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Existing law, the Insurance Information and Privacy Protection Act, establishes privacy standards for the collection, use, and disclosure of information gathered in connection with insurance transactions by insurance institutions, agents, or insurance-support organizations that meet specified criteria.
"Minimum Necessary" means, when protected health information is used, disclosed, or requested, reasonable efforts must be taken to determine how much information will be sufficient to serve the intended purpose.
Notwithstanding Paragraph (1) above, the following persons shall not be considered "insurance support organizations" for purposes of this Act: agents, government institutions, insurance institutions, medical care institutions and medical professionals.
The NAIC Model Laws, Regulations, and Guidelines (available in the library) contains documents promulgated by the National Association of Insurance Commissioners as proposed statements of insurance laws that should be adopted by the 50 states.
The Privacy Rule permits use and disclosure of protected health information, without an individual's authorization or permission, for 12 national priority purposes.
There are a few scenarios where you can disclose PHI without patient consent: coroner's investigations, court litigation, reporting communicable diseases to a public health department, and reporting gunshot and knife wounds.
HIPAA Exceptions DefinedTo public health authorities to prevent or control disease, disability or injury. To foreign government agencies upon direction of a public health authority. To individuals who may be at risk of disease. To family or others caring for an individual, including notifying the public.
Obtaining consent (written permission from individuals to use and disclose their protected health information for treatment, payment, and health care operations) is optional under the Privacy Rule for all covered entities.
To disclose patient information, healthcare executives must determine that patients or their legal representatives have authorized the release of information or that the use, access or disclosure sought falls within the permitted purposes that do not require the patient's prior authorization.
Protected health information includes all individually identifiable health information, including demographic data, medical histories, test results, insurance information, and other information used to identify a patient or provide healthcare services or healthcare coverage.