An entity can obtain informal permission by asking the individual outright, or by circumstances that clearly give the individual the opportunity to agree, acquiesce, or object.Opportunity to agree or object to the disclosure of PHI.Treatment, payment, and healthcare operations.Disclosure to the individual (if the information is required for access or accounting of disclosures, the entity MUST disclose to the individual).The law permits, but does not require, a covered entity to use and disclose PHI, without an individual’s authorization, for the following purposes or situations: Top of Page Permitted Uses and Disclosures Business associates: A person or organization (other than a member of a covered entity’s workforce) using or disclosing individually identifiable health information to perform or provide functions, activities, or services for a covered entity.These functions, activities, or services include:.In most instances, healthcare clearinghouses will receive individually identifiable health information only when they are providing these processing services to a health plan or healthcare provider as a business associate. Healthcare clearinghouses: Entities that process nonstandard information they receive from another entity into a standard (i.e., standard format or data content), or vice versa.Government- and church-sponsored health plansĮxception: A group health plan with fewer than 50 participants that is administered solely by the employer that established and maintains the plan is not a covered entity.Long-term care insurers (excluding nursing home fixed-indemnity policies).Medicare, Medicaid, Medicare+Choice, and Medicare supplement insurers.Health maintenance organizations (HMOs).Health, dental, vision, and prescription drug insurers.Other transactions for which HHS has established standards under the HIPAA Transactions Rule.Healthcare providers: Every healthcare provider, regardless of size of practice, who electronically transmits health information in connection with certain transactions.The following types of individuals and organizations are subject to the Privacy Rule and considered covered entities: The Privacy Rule permits important uses of information while protecting the privacy of people who seek care and healing. A major goal of the Privacy Rule is to make sure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high-quality healthcare, and to protect the public’s health and well-being. The Privacy Rule also contains standards for individuals’ rights to understand and control how their health information is used. These individuals and organizations are called “covered entities.” The Privacy Rule standards address the use and disclosure of individuals’ health information (known as protected health information or PHI) by entities subject to the Privacy Rule. Compare HIPAA with FERPA HIPAA Privacy Rule
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