med insurance, HIPPA and SMs

[nala_mia8]

BM and SD live in OH, DH and SM live in TX.

I (the SM) am considering adding SD to my medical insurance since BM told us SD isn't covered when she is outside the state of OH. I composed an email, sent it to her, and BM had 1 concern that I wanted to run by you. I hope this is OK by your guidelines, I know DH is supposed to post about most issues, but since this is my medical insurance, I hope this is the proper format.

I don't know anything about how HIPPA, medical insurance and a stepparent fit together. This is BM's concern, "Without the legal standing as a parent I don't know if you can process claims or even claim her as a dependant. I don't want her claims to be denied simply because you don't have the legal authority to ask. I don't mean that as an insult, just a reality with HIPPA."

I think I can add her to my plan (still checking), I have no desire to claim her as a dependent, and I'm pretty sure I can process claims and ask about claims on her behalf since it's MY insurance. SD will see our son's pediatrician (only for sick kid appts when she's with us), DH and I would both sign the HIPPA document and the insurance card is in my name. DH is self-employed, so I carry my entire family on my medical insurance.

Question:
I can understand me not being able to call BM's insurance, but I should have full rights to anyone on MY insurance, right? Not sure how HIPPA comes into play in this situation.

Thanks!

[4honor]

What we have done in the past is that I have a duly sworn and notarized Limited power of attorney on SS that is current until SS turns 18. We have given copies of this to the insurance company and to any/all doctors, school etc. That way, they will speak with me if DH is unavailable and there has never been any problems, even when I was military. This has been in place for about 9 years.

The "LIMIT" is for all things pertaining to SS (DH has joint legal custody.) I can't go out and sell our house without him, as I have no power of attorney to do so - just with regard to SS. BM balked at first, but later realized that if she or DH were unable to sign for medical consent for SS I would be able to -- and more likely to understand the risks invovled.

As for placing a child on a step parent's insurance, I have never seen an instance where it has been refused, so long as the bio-parent/spouse is also on the insurance.

I am not an attorney. I give my experience as anecdotal and not legal advice.

[socrateaser]

>Question:
>I can understand me not being able to call BM's insurance, but
>I should have full rights to anyone on MY insurance, right?

What 4 honor said is correct. The issue with HIPPA is that in order to process the claim, the insurer needs authorization to access medical information for a child that is not your legal dependent.

So, as long as you can get authorization from your husband, assuming he has joint custody and the legal right to authorize access, then you should be okay.

[nala_mia8]

yes, DH has joint legal (that's what they call it in TX), so he has the authority to give me access.

thanks!

[I cry_ in_the_dark]

"So, as long as you can get authorization from your husband, assuming he has joint custody and the legal right to authorize access, then you should be okay."

In the same respect, what constitutes authorization?

The school has an authorization to provide certain medications, ie, tylenol, cough drops etc, to children. This authorization is signed by the step-mom, who has neither legal custody nor power of attourney. Joint legal custody exists between mother and father.

The issue is, one of the children was recently diagnosed as having an allergy to phenyl...a common medication in cold medicines, also found in cough drops.

So, to follow format...
1. What constitutes authorization? Is the authorization signed by step mom legal (just because he said she could?)

2. Is there a way to tactfully advise the school that they have authorization from someone that has no legal right to give that authorization?

3. Is there a tactful way to advise the school that I will not hesitate to sue their behinders if they administer a cough drop to my child and he has a reaction?

4. Or...am I out of line?

[socrateaser]

>So, to follow format...
>1. What constitutes authorization? Is the authorization signed
>by step mom legal (just because he said she could?)

Maybe (probably not). Spouses are considered partners. Partners are agents of their partnership and have actual implied authority to act on behalf of the partnership. A minor child is under the custodial authority of the parent, thus the parent's new spouse can act as parent's agent to authorize certain activities for the child on behalf of the other parent.

However, a child is not not an asset, like a car or a bank account, so it is doubtful that the scope of agency authority implied by the marriage extends to control and custody of the child, especially in the face of a court order expressly describing custodial rights.

However, the stepmom can claim to have authority, and having done so, thereby acts with apparent agency authority for her spouse, and the school will not be liable for acts not authorized by a parent or agent wih actual custodial authority.

The stepparent may be liable for breach of the warranty of authority, which is an action asserted outside of the scope of agency, which is not binding on the principal/parent.

But, here, we are once again dealing with a child, not money or property, so the lines of what the agent/stepmom can do are blured substantially, because there's nothing to claim a recovery for by someone injured by this possibly unlawful usurpation of authority.

The point of the above discussion is to show how muddy all of this really is. The stepparent probably has no authority, but what of it, unless the child is injured by the stepparent's actions, there's no cause of action for which a court can grant relief.
>
>2. Is there a way to tactfully advise the school that they
>have authorization from someone that has no legal right to
>give that authorization?

Well, it's up to you to be tactful, but you could tell them that if the child is injured during activities authorized by a stepparent with no lawful authority, that you will not hesistate to sue the school for negligence, and they will have no defense whatsoever, no matter what amount of reasonable care they may have used with respect to the activity itself.

>3. Is there a tactful way to advise the school that I will not
>hesitate to sue their behinders if they administer a cough
>drop to my child and he has a reaction?

See above.

As for being "out of line," I don't know -- you're probably more than a little emotional about the situation, but I can't tell if it's justified or not in this instance.