home. There are variations to this set up but most follow this general plan.
Florida model operators should consult with their legal team about how HIPAA laws apply to the sober living homes they operate. Factors such as how the sober living home business is structured in relationship to the addiction treatment business weigh heavily on how HIPAA laws might play out in this circumstance.
Here’s the Top Ways Your Sober Living Home Could Accidentally Violate HIPAA Laws
If your sober living home is a covered entity and any of the following things happen, you could be in violation of HIPAA:
Your sober living home manager transmits PHI to a third party without the resident’s written consent
Admin includes PHI in a non-encrypted email to a patient or a patient’s family
Your organization confirms or denies a resident’s occupancy at your sober living home to a MAT program's admissions department
Your legal team releases PHI to government agencies or community groups to prove disability status of residents in an effort to invoke FHA protections for your sober living home
These examples are some of the top ways we’ve seen sober living homes violate HIPAA laws, but it’s not an exhaustive list. Be sure to consult your legal team about potential HIPAA violations at your facility.
We’re Here to Help
Better safe than sorry when it comes to HIPAA laws. If your sober living home accepts any payment for “medical services”—or if you think you might in the future, if, say, insurance companies begin reimbursing sober living homes for rental payments—then you’ll want to start following HIPAA laws now.
The Sober Living App makes it a snap to comply with all of the HIPAA laws that can apply to sober living homes. Our intuitive, all-in-one software solution for sober living homes uses the highest level of privacy available to protect your resident’s PHI from improper disclosure.
Why not test drive our system for free today?