How should covered entities respond to patients who refuse to sign the NOPP acknowledgment?

The appropriate response for covered entities when a patient refuses to sign the Notice of Privacy Practices (NOPP) acknowledgment is to document the refusal and continue care. This aligns with the regulations set forth by the Health Insurance Portability and Accountability Act (HIPAA), which stipulate that while covered entities must make reasonable efforts to obtain a patient's acknowledgment of the NOPP, refusing to sign does not permit them to withhold necessary medical services.

By documenting the refusal, the covered entity ensures they have a record of the patient's decision, which is important for compliance purposes. This documentation serves as evidence that the entity has complied with the requirement to present the NOPP, while continuing to provide care ensures that the patient receives the medical attention they need without unnecessary interruption.

Additionally, it's important to recognize that forcing a patient to sign the acknowledgment would not only violate their rights but could also lead to significant ethical and legal issues. Consulting legal counsel, while it might sometimes be prudent in complex cases, is not generally necessary for the straightforward case of a refusal to sign the NOPP. Thus, continuing care and proper documentation is the most appropriate and compliant course of action.