Permitted Disclosure - Mpje

1. What HIPAA permission allows disclosure of PHI to avert a serious and imminent threat to health or safety?

   To prevent or lessen a serious and imminent threat. HIPAA permits PHI disclosures if reasonably necessary to prevent or lessen a serious, imminent threat to an individual's or the public's health or safety.

2. What HIPAA permission allows disclosure of PHI to law enforcement in limited, specified circumstances?

   Law enforcement purposes (as permitted/required). HIPAA permits limited PHI disclosures to law enforcement for specific purposes like identifying suspects or reporting crimes as required by law.

3. What HIPAA permission allows disclosure of PHI to a public health authority for required reporting?

   Public health activities. HIPAA authorizes PHI disclosures for public health activities, including mandatory reporting to authorities to protect community health.

4. What HIPAA category permits using PHI for pharmacy auditing, compliance, and fraud/abuse detection?

   Health care operations. HIPAA allows PHI use for health care operations to conduct auditing, ensure compliance, and detect fraud or abuse in pharmacy activities.

5. Does the HIPAA minimum necessary standard apply to disclosures for treatment?

   No, it does not apply to treatment disclosures. HIPAA exempts treatment disclosures from the minimum necessary standard to allow full information sharing for effective patient care.

6. What is the HIPAA term for sharing PHI with a vendor performing services for the pharmacy under contract?

   Business associate disclosure (with BAA). HIPAA permits PHI sharing with business associates who provide services on behalf of the covered entity, provided a BAA is in place.

7. Which HIPAA permission allows disclosure of PHI to a coroner or medical examiner for identification or cause of death?

   Coroners and medical examiners. HIPAA permits PHI disclosures to coroners or medical examiners to assist in identifying deceased persons or determining cause of death.

8. What HIPAA permission allows a pharmacy to share PHI with a patient's family involved in the patient's care?

   Disclosures to persons involved in care (with conditions). HIPAA allows limited PHI disclosures to family or others involved in care if conditions like patient agreement or best interest are met.

9. What HIPAA category permits a pharmacy to disclose PHI to another provider for continuity of care?

   Treatment. HIPAA permits PHI disclosure for treatment to ensure coordination and continuity of patient care among providers without requiring authorization.

10. What HIPAA category permits using PHI for pharmacy quality assessment and improvement activities?

    Health care operations. HIPAA permits PHI use for health care operations, including quality assessment to improve services and outcomes in pharmacy practice.

11. What is required under HIPAA before a pharmacy may use PHI for marketing that is not otherwise permitted?

    Valid patient authorization. HIPAA requires valid patient authorization for marketing uses of PHI unless they fall under exceptions like face-to-face or nominal value communications.

12. Which condition generally allows disclosure to a family member involved in care when the patient is present?

    Patient agrees, is given opportunity to object, or does not object. HIPAA permits such disclosures when the patient is present if they agree, have the chance to object, or do not object to maintain care involvement.

13. What HIPAA permission allows disclosure of PHI for oversight activities such as audits or inspections?

    Health oversight activities. HIPAA authorizes PHI disclosures for health oversight activities to enable government agencies to conduct audits and inspections for compliance.

14. What HIPAA category permits a pharmacy to use PHI to bill an insurer or collect a copayment?

    Payment. HIPAA allows PHI use for payment activities, such as billing insurers or collecting copayments, to obtain reimbursement for services provided.

15. What is the HIPAA standard that limits PHI used/disclosed to what is needed for the purpose?

    Minimum necessary standard. HIPAA's minimum necessary standard requires limiting PHI to the least amount needed to accomplish the intended purpose of use or disclosure.

16. What HIPAA category permits using PHI for formulary checks or prior authorization processing?

    Payment. HIPAA classifies formulary checks and prior authorizations as payment activities to facilitate reimbursement and coverage determinations.

17. Does the HIPAA minimum necessary standard apply to payment and health care operations uses/disclosures?

    Yes, it applies to payment and operations. HIPAA applies the minimum necessary standard to payment and operations to protect patient privacy by restricting PHI to essential amounts.

18. What HIPAA permission allows disclosure of PHI to report adverse drug events to FDA or a manufacturer?

    Public health activities. HIPAA permits PHI disclosures for public health activities, such as reporting adverse events to monitor drug safety and prevent harm.

19. What HIPAA category permits a pharmacy to use PHI to fill, check, and dispense a prescription?

    Treatment. HIPAA allows PHI use for treatment purposes, which include providing health care services like filling and dispensing prescriptions without patient authorization.

20. Under HIPAA, what is the term for sharing PHI for the pharmacy's own appointment or refill reminders?

    Health care operations (communications about treatment). HIPAA categorizes refill and appointment reminders as health care operations for communicating about treatment to support patient adherence and care.

21. What agreement must generally be in place before a pharmacy shares PHI with a business associate?

    Business associate agreement (BAA). HIPAA requires a BAA to ensure business associates safeguard PHI and comply with privacy and security rules when handling it for the pharmacy.

22. What HIPAA permission allows a pharmacy to disclose PHI in response to a valid court order or subpoena?

    Judicial and administrative proceedings (as permitted/required). HIPAA allows PHI disclosures in judicial proceedings when required or permitted by a valid court order or subpoena to comply with legal processes.

23. When a patient is incapacitated, what standard permits disclosure to family involved in care?

    Provider professional judgment in the patient's best interest. HIPAA allows providers to use professional judgment to disclose PHI to family when the patient is incapacitated and it serves the patient's best interest.

24. What is the HIPAA permission for using/disclosing PHI for workers' compensation programs as authorized by law?

    Workers' compensation (as authorized by law). HIPAA allows PHI use or disclosure for workers' compensation to comply with laws providing benefits for work-related injuries or illnesses.

25. Under HIPAA, is patient authorization required for uses/disclosures for treatment, payment, or operations?

    No, authorization is not required for TPO. HIPAA exempts treatment, payment, and operations (TPO) from authorization requirements to facilitate essential health care functions.

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