what are hipaa's special requirements for disclosing protected health information? course hero

by Claude Greenfelder 5 min read

What information can a covered entity disclose under HIPAA?

Jan 02, 2022 · HIPAA requires physical, technical, and administrative safeguards to be implemented. Technologies such as encryption software and firewalls are covered under technical safeguards. Physical safeguards for PHI data include keeping physical records and electronic devices containing PHI under lock and key.

What are the rules for uses and disclosures of protected health information?

Apr 14, 2003 · HIPAA Procedure 5031 - Authorization Requirements for Use and Disclosure of Protected Health Information, Including Verification of Identification Page 3 Version 12-17-2020 communications or records determines that the disclosure is needed to accomplish the objectives of diagnosis or treatment and the patient is informed of the disclosure;

Who is covered by the security rule under HIPAA?

A covered entity is required to disclose protected health information: (i) To an individual, when requested under, and required by § 164.524 or § 164.528; and (ii) When required by the Secretary under subpart C of part 160 of this subchapter to investigate or determine the covered entity's compliance with this subchapter.

What are the physical and technical safeguards required under the HIPAA?

Summary of the HIPAA Security Rule. This is a summary of key elements of the Security Rule including who is covered, what information is protected, and what safeguards must be in place to ensure appropriate protection of electronic protected health information. Because it is an overview of the Security Rule, it does not address every detail of ...

What are HIPAA's special requirements for disclosing protected health information in regard to privacy and release of information?

Individuals have the right to request that a covered entity restrict use or disclosure of protected health information for treatment, payment or health care operations, disclosure to persons involved in the individual's health care or payment for health care, or disclosure to notify family members or others about the ...Dec 28, 2000

What is required for releasing protected health information?

You must ensure that release of PHI is only granted with permission from the appropriate individual. Staff should be trained to ask for verification of the identity and the authority of the individual making the request.Jul 2, 2019

What are the authorization requirements for use and disclosure of protected health information?

An authorization must specify a number of elements, including a description of the protected health information to be used and disclosed, the person authorized to make the use or disclosure, the person to whom the covered entity may make the disclosure, an expiration date, and, in some cases, the purpose for which the ...

What is a disclosure of protected health information for the purpose of treatment?

An authorization is a detailed document that gives covered entities permission to use protected health information for specified purposes, which are generally other than treatment, payment, or health care operations, or to disclose protected health information to a third party specified by the individual.

What are the 8 requirements of a valid authorization to release information?

Valid HIPAA Authorizations: A ChecklistNo Compound Authorizations. The authorization may not be combined with any other document such as a consent for treatment. ... Core Elements. ... Required Statements. ... Marketing or Sale of PHI. ... Completed in Full. ... Written in Plain Language. ... Give the Patient a Copy. ... Retain the Authorization.Nov 25, 2014

What are the three rules of HIPAA?

The three components of HIPAA security rule compliance. Keeping patient data safe requires healthcare organizations to exercise best practices in three areas: administrative, physical security, and technical security.

When HIPAA requires authorization to disclose information the authorization must what?

The core elements of a valid authorization include: A meaningful description of the information to be disclosed. The name of the individual or the name of the person authorized to make the requested disclosure. The name or other identification of the recipient of the information.

What is HIPAA compliant authorization?

HIPAA authorization is consent obtained from a patient or health plan member that permits a covered entity or business associate to use or disclose PHI to an individual/entity for a purpose that would otherwise not be permitted by the HIPAA Privacy Rule.Oct 9, 2021

What does HIPAA's minimum necessary and related standards require of healthcare workers?

When the HIPAA “Minimum Necessary” Standard Applies That includes uses, requests, and disclosures of physical PHI such as charts and medical images, electronic copies of protected health information such as the information stored in EHRs, and also verbal disclosures.Jan 15, 2021

What four items must be included in a record of disclosures of protected health information?

It must be signed and dated. It must be written in plain language. It must have an expiration date. It must state the right to refuse authorization.

How many permitted uses and disclosures of protected health information are there?

12 nationalThe Privacy Rule allows the use and disclosure of PHI without authorization, and without providing and opportunity to agree or object for 12 national priority purposes. These are permitted, though not required by the Rule due to the important uses made of health information.Nov 4, 2018

What is purpose of disclosure?

The purpose of disclosure is to make available evidence which either supports or undermines the respective parties' cases.

What is the difference between PII, PHI, and IIHA?

PII is Personally Identifiable Information that is used outside a healthcare context, while PHI (Protected Health Information) and IIHA (Individual...

Would patient information such as “Mr. Brown from New York” be considered PHI?

Although there could be thousands of Mr. Browns in New York, there is likely no more than a handful of Mr. Kwiatowskis in Crivitz, WI. As it would...

Are email addresses that don´t reveal a person´s name considered identifiers for PHI purposes?

It is quite simple to find out who an email address such as “[email protected]“ belongs to by doing a little research on social media or using a re...

What is the difference between an allowable disclosure of PHI and an incidental disclosure?

Covered entities are allowed to disclose PHI for treatment, payment, and health care operations. An incidental disclosure is a secondary, accidenta...

How do you determine what a reasonably anticipated threat to PHI is?

All covered entities and business associates are required to conduct frequent risk analyses in order to identify threats to the integrity of PHI. I...

What is the summary of the HIPAA Privacy Rule?

This is a summary of key elements of the Privacy Rule including who is covered, what information is protected, and how protected health information can be used and disclosed. Because it is an overview of the Privacy Rule, it does not address every detail of each provision. Summary of the Privacy Rule PDF - PDF.

What is protected health information?

The Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic , paper , or oral. The Privacy Rule calls this information "protected health information (PHI).".

What is a privacy practice notice?

Privacy Practices Notice. Each covered entity, with certain exceptions, must provide a notice of its privacy practices. 51 The Privacy Rule requires that the notice contain certain elements. The notice must describe the ways in which the covered entity may use and disclose protected health information. The notice must state the covered entity’s duties to protect privacy, provide a notice of privacy practices, and abide by the terms of the current notice. The notice must describe individuals’ rights, including the right to complain to HHS and to the covered entity if they believe their privacy rights have been violated. The notice must include a point of contact for further information and for making complaints to the covered entity. Covered entities must act in accordance with their notices. The Rule also contains specific distribution requirements for direct treatment providers, all other health care providers, and health plans. See additional guidance on Notice.

What is covered entity authorization?

A covered entity must obtain the individual’s written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule. 44 A covered entity may not condition treatment, payment, enrollment, or benefits eligibility on an individual granting an authorization, except in limited circumstances. 45

What is administrative simplification?

Collectively these are known as the Administrative Simplification provisions. HIPAA required the Secretary to issue privacy regulations governing individually identifiable health information, if Congress did not enact privacy legislation within three years of the passage of HIPAA.

What is the minimum necessary requirement?

Minimum Necessary. A central aspect of the Privacy Rule is the principle of “minimum necessary” use and disclosure. A covered entity must make reasonable efforts to use, disclose, and request only the minimum amount of protected health information needed to accomplish the intended purpose of the use, disclosure, or request. 50 A covered entity must develop and implement policies and procedures to reasonably limit uses and disclosures to the minimum necessary. When the minimum necessary standard applies to a use or disclosure, a covered entity may not use, disclose, or request the entire medical record for a particular purpose, unless it can specifically justify the whole record as the amount reasonably needed for the purpose. See additional guidance on Minimum Necessary.

What is hybrid entity?

The Privacy Rule permits a covered entity that is a single legal entity and that conducts both covered and non-covered functions to elect to be a “hybrid entity.” 77 (The activities that make a person or organization a covered entity are its “covered functions.”.

What is Yale's disclosure policy?

Except for reports of child abuse or neglect permitted as a disclosure to a public health authority or other appropriate government authority authorized by law to receive reports of child abuse or neglect, Yale may disclose protected health information about an individual whom Yale reasonably believes to be a victim of abuse, neglect, or domestic violence to a government authority , including a social service or protective services agency, authorized by law to receive reports of such abuse, neglect, or domestic violence:

What is a psychotherapy note?

These are notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or group, joint, or family counseling session and that are separated from the rest of the individual’s medical record. Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: Diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.

What is Yale policy and procedure?

Yale staff will refer to the Yale Policy and Procedure on Uses and Disclosures of Protected Health Information for Research to determine, for each use or disclosure for research purposes, whether an Authorization is required.

Does Yale use protected health information?

Yale may use or disclose protected health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of cadaveric organs, eyes, or tissue for the purpose of facilitating organ, eye or tissue donation and transplantation.

Does Yale have a medical examiner?

Yale may disclose protected health information to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death, or other duties as authorized by law. If Yale also performs the duties of a coroner or medical examiner Yale may use protected health information for the purposes described in this paragraph.

Does Yale have a health oversight agency?

Permitted disclosures. Yale may disclose protected health information to a health oversight agency for oversight activities authorized by law, including audits; civil, administrative, or criminal investigations; inspections; licensure or disciplinary actions; civil, administrative, or criminal proceedings or actions; or other activities necessary for appropriate oversight of:

Can you disclose drug abuse information without authorization?

Information relating to the identity, diagnosis, prognosis, or treatment of any patient by a federally assisted alcohol or drug abuse program may not be disclosed without the Authorization of the patient or the patient’s Personal Representative, except for disclosures:

Who may not use or disclose protected health information?

(a) Standard. A covered entity or business associate may not use or disclose protected health information, except as permitted or required by this subpart or by subpart C of part 160 of this subchapter.

What is protected health information?

A covered entity may use protected health information to create information that is not individually identifiable health information or disclose protected health information only to a business associate for such purpose, whether or not the de-identified information is to be used by the covered entity. (2) Uses and disclosures of de-identified ...

What is a business associate required to disclose?

A business associate is required to disclose protected health information: (i) When required by the Secretary under subpart C of part 160 of this subchapter to investigate or determine the business associate's compliance with this subchapter. (ii) To the covered entity, individual, or individual's designee, as necessary to satisfy ...

How long does a covered entity have to keep health information after death?

A covered entity must comply with the requirements of this subpart with respect to the protected health information of a deceased individual for a period of 50 years following the death of the individual. (g) (1) Standard: Personal representatives.

What is covered entity?

A covered entity is permitted to use or disclose protected health information as follows: (i) To the individual; (ii) For treatment, payment, or health care operations, as permitted by and in compliance with § 164.506;

What is required by 164.520?

A covered entity that is required by § 164.520 to have a notice may not use or disclose protected health information in a manner inconsistent with such notice. A covered entity that is required by § 164.520 (b) (1) (iii) to include a specific statement in its notice if it intends to engage in an activity listed in § 164.520 (b) (1) (iii) (A)– (C), ...

What is covered entity required to disclose?

A covered entity is required to disclose protected health information : (i) To an individual, when requested under, and required by § 164.524 or § 164.528; and.

What is HIPAA protected health information?

The HIPAA Privacy Rule protects the privacy of individually identifiable health information, called protected health information (PHI), as explained in the Privacy Rule and here - PDF - PDF. The Security Rule protects a subset of information covered by the Privacy Rule, which is all individually identifiable ...

What is the HIPAA Privacy and Security Rule?

1 To fulfill this requirement, HHS published what are commonly known as the HIPAA Privacy Rule and the HIPAA Security Rule. The Privacy Rule, or Standards for Privacy of Individually Identifiable Health Information, establishes national standards for the protection of certain health information. The Security Standards for the Protection of Electronic Protected Health Information (the Security Rule) establish a national set of security standards for protecting certain health information that is held or transferred in electronic form. The Security Rule operationalizes the protections contained in the Privacy Rule by addressing the technical and non-technical safeguards that organizations called “covered entities” must put in place to secure individuals’ “electronic protected health information” (e-PHI). Within HHS, the Office for Civil Rights (OCR) has responsibility for enforcing the Privacy and Security Rules with voluntary compliance activities and civil money penalties.

What is the summary of the HIPAA security rule?

This is a summary of key elements of the Security Rule including who is covered, what information is protected, and what safeguards must be in place to ensure appropriate protection of electronic protected health information. Because it is an overview of the Security Rule, it does not address every detail ...

What is the HITECH Act?

The HITECH Act of 2009 expanded the responsibilities of business associates under the HIPAA Security Rule. HHS developed regulations to implement and clarify these changes. See additional guidance on business associates.

What is the Privacy Rule?

The Privacy Rule, or Standards for Privacy of Individually Identifiable Health Information, establishes national standards for the protection of certain health information. The Security Standards for the Protection of Electronic Protected Health Information (the Security Rule) establish a national set of security standards for protecting certain ...

What is the goal of the Security Rule?

A major goal of the Security Rule is to protect the privacy of individuals’ health information while allowing covered entities to adopt new technologies to improve the quality and efficiency of patient care.

Why are risk analysis and management provisions of the Security Rule addressed separately?

The risk analysis and management provisions of the Security Rule are addressed separately here because, by helping to determine which security measures are reasonable and appropriate for a particular covered entity, risk analysis affects the implementation of all of the safeguards contained in the Security Rule.

Why is information important in healthcare?

Physicians, medical professionals, hospitals and other clinical institutions generate, use and share it to provide good care to individuals, to evaluate the quality of care they are providing, and to assure they receive proper payment from health plans.

What is the capability of relevant players in the health care system?

The capability for relevant players in the health care system – including the patient – to be able to quickly and easily access needed information to make decisions, and to provide the right care at the right time, is fundamental to achieving the goals of health reform.

Why do health plans use and share care?

Health plans generate, use and share it to pay for care, to assure care for their members is well coordinated and that populations of individuals with chronic conditions are receiving appropriate care.

Is HIPAA a privacy law?

For more than a decade, the HIPAA regulations have provided a strong privacy and security foundation for the health care system. Although the regulations have been in effect for quite some time, health care providers frequently still question whether the sharing of health information, even for routine purposes like treatment or care coordination, ...

Treatment

  • Treatment is the provision, coordination, or management of health care and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another.20
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Definition

  • Payment encompasses activities of a health plan to obtain premiums, determine or fulfill responsibilities for coverage and provision of benefits, and furnish or obtain reimbursement for health care delivered to an individual21 and activities of a health care provider to obtain payment or be reimbursed for the provision of health care to an individual.
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Activities

  • Health care operations are any of the following activities: (a) quality assessment and improvement activities, including case management and care coordination; (b) competency assurance activities, including provider or health plan performance evaluation, credentialing, and accreditation; (c) conducting or arranging for medical reviews, audits, or legal services, includin…
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Resources

  • Public Health Activities. Covered entities may disclose protected health information to: (1) public health authorities authorized by law to collect or receive such information for preventing or controlling disease, injury, or disability and to public health or other government authorities authorized to receive reports of child abuse and neglect; (2) entities subject to FDA regulation re…
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Scope

  • Victims of Abuse, Neglect or Domestic Violence. In certain circumstances, covered entities may disclose protected health information to appropriate government authorities regarding victims of abuse, neglect, or domestic violence.31 Health Oversight Activities. Covered entities may disclose protected health information to health oversight agencies (as defined in the Rule) for purposes o…
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Purpose

  • Law Enforcement Purposes. Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes under the following six circumstances, and subject to specified conditions: (1) as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; (2) to identify or locate a suspect, fugitive, m…
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Uses

  • Cadaveric Organ, Eye, or Tissue Donation. Covered entities may use or disclose protected health information to facilitate the donation and transplantation of cadaveric organs, eyes, and tissue.36
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Introduction

  • Research. Research is any systematic investigation designed to develop or contribute to generalizable knowledge.37 The Privacy Rule permits a covered entity to use and disclose protected health information for research purposes, without an individuals authorization, provided the covered entity obtains either: (1) documentation that an alteration or waiver of individuals au…
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Functions

  • Essential Government Functions. An authorization is not required to use or disclose protected health information for certain essential government functions. Such functions include: assuring proper execution of a military mission, conducting intelligence and national security activities that are authorized by law, providing protective services to the President, making medical suitability …
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Advantages

  • The covered entities in an organized health care arrangement may use a joint privacy practices notice, as long as each agrees to abide by the notice content with respect to the protected health information created or received in connection with participation in the arrangement.53 Distribution of a joint notice by any covered entity participating in the organized health care arra…
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Operation

  • A health plan must distribute its privacy practices notice to each of its enrollees by its Privacy Rule compliance date. Thereafter, the health plan must give its notice to each new enrollee at enrollment, and send a reminder to every enrollee at least once every three years that the notice is available upon request. A health plan satisfies its distribution obligation by furnishing the notice …
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