Accounting for disclosures to health oversight agencies and law enforcement officials must be temporarily suspended on their written representation that an accounting would likely impede their activities.
Restriction Request. A covered entity that does agree must comply with the agreed restrictions, except for purposes of treating the individual in a medical emergency.
Confidential Communications Requirements. Health plans and covered health care providers must permit individuals to request an alternative means or location for receiving communications of protected health information by means other than those that the covered entity typically employs. Similarly, an individual may request that the provider send communications in a closed envelope rather than a post card. Health plans must accommodate reasonable requests if the individual indicates that the disclosure of all or part of the protected health information could endanger the individual.
Any covered entity may condition compliance with a confidential communication request on the individual specifying an alternative address or method of contact and explaining how any payment will be handled. HHS recognizes that covered entities range from the smallest provider to the largest, multi-state health plan. Therefore the flexibility and scalability of the Rule are intended to allow covered entities to analyze their own needs and implement solutions appropriate for their own environment.
Privacy Policies and Procedures. A covered entity must develop and implement written privacy policies and procedures that are consistent with the Privacy Rule. Privacy Personnel. Workforce Training and Management. Workforce members include employees, volunteers, trainees, and may also include other persons whose conduct is under the direct control of the entity whether or not they are paid by the entity. A covered entity must mitigate, to the extent practicable, any harmful effect it learns was caused by use or disclosure of protected health information by its workforce or its business associates in violation of its privacy policies and procedures or the Privacy Rule.
Data Safeguards. A covered entity must maintain reasonable and appropriate administrative, technical, and physical safeguards to prevent intentional or unintentional use or disclosure of protected health information in violation of the Privacy Rule and to limit its incidental use and disclosure pursuant to otherwise permitted or required use or disclosure.
See additional guidance on Incidental Uses and Disclosures. A covered entity must have procedures for individuals to complain about its compliance with its privacy policies and procedures and the Privacy Rule. Among other things, the covered entity must identify to whom individuals can submit complaints to at the covered entity and advise that complaints also can be submitted to the Secretary of HHS.
Retaliation and Waiver. A covered entity may not retaliate against a person for exercising rights provided by the Privacy Rule, for assisting in an investigation by HHS or another appropriate authority, or for opposing an act or practice that the person believes in good faith violates the Privacy Rule. Documentation and Record Retention. A covered entity must maintain, until six years after the later of the date of their creation or last effective date, its privacy policies and procedures, its privacy practices notices, disposition of complaints, and other actions, activities, and designations that the Privacy Rule requires to be documented.
The only administrative obligations with which a fully-insured group health plan that has no more than enrollment data and summary health information is required to comply are the 1 ban on retaliatory acts and waiver of individual rights, and 2 documentation requirements with respect to plan documents if such documents are amended to provide for the disclosure of protected health information to the plan sponsor by a health insurance issuer or HMO that services the group health plan.
The Rule contains provisions that address a variety of organizational issues that may affect the operation of the privacy protections.
Hybrid Entity. A covered entity that does not make this designation is subject in its entirety to the Privacy Rule. Affiliated Covered Entity. Legally separate covered entities that are affiliated by common ownership or control may designate themselves including their health care components as a single covered entity for Privacy Rule compliance.
An affiliated covered entity that performs multiple covered functions must operate its different covered functions in compliance with the Privacy Rule provisions applicable to those covered functions. Organized Health Care Arrangement.
A covered entity that performs multiple covered functions must operate its different covered functions in compliance with the Privacy Rule provisions applicable to those covered functions. Group Health Plan disclosures to Plan Sponsors. Personal Representatives. The Privacy Rule permits an exception when a covered entity has a reasonable belief that the personal representative may be abusing or neglecting the individual, or that treating the person as the personal representative could otherwise endanger the individual.
Special Case: Minors. In most cases, parents are the personal representatives for their minor children. Therefore, in most cases, parents can exercise individual rights, such as access to the medical record, on behalf of their minor children. In certain exceptional cases, the parent is not considered the personal representative. In these situations, the Privacy Rule defers to State and other law to determine the rights of parents to access and control the protected health information of their minor children.
See additional guidance on Personal Representatives. In general, State laws that are contrary to the Privacy Rule are preempted by the federal requirements, which means that the federal requirements will apply. Exception Determination. In addition, preemption of a contrary State law will not occur if HHS determines, in response to a request from a State or other entity or person, that the State law:.
The Department of Health and Human Services, Office for Civil Rights OCR is responsible for administering and enforcing these standards and may conduct complaint investigations and compliance reviews. Consistent with the principles for achieving compliance provided in the Privacy Rule, OCR will seek the cooperation of covered entities and may provide technical assistance to help them comply voluntarily with the Privacy Rule. Covered entities that fail to comply voluntarily with the standards may be subject to civil money penalties.
In addition, certain violations of the Privacy Rule may be subject to criminal prosecution. These penalty provisions are explained below. Civil Money Penalties. OCR may impose a penalty on a covered entity for a failure to comply with a requirement of the Privacy Rule.
Penalties may not exceed a calendar year cap for multiple violations of the same requirement. When may a covered entity use or disclose a patient's PHI with another person? Generally speaking, covered entities may disclose PHI to anyone a patient wants. If the patient is deceased , the provider may disclose protected health information to the people who were involved in the patient's care or payment prior to death. The only exception to this is when the provider knows that disclosing the information violates a preference that the patient previously expressed.
How much health information may a covered entity disclose? When a covered entity discloses information to another person, HIPAA states that the information should be relevant to that person's involvement in the patient's health care. For example, if a patient is incapable of agreeing, a provider might discuss payment for the treatment with another person directly involved in paying for the care. The U. A covered entity does not need patient authorization to use or disclose certain protected health information PHI to a business associate or an institutionally related foundation to raise funds for its own benefit.
Each time it makes a fundraising communication, a covered entity must provide a "clear and conspicuous" opportunity to opt out of receiving further communications. However, individuals should pay attention to the scope of the opt out each time they receive one. A covered entity can exercise discretion over whether to apply an opt out to a specific campaign or to all fundraising in general.
Opt outs may not be too burdensome on the individual or cost more than a nominal amount of money. A covered entity's notice of privacy practices must also state that it may contact the individual to raise funds for the covered entity but that the individual has a right to opt out of receiving the communications. The Privacy Rule prohibits most health insurers from using or disclosing genetic information for underwriting purposes such as determining eligibility or setting the cost of premiums.
This prohibition applies to group health plans such as employer sponsored plans , health insurance issuers including HMOs , and issuers of Medicare supplemental policies. It does not apply to long-term care insurers. The World Privacy Forum also has genetic privacy resources.
Posted: Jul 01 Revised: Jul 24 Introduction Medical information uses and disclosures: basics a. What is a notice of privacy practices? What does it mean to "consent" versus "authorize"? What is the "minimum necessary" standard? Does the Privacy Rule apply to protected health information after death? Treatment, payment and health care operations b. Business associates c. Other disclosures that do not require patient consent When must a covered entity obtain patient authorization?
Marketing and patient authorization c. We may disclose your PHI in the course of a judicial or administrative proceeding, in response to an order of a court or administrative tribunal, or in certain conditions in response to a subpoena, discovery request, or other lawful process. Law Enforcement. We may disclose your PHI to a law enforcement official for law enforcement purposes.
These disclosures include the following purposes: 1 Disclosures pursuant to legal processes and as otherwise required by law; 2 disclosures of limited information for identification and location of a suspect, fugitive, material witness, or missing person; 3 disclosures about an individual who is suspected to be a crime victim; 4 disclosure if there is suspicion that a death occurred as a result of a crime; 5 disclosure if we believe that a crime has occurred on our premises; and 6 disclosures which are related to reporting a crime in response to or during a medical emergency.
Information about Deceased Individuals. We may disclose PHI to a coroner or medical examiner for identification purposes, determining cause of death, or for other duties required by law.
We are required to protect you health information for 50 years following your death. Organ Donation. We may disclose PHI as necessary to facilitate organ, eye, or tissue donation and transplantation.
In some instances, we may disclose your PHI for research purposes. All research projects which use PHI are subject to a special approval process which will, among other things, evaluate the precautions used to protect patient medical information. In many cases, information which identifies you will be removed. Workers' Compensation. We may disclose your PHI as authorized to comply with workers' compensation laws and other similar programs. Threats to Health or Safety.
We may disclose limited PHI if we believe it is necessary to prevent or lessen a serious and imminent threat to you or to the public. Specialized Government Functions. We may disclose your PHI for the following government functions: 1 Military and veterans activities, including information relating to armed forces personnel for the execution of military missions, separation or discharge from military services, veterans benefits, and foreign military personnel; 2 National security and intelligence activities; 3 Protective services for the president and others; 4 Medical suitability determinations; 5 Correctional institutions and other law enforcement custodial situations, including information about inmates of correctional facilities if necessary to protect the health and safety of the inmate or others; and 6 government programs providing public benefits as authorized by law and for purposes of sharing eligibility or enrollment information or for other covered functions.
Other uses and disclosures of your PHI will be made only with your written authorization unless otherwise permitted or required by law. These include:. Psychotherapy notes. These are notes made by a mental health professional documenting conversations during private counseling sessions or in joint or group therapy. Request Demo. Sarah Badahman Disclosures , Privacy. Share on facebook Facebook. Share on twitter Twitter. Share on linkedin LinkedIn.
Acceptable operations disclosures include: Ensuring patient safety Developing protocol Completing training or compliance programs Conducting quality assessments and improvement activities Detecting fraud and abuse Planning business activities and development Furthermore, besides TPO disclosures, there are other situations when sharing PHI is okay.
Compliance is complicated.
0コメント