Foreign support and HIPPA

Any Dexcom users call Tech Support and find you’re talking to a foreigner in, say, the Philippine Islands? I do, every time.
Why is Dexcom even allowed to use foreigners to talk to us about our medical issues and not violate HIPPA laws?

It’s perfectly allowed, if unfortunate. Your health information is allowed to be shared with appropriate entities in the course of doing their job, and it’s not limited to businesses/people in the US.

Do the HIPAA Rules allow a covered entity or business associate to use a CSP [Customer Service Provider] that stores ePHI on servers outside of the United States?


Yes, provided the covered entity (or business associate) enters into a business associate agreement (BAA) with the CSP and otherwise complies with the applicable requirements of the HIPAA Rules. However, while the HIPAA Rules do not include requirements specific to protection of electronic protected health information (ePHI) processed or stored by a CSP or any other business associate outside of the United States, OCR notes that the risks to such ePHI may vary greatly depending on its geographic location. In particular, outsourcing storage or other services for ePHI overseas may increase the risks and vulnerabilities to the information or present special considerations with respect to enforceability of privacy and security protections over the data. Covered entities (and business associates, including the CSP) should take these risks into account when conducting the risk analysis and risk management required by the Security Rule. See 45 CFR §§ 164.308(a)(1)(ii)(A) and (a)(1)(ii)(B). For example, if ePHI is maintained in a country where there are documented increased attempts at hacking or other malware attacks, such risks should be considered, and entities must implement reasonable and appropriate technical safeguards to address such threats.


There are diabetics all over the world.
If all the support people were in the USA then people in other nations might have the same complaint.
These companies are world wide and have customers world wide. We shouldn’t expect them to be in the USA necessarily.

Add that to the fact that American employees are much much more expensive than outside the USA. It’s just a fact.

As far as Hippa is concerned, if an employee of the company that you are using has access to your information it’s totally acceptable as needed.
It doesn’t matter where that employee lives or if he or she has an accent. Or what race he or she is.

They are foreigners to us but we are foreigners to them too.

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Once in a while I get into a conversation with the Dexcom reps and I enjoy hearing about life in the Philippines. One young guy was telling me about his mom who is a diabetic and on a kidney machine, but still is the center of the family. His sister is a physician.

I am calling a company about my CGM, so of course the reps realize that I am a diabetic. That doesn’t bother me at all.

I was going through cancer treatment when the Hippa law first came out. So, one day, I’m checking in for a CT scan and the receptionist hands me this several page paper that I’m supposed to sign. Since I never used to sign anything without first reading it completely, I read the entire thing.

What I got from it? As near as I can tell, nearly everyone in the universe can get your medical information except for you, yourself.


Isn’t THAT the truth?!!

I haven’t called dexcom in years…what do you talk about?

My G6 sensors often fail so I have to get new ones. Now my receiver isn’t working well, so they are sending me another one. Once my transmitter quit working so I needed a new one.

I hope that I have better luck with the G7.

Kind of an uphill battle but just so y’all know, it’s HIPAA not HIPPA.

Health Insurance Portability and Accountability Act


my topic was not about race or language.

Being HIPAA was devised by government, we shouldn’t be surprised. There is far less certainty our medical info is preserved outside the U.S. China undertook an ongoing campaign to collect as much medical data about people from other countries as it can get. It’s a concern to many in Congress but no legislation has been enacted to end that practice in the U.S.