June 26, 2019
New Frequently Asked Questions on HIPAA and Health Plans Support Care Coordination and Continuity of Care
Today, the Office for Civil Rights at the U.S. Department of Health and Human Services issued a frequently asked question (FAQ) document that clarifies how the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule permits health plans to share protected health information (PHI) in a manner that furthers the HHS Secretary's goal of promoting coordinated care.
The FAQ explains when and how one health plan can share PHI about individuals in common with a second health plan for care coordination purposes under the Privacy Rule. The FAQ also clarifies that, in certain circumstances, the Privacy Rule permits a health plan to use PHI to inform individuals about a replacement for health insurance, even if the plan received the PHI for a different purpose, and without the communication to the individual being deemed marketing. For example, a health plan could use PHI to inform customers reaching the age of Medicare eligibility of the availability of Medicare Advantage plans for continuity of care purposes without seeking a separate authorization for the communication.