Does HIPAA Apply to Doulas?

Does HIPAA Apply to Doulas?

As a doula, it is critical that your clients feel they can trust you and be vulnerable with you, whether it is in the delivery room or during a discussion. Your job as a doula is to gain and keep your client’s trust, and how you do that is part of your unique offering. But there are also laws around privacy- namely HIPAA, the Health Insurance Portability Accountability Act, which protects patients’ rights. HIPAA is often misunderstood, and there is a pervasive myth that doulas are subject to this law. Is that true? And should you be worried about violating HIPAA in your doula work?

What is HIPAA?

HIPAA, the Health Insurance Portability Accountability Act, is a law in the United States that relates to electronic communications and personal records. This law covers a range of topics, but the most well known is protection of patient privacy. The 1996 law requires Health and Human Services to set standards for electronic health care transaction, set codes, identifiers, and security. As technology grew the law was an acknowledgment that it may impact patients’ privacy and a way to set standards to protect it.

HIPAA applies explicitly to health plans, health care clearing houses, certain healthcare providers, and their business associates – as long as they transmit information in an electronic form in connection with a transaction that has an HHS standard.

Doulas and HIPAA

The definition of HIPAA explicitly cites certain healthcare professionals as being subject to the laws. Doulas, whether labor or postpartum doulas, are not included in these specifications. As a rule, doulas should not be performing any medical tasks that would qualify them as a medical provider.

Doulas also rarely are involved in the transactions that HIPAA sets standards around. These transactions are administrative and include things like enrollment or disenrollment in a health plan, coordination of benefits, and referral authorization. Because doulas are rarely covered by insurance directly, these transactions are generally not of concern.

Confidentiality and Ethics

The lack of inclusion in HIPAA means that doulas are not held to certain standards surrounding a specific set of electronic transactions and communications. However, this does not mean doulas don’t have an ethical obligation to practice confidentiality with their patients. In fact, many certifying organizations have a Code of Conduct that doulas sign in which they agree to maintain the privacy of clients.

With the exception of scenarios where a life is at risk or another emergency, a doula should never share what their client has told them in confidence. This connection maintains ethical guidelines of certifying organizations, but more importantly, it helps clients feel safe and heard by their doula.

It is also critical to protect any client data you do have, even if it is not specified by HIPAA. Any devices where you store data, or applications like Birthbase, should be password protected and kept in safe locations. As a part of contracting, you can get permission to use photos or information on social media, but clients should always be able to opt out. Management of all client materials will show your professionalism and improve your relationship with clients.