Medical. Is it legal to treat someone without reporting it to the US government? I have a friend that wants to treat me, but is highly concerned about doing so "off the clock" if you will. He's an oncologist for a large Hospital and is forbidden from doing work outside of the hospital as it could damage their reputation if a doctor were to "damage" someone outside of work hours. My main question is aside from his employer, could he legally treat me without reporting back or keeping it off the books? I don't want to get him in legal trouble, but I also don't really know the legalities and procedure of this. He's only been working for the hospital for 2 years and they apparently don't go over legal matters in school. If anyone could point me in the right direction or link me to anything I would highly appreciate it. "To add to this, he is a fully licensed and certified M.D. / D.O." I didn't want it to sound shady or anything, I just want him to be my private doctor, rather than someone I don't know.
There is no general law requiring a doctor to report to the government that they have given medical treatment. On the contrary, there is a federal rule (the "Privacy Rule") that somewhat requires keeping medical information private. There may be certain instances where a report must be made, such as the obligation to report gunshot wounds or suspected child abuse. There could be entanglements regarding use of drugs that require a prescription, where there is a required paper trail.
Yes, in Ukraine, it is legal for doctors to prescribe it, for pharmacies to sell it if prescribed, and for patients to buy it. It is registered with the State Register of Medicines of Ukraine. I’ve seen published cases where the facts mention prescriptions and sales in 2020. It is also frequently supplied through public procurement (as Hydazepam or Gidazepam). As you already noticed, hydazepam is not on the effective list of narcotics, psychotropic substances, and precursors by the Cabinet of Ministers of Ukraine. I’ve even encountered a recent court decision citing an expert report from the end of 2019 stating that it doesn’t belong to them under the list which was effective then. In 2019, a procedure was adopted for determining analogous substances, which reproduce the psychoactive effects of the drugs from the above-mentioned list. But no list of such analogous substances has been published yet. According to the effective procedure, the list must be published at the website of CMHMDAMH.
HIPAA does not legally protect physicians from disclosing PHI to another party, although there are a few exceptions: HHS provides an excellent resource on these, but the regulation most relevant to your question is Permitted Uses and Disclosures (5) Public Interest and Benefit Activities, which includes "Required by Law. Covered entities may use and disclose protected health information without individual authorization as required by law (including by statute, regulation, or court orders)." These statues, regulations, and court orders vary from state, but almost all of them refer to STDs and not genetic conditions (in some states, physicians are required to disclose positive STD test results to known sexual partners, but I can't find similar legislation for genetic tests). Here's an example of a voluntary patient information disclosure form – you'll notice that an individual has to specify the parties to whom they're willing to have PHI disclosed. The example you provided is still a violation of the Privacy Rule in the U.S., but this is a very curious grey area in bioethics and law. Disclosure of Genetic Information Within Families: How nurses can facilitate family communication. Gallo et al. Am J Nurs. 2009 Apr; 109(4): 65–69. (Emphasis mine.) HIPAA and Genetic Disclosure Does the law affect families? The privacy rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) went into effect on April 14, 2003. The rule created new requirements for health care providers, third-party payers, and health care clearinghouses to protect the privacy and security of health information, including genetic information, that could identify a person. A person's decision not to disclose her or his risk of developing a genetic condition to a family member may pose a dilemma for the health care professional, who has to choose between ethical obligations to inform the at-risk party and legal requirements to respect and protect the patient's privacy. The potential for harm to family members often plays a large role in the decision. For example, in rare cases, the use of a certain surgical anesthesia can cause death in people with the mutation that disposes them to malignant hyperthermia. Likewise, strenuous exercise can bring on sudden death in people with hypertrophic cardiomyopathy. In such cases, clinicians should carefully explain the reasons for sharing information with family members, strongly encourage patients to notify at-risk relatives, and offer to help develop a plan for notifying them. When patients choose not to notify family members, clinicians typically respect the decision. There are situations, however, in which the clinician may consider overriding the patient's preferences because the family member is judged to be in danger of serious or immediate harm or there is a high likelihood that a dangerous condition will occur that can be either prevented or adequately treated with early recognition. Clinicians who believe it is necessary to override a patient's wish regarding the notification of family members, should consider consulting an ethics committee or legal council. In most situations, though, the risk of serious harm associated with nondisclosure is not clearly immediate. For instance, if a woman has tested positive for the BRCA1 or BRCA2 mutation but doesn't want to upset her two sisters by sharing that information with them, the need for disclosure isn't clearly urgent. Each sister has a one in two chance of carrying the same mutation. It would be understandable for the patient to try to learn more about what the mutation means for her and her children and to give careful thought to whether and how she'll share her test results with her sisters. Clinicians can best help family members by clearly informing patients who test positive for genetic conditions or the mutations that cause them about the risks faced by their family members, discussing the value of disclosure and offering assistance with it. The "Duty to Warn" a Patient's Family Members About Hereditary Disease Risks. Offit et al. JAMA. 2004;292(12): 1469–1473. (I can send you the full-text of this if you want it; it contains an excellent overview of cases and their outcomes relating to disclosing genetic information in the U.S. under HIPAA.) In general, the special nature of genetic tests has been viewed as a barrier to physicians' breaching the confidentiality of personal genetic information. However, the failure to warn family members about hereditary disease risks has already resulted in 3 lawsuits against physicians in the United States. While the findings of case law and the state and federal statutes that bear on the issue of "duty to warn" of inherited health risk are still being defined, we believe that health care professionals have a responsibility to encourage but not to coerce the sharing of genetic information in families, while respecting the boundaries imposed by the law and by the ethical practice of medicine. ...in considering whether to breach patient confidentiality to warn of risks of a genetic disease, clinicians need to balance the actual risk of that disease, the efficacy of potential preventive interventions, as well as emerging legal considerations and potential liabilities. Overriding patient confidentiality and genetic privacy might very well mean violation of HIPAA and certain state regulations, with attendant civil or criminal liability. At the same time, in one state appellate court decision that has not been overturned, the estate of a physician was held liable for his failure to warn relatives of hereditary disease risk.
All laws (federal, state and local) apply to everybody, unless you have diplomatic immunity. That is, unless e.g. the federal government decides as a matter of policy to ignore certain federal laws. California does not have a law generally prohibiting the use of marijuana, though public consumption is illegal, minor consumption is illegal, and possession over 28.5 grams is illegal. So that is one less law to be concerned with violating. The federal law still exists, and has not been repealed for anyone. However, the federal government by policy is not pursuing marijuana cases in legal contexts in those states that have legalized marijuana. The complication for foreign students is that there are also immigration laws whereby you may be deported for a drug offense (that link is full of technical details on immigration and drug laws, worth reading). The immigration laws basically make it easy to penalize a foreigner (for example you might be deemed "inadmissible" so you cannot be re-admitted to the US if you leave; it just depends on what their grounds are for action). For example, "a noncitizen is inadmissible as of the moment that immigration authorities gain substantial and probative 'reason to believe' the noncitizen has ever participated in drug trafficking," which does not mean a conviction. It is reported that in California, DHS officers have treated minor infractions as "convictions," which means to be safe you have to avoid even infractions. It appears (and hire an immigration attorney if you want to test this) that trouble only arises if there is reason to believe you are trafficking, if you are a drug addict or abuser, if you are "convicted" (not necessarily "tried and found guilty," it also includes certain legal maneuverings), or if you admit to drug use (even in the case of home use under doctor's orders, i.e. a California-legal context). This incidentally includes non-use but working for the marijuana industry. It is possible that you could get stopped on the street by a random immigration search, and if you are in possession, then... it is not guaranteed that possession of a small amount of marijuana, when caught by federal authorities, cannot lead to immigration problems.
Doctors are obliged to act in the best interest of their patients. If it would be in your best interest to see another doctor (due to the doctor being out of practice for that particular diagnosis), your current doctor would be obligated to tell you and refuse treatment. The physician‑patient relationship is fiduciary in nature and certain duties arise from that special relationship of trust and confidence. These include the duties of the doctor to act with utmost good faith and loyalty[.] MvInerney v. MacDonald Now, onto your question about the counselors assessment; probably not worth it's weight in salt. They likely have little to no training regarding diagnostic medicine and are by no means an expert.
You give no jurisdiction but in general: First, police have no obligation to be honest. So, yes they can collect this without consent by e.g. taking hair from your hairbrush (with a warrant) or giving you a glass of water while interviewing you and getting it from your fingerprint oils (which may not actually be technically possible but never mind that). No, they can't take it by "force" by sticking a swab in your mouth. Yes, it will almost certainly go into a database. Of course, there are some jurisdictions where police are entitled to decide you are guilty based on the fact that you didn't pay them a bribe.
HIPAA imposes obligations on some people, but not all people. In the case of security and privacy questions, you would consult 45 CFR Part 164. A patient's actions are not subject to government sanctions, so a patient can provide or decline to provide email addresses following their own judgment. A healthcare or insurance provider would be required to securely keep PII under wraps. The regulations also do not impose obligations on unknowing potentially involved third-parties, i.e. no obligation is imposed on Google to know that an individual is using a Gmail account to transmit PII-related information. The medical provider has an obligation to store and transmit such information securely, which would mean for example that they do not send insecure plain text emails saying &quot;Sally Jones at 12345 67th Ave SW was treated for a loathsome disease, we're coding that as 0102, and we want $500&quot;. That obligation is passed on to employees via employment-contractual obligations, for example that may dictate what computer or software you can use to do the job. If the provider passes the buck to the employee (and I assume that the employee is just an employee), they have violated the security rule. In that case, they may be attempting to mitigate the consequences of their actions or at least check if there were identifiable violations of the privacy rule. In the scenario where SmithMed provides all of the infrastructure needed to bill insurance companies, it is not a HIPAA violation to inspect computer logs, email etc. to verify that the employee has been complying with security and privacy policies. It would likewise not be a HIPAA violation to inspect third-party accounts (Gmail etc) to determine whether there has been a security / privacy rule violation. That is as far as HIPAA takes you. Whether or not the ex-employee has an obligation to turn over their email account information is mostly determined by the employment contract, but it is highly unlikely that any such contract has a &quot;gimme your personal email on termination&quot; clause. It is not inconceivable that the employee negligently used their personal account rather than opening a new billing-job only account. Also depending on the email service provider, it may well be a violation of the terms of service to hand over your account information. (Instead, for a certain email provider, the company is expected to set up and pay for a company account). Those are considerations bearing on possible legal impediments to turning over the email information. Needless to say, don't share passwords etc. because that exposes you legally, but that is not about HIPAA.
You may not assault a violator, you may notify the authorities. If your state has passed a law making it a felony to be outside without a mask, you can perform a citizen's arrest (but no state has such a law). So you cannot take the law into you own hands, and you run the risk of being arrested on felony assault charges if you do. There is always a significant risk that you are wrong about whether the order applies to a particular individual. You can always file a lawsuit, but you'd be in highly-experimental legal territory in terms of succeeding, specifically the claim that the person endangered your health (you can't sue on behalf of others, except e.g. as a parent on behalf of harm done to a child). For instance, nobody has successfully sued another person for going out in public having the flu on the grounds that they unreasonably put plaintiff at risk. You would have to experiment with that argument, to show that going out with a mask is reasonable and going out without a mask is unreasonable.