What Is HIPAA Authorization?

What Is HIPAA Authorization
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The HIPAA Privacy Rule permits the sharing of health information by healthcare providers, health plans, healthcare clearinghouses, business associates of HIPAA-covered entities and other entities covered by HIPAA Rules under certain circumstances.

The HIPAA Privacy Rule, effective since April 14, 2003, brought forth standards covering the permittable uses and disclosures of health information, including to whom information can be disclosed and under what circumstances protected health information (PHI) can be shared.

HIPAA Journal’s recent article, “What is HIPAA Authorization?” says that permitted uses and disclosures are generally for treatment, payment, or health care operations and reporting issues, such as domestic abuse, to public health agencies.

HIPAA authorization is consent from a patient or health plan member that lets a covered entity or business associate use or disclose PHI to an individual/entity for a purpose otherwise not allowed by the HIPAA Privacy Rule.

Without HIPAA authorization, this use or disclosure of PHI would violate HIPAA Rules and could result in a severe financial penalty. It may even be criminal.

Federal regulations detail the uses and disclosures of PHI that require authorization from a patient or plan member before information can be shared or used. HIPAA authorization is required for the following:

  • Use or disclosure of PHI otherwise not permitted by the HIPAA Privacy Rule;
  • Use or disclosure of PHI for marketing purposes, except when communication occurs face-to-face between the covered entity and the individual or when the communication involves a promotional gift of nominal value;
  • Use or disclosure of psychotherapy notes other than for specific treatment, payment, or health care operations;
  • Use or disclosure of substance abuse and treatment records;
  • Use or disclosure of PHI for research purposes; and
  • Before the sale of protected health information.

A HIPAA authorization is a detailed document in which specific uses and disclosures of protected health are fully explained.

By signing the authorization, a person is consenting to have their health information used or disclosed for the reasons stated on the authorization. Check with your estate planning attorney to make sure your Healthcare Directive includes a HIPPA release.

Reference: HIPAA Journal (October 9, 2021) “What is HIPAA Authorization?”