Disclosures of PHI as Permitted or Required by Law: Difference between revisions

Effective Date: '''Draft 08/19/22'''<br />

UNMC shall disclose Protected Health Information (PHI) as permitted or required by law in accordance with the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and UNMC policies to maintain confidentiality of PHI and protect patient privacy.

Employees, medical staff, volunteers, trainees, and other persons whose conduct, in the performance of work for UNMC, is under the direct control of UNMC, whether or not they are paid by UNMC.

Disclosures of PHI may be made without a written Individual authorization for the following purposes. Any other disclosures not described below cannot be made unless specifically authorized by another UNMC policy, the Privacy Office, or General Counsel’s office. Unless otherwise provided by UNMC Policy No. 6057, [https://wiki.unmc.edu/index.php/Use_and_Disclosure_of_Protected_Health_Information Use and Disclosure of Protected Health Information], all disclosures of PHI permitted by this policy or any other UNMC policy are limited to the minimum necessary to accomplish the intended purpose of the use, disclosure or request. All disclosures, regardless if a written Individual authorization is required or not for any given disclosure, must be documented in the EMR. If a written Individual authorization is required, such authorization must be included in the patient’s medical record.<br />

Disclosures '''required by law''', to the extent the disclosure complies with and is limited to the relevant requirements of such law. Examples of these types of disclosures include:  

**Forward any order of a court or administrative tribunal or any subpoena, discovery request, or other lawful process that is not accompanied by an order of a court or administrative tribunal to the Health Information Management department (HIM) for processing. For urgent requests that cannot wait for HIM, contact Risk (consult Web On Call or the hospital operator to reach on-call Risk staff) or General Counsel’s office with any questions.

Disclosures to '''funeral directors''' as required by law as necessary to carry out their duties regarding decedents. In Nebraska, funeral directors in charge of the funeral of any person who dies in Nebraska are to cause a death certificate to be filled out. That form must include a statement of the cause of death made by the physician, physician assistant, or nurse practitioner who last attended the deceased.  

*to prevent or lessen a serious and imminent threat to the health or safety of a person or the public and such disclosure of PHI is to a person or persons reasonably able to prevent or lessen the threat (e.g., the target of the threat, family members, school administrators, risk management, and/or law enforcement). If law enforcement is to be contacted, first contact campus Public Safety (unless the threat is immediate, in which case law enforcement should be contacted immediately).   

**where it appears from all the circumstances that the individual has escaped from a correctional institution or from lawful custody.

To officials of the Department of State for the purpose of '''medical suitability determinations'''.

'''Note:''' Staff should not proactively alert military command authority regarding the voluntary treatment or admission of active military personnel unless the Individual presents a serious and imminent threat to the Individual or others (see the first bullet under serious and imminent threat section above for more details on this point).

Disclosures for '''workers' compensation'''. UNMC may disclose PHI as authorized by and to the extent necessary to comply with laws relating to workers' compensation or other similar programs, established by law, that provide benefits for work-related injuries or illness without regard to fault.   Per state law, information disclosed should be limited to only that information relevant to the injury. A workers’ compensation plan’s request for “all medical records” should generally be denied unless the services to the Individual were limited to one episode of care related to the injury.

 

*General Counsel’s o0ffice (Hospital or University??)

*UNMC Policy No. 6304, [[Disclosure of PHI for Law Enforcement Purposes]

Nebraska Medicine Policy Reporting Abuse, Neglect or Injury policy, PE 03;  

Nebraska Medicine Policy Infant Drug Testing Guidelines for Providers policy, SH21

Nebraska Medicine Policy Drug Testing Guidelines for Providers: Pregnant and Postpartum Patients policy, AD48