May a covered entity use or disclose protected health information for litigation? May a covered entity use or disclose protected health information for litigation?
May a covered entity use or disclose protected health information for litigation?
Answer:
A covered entity may use or disclose protected health information as permitted or required by the Privacy Rule, see 45 CFR 164.502(a)
(PDF); and, subject to certain conditions the Rule typically permits
uses and disclosures for litigation, whether for judicial or
administrative proceedings, under particular provisions for judicial and
administrative proceedings set forth at 45 CFR 164.512(e) (GPO), or as part of the covered entity’s health care operations, 45 CFR 164.506(a) (PDF).
Depending on the context, a covered entity’s use or disclosure of
protected health information in the course of litigation also may be
permitted under a number of other provisions of the Rule, including uses
or disclosures that are:
- required by law (as when the court has ordered certain disclosures),
- for a proceeding before a health oversight agency (as in a contested licensing revocation),
- for payment purposes (as in a collection action on an unpaid claim), or
- with the individual’s written authorization.
Where a covered entity is a party to a legal proceeding, such as
a plaintiff or defendant, the covered entity may use or disclose
protected health information for purposes of the litigation as part of
its health care operations. The definition of “health care operations”
at 45 CFR 164.501
(GPO) includes a covered entity’s activities of conducting or arranging
for legal services to the extent such activities are related to the
covered entity’s covered functions (i.e., those functions that make the
entity a health plan, health care provider, or health care
clearinghouse), including legal services related to an entity’s
treatment or payment functions. Thus, for example, a covered entity that
is a defendant in a malpractice action or a plaintiff in a suit to
obtain payment may use or disclose protected health information for such
litigation as part of its health care operations. The covered entity,
however, must make reasonable efforts to limit such uses and disclosures
to the minimum necessary to accomplish the intended purpose. See 45 CFR 164.502(b) , 164.514(d).
Where the covered entity is not a party to the proceeding, the
covered entity may disclose protected health information for the
litigation in response to a court order, subpoena, discovery request, or
other lawful process, provided the applicable requirements of 45 CFR 164.512(e) (GPO) for disclosures for judicial and administrative proceedings are met.
| Pharmacy Chain Institutes New Safeguards for PHI in Pseudoephedrine Log Books Covered Entity: Pharmacies Issue: Safeguards A grocery store based pharmacy chain maintained pseudoephedrine log books containing protected health information in a manner so that individual protected health information was visible to the public at the pharmacy counter. Initially, the pharmacy chain refused to acknowledge that the log books contained protected health information. OCR issued a written analysis and a demand for compliance. Among other corrective actions to resolve the specific issues in the case, OCR required that the pharmacy chain implement national policies and procedures to safeguard the ...read more |
| May a covered entity use or disclose protected health information for litigation? Answer: A covered entity may use or disclose protected health information as permitted or required by the Privacy Rule, see 45 CFR 164.502(a) (PDF); and, subject to certain conditions the Rule typically permits uses and disclosures for litigation, whether for judicial or administrative proceedings, under particular provisions for judicial and administrative proceedings set forth at 45 CFR 164.512(e) (GPO), or as part of the covered entity’s health care operations, 45 CFR 164.506(a) (PDF). Depending on the context, a covered entity’s use or disclosure of protected health information in ...read more |
| Entity Rescinds Improper Charges for Medical Record Copies to Reflect Reasonable, Cost-Based Fees Covered Entity: Private Practice Issue: Access A patient alleged that a covered entity failed to provide him access to his medical records. After OCR notified the entity of the allegation, the entity released the complainant’s medical records but also billed him $100.00 for a “records review fee” as well as an administrative fee. The Privacy Rule permits the imposition of a reasonable cost-based fee that includes only the cost of copying and postage and preparing an explanation or summary if agreed to by the individual. To ...read more |
| Private Practice Revises Access Procedure to Provide Access Despite an Outstanding Balance Covered Entity: Private Practice Issue: Access A complainant alleged that a private practice physician denied her access to her medical records, because the complainant had an outstanding balance for services the physician had provided. During OCR’s investigation, the physician confirmed that the complainant was not given access to her medical record because of the outstanding balance. OCR provided technical assistance to the physician, explaining that, in general, the Privacy Rule requires that a covered entity provide an individual access to their medical record within 30 days of ...read more |
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