Use and Disclosure of Protected Health Information: Difference between revisions

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== Procedures ==
== Procedures ==
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===Use/Disclosure of PHI Related to Healthcare===
Protected Health Information (PHI) may be used and disclosed by the ACE for its own treatment, payment and healthcare operations (as defined above).  These entities may share PHI with one another without patient authorization to conduct business on behalf of the organizations.
:#Care providers may share medical information with the individual and other people that individual would like to be involved in his/her care (i.e. family members, other relatives, friends, etc.).  If possible, care providers should obtain the individual’s permission to share information with others during the course of treatment.  However, care providers may use their professional judgment and reasonably infer from the circumstances that an individual does not object to sharing information with others who may visit or call on the telephone.  Only information relevant to such person’s involvement with the individual’s care should be shared.
:#The ACE may disclose a decedent’s PHI to family member and other who were involved in the care of payment for care of the decedent prior to death, unless doing so is inconsistent with any prior expressed preference of the individual.
The ACE may disclose PHI for the treatment activities of a healthcare provider.
The ACE may disclose PHI to another covered entity or a healthcare provider for the payment activities of the entity that receives the information.
UNMC shall enter into a business associate agreement with outside entities performing services on its behalf that required PHI to perform the services. See Contracts Policy.
Individuals shall sign an acknowledgement of receipt of the Notice of Privacy Practices when they first access the ACE for direct treatment, explaining how their PHI may be used and disclosed.  See Notice of Privacy Practices Policy.
Individuals will be given the opportunity to agree or object to follow uses/disclosures of their PHI:
:#Use of their name, location and general condition in the facility directory.
:#Disclosure of religious affiliation to clergy members.
:#Disclosure of PHI to family member, other relative, or close personal friend of the individual, or any other person identified by the individual, the PHI directly relevant to such person's involvement with the individual's care or payment.
Request for restrictions.  Individuals may request restrictions on how their health information is used or disclosed for treatment, payment or healthcare operation purposes, or to certain family member or others involved in their care.  Requests for restrictions can be denied, with one exception.  Requests to restrict self-pay account information from being sent to third party payers must be approved if the account is paid in full out of pocket in advance.
:#All requests for restrictions must be in writing and shall be forwarded to the Health Information Management Department Manager of Health Information Logistics.  The Privacy Officer shall be notified and shall coordinate the request for restrictions to the Medical Director of Information Technology for approval/disapproval.  If a request for restriction is approved, processes must be implemented to restrict the use or disclosure of the information within the scope of the approved restriction.  Information subject to an approved restriction can be used for emergency treatment if needed, but the healthcare provider cannot further use or disclose the information.
:#Requests to have medical information removed from a medical information system/medical record will not generally be approved, since records of treatment provided must be kept and made available for several regulatory and business purposes.
===Use/Disclosure of PHI RElated for Trainign Healthcare Professionals===
Training healthcare professionals is a category of healthcare operations.  Staff may share PHI with students, residents, trainees and faculty supervising such individuals pursuant to a clinical affiliation agreement between UNMC and the affiliation institution.  Individuals receiving training and faculty supervising such individuals at UNMC shall be considered members of UNMC’s workforce for purposes of HIPAA.
===Use/Disclosure of PHI Permitted/Required by Law===
Disclosure of PHI beyond treatment, payment and healthcare operations (TPO) may be made without individual authorization for the following purposes:
:#Disclosure required by law
:#Disclosures for public health activities when the public health authority is authorized by law to receive reports; (i.e., controlling disease; vital events such as birth/death; public health surveillance; FDA device tracking; requests related to workers’ compensation)
:##Disclosures to a school, limted to proof of immunization of a student or prospective student, and UNMC has obtained and documented agreement from the parent, legal guardian, or the individual if the individual is an adult or emancipated minor.
:#Reports of suspected abuse, neglect or domestic violence made by mandatory reporters to governmental agencies authorized by law to receive such reports.
:#Disclosures for law enforcements purposes.  See Use/Disclosure of PHI for Law Enforcement Purposes.
:#Disclosure for health oversight activities authorized by law, such as audits, investigations, licensure or disciplinary actions.
:#Disclosure for judicial or administrative proceedings pursuant to a court or administrative tribunal order or subpoena.
:#Disclosure about decedents to medical examiners and coroners consistent with law.
:#Disclosures to funeral directors, consistent with law to carry out their duties regarding decedents.
:#Disclosures for cadaveric organ, eye or tissue donation to organ procurement organizations.
:#Disclosures to prevent serious threat to health or safety consistent with applicable law.
:#Disclosures about military personnel to military command authority in limited circumstances.




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