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.
| § 164.314 Organizational requirements. (a) (1) Standard: Business associate contracts or other arrangements. The contract or other arrangement required by § 164.308(b)(3) must meet the requirements of paragraph (a)(2)(i), (a)(2)(ii), or (a)(2)(iii) of this section, as applicable. (2) Implementation specifications (Required) - (i) Business associate contracts. The contract must provide that the business associate will - (A) Comply with the applicable requirements of this subpart; (B) In accordance with § 164.308(b)(2), ensure that any subcontractors that create, receive, maintain, or transmit electronic protected health information on behalf of the business associate agree to comply with the applicable requirements of ...read more |
| Mental Health Center Provides Access after Denial Covered Entity: Mental Health Center Issue: Access, Authorization The complainant alleged that a mental health center (the "Center") improperly provided her records to her auto insurance company and refused to provide her with a copy of her medical records. The Center provided OCR with a valid authorization, signed by the complainant, permitting the release of information to the auto insurance company. OCR also determined that the Center denied the complainant's request for access because her therapists believed providing the records to her would likely cause her substantial harm. The Center did not, ...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 |
| National Pharmacy Chain Extends Protections for PHI on Insurance Cards Covered Entity: Pharmacies Issue: Impermissible Uses and Disclosures; Safeguards A pharmacy employee placed a customer's insurance card in another customer's prescription bag. The pharmacy did not consider the customer's insurance card to be protected health information (PHI). OCR clarified that an individual's health insurance card meets the statutory definition of PHI and, as such, needs to be safeguarded. Among other corrective actions to resolve the specific issues in the case, the pharmacy revised its policies regarding PHI and retrained its staff. The revised policies are applicable to all individual ...read more |
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11/12/22 May a covered entity use or disclose protected health information for litigation?
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