Question

1.A health care provider discloses PHI to a health plan for the plan’s Health Plan Employer Data and Information Set (HEDIS) purposes. This health plan has a relationship with the individual who is the subject of the information. Should there be any limit to the disclosure?

2. As part of a worker’s compensation claim case in California, John Doe authorized that his medical records be released. Doe’s HIV status was revealed in the process, even though it was not relevant to the case. Despite the existence of a strong HIV confidentiality law in California, the court ruled that there was no obligation to segregate the information (California Appellate Court, 2000). How does HIPAA address this?

3. As part of a worker’s compensation claim case in California, John Doe authorized that his medical records be released. Doe’s HIV status was revealed in the process, even though it was not relevant to the case. Despite the existence of a strong HIV confidentiality law in California, the court ruled that there was no obligation to segregate the information (California Appellate Court, 2000). What could be part of the authorization that might prevent this full disclosure?

4. A surgeon’s office often contacts the hospital and other health care providers to collect pre-op information over the phone. This aids the surgeon in determining if there are medical concerns to be addressed prior to surgery. The patient has not received the Notice of Privacy Practices as yet. Does the Privacy Rule prohibit this disclosure since the patient has not signed an NOPP receipt from this surgeon?

Answer 1

1. Health Insurance Portability and Accountability Act (HIPPA) sets the privacy rule standards to address the use and disclosure of individuals’ health information called as protected health information (PHI).

While disclosure of PHI for any kind of purpose by healthcare instituition or organization following things need to be kept protected:

All individually identifiable information needs to be protected. This includes any past history, present and future physical and metal health conditions. It also includes healthcare provisions and facilities used by the individual and any past, present and future payments done by individual for these facilities which may risk identity of individual.