Here at HIPAAgps, we are committed to helping our clients stay up to date on any changes or additions to HIPAA and related statutes.

Health and Human Services (HHS) Office for Civil Rights (OCR) just recently created a new FAQ on HIPAA and Health Plans Support Care Coordination and Continuity of Care.  For the most part, this FAQ revolves around health plans, so health care providers and business associates won’t be affected.

The first question is if one health plan can share protected health information (PHI) with another health plan for care coordination.  This might be in the case where a patient has a primary and a secondary health plan.  Per HHS, the answer is yes.  Both health plans can share information about a patient as long as it is for care purposes and nothing else.  This means the patient must be member of both health plans.  HHS also reminds that the minimum necessary standard still applies.

The second question asks if the Privacy Rule allows a covered entity to use and disclose PHI to inform patients about other available health plans that it offers.  Normally, HIPAA restricts marketing to patients without their authorization.  However, one of the exceptions is if the communications are regarding replacements to, or enhancements of, existing health plans.  In this case, the covered entity/ health plan cannot receive financial remuneration for the communications.

The example provided by HSS states:

“For example, in a situation where Plan A discloses PHI about an individual to Plan B (a separate covered entity), Plan B is permitted to send communications to the individual about Plan B’s health plan options that may replace the individual’s current plan (e.g, Medicare plans for individuals reaching the age of Medicare eligibility), without the individual’s authorization, so long as Plan B (1)  receives no remuneration for sending the communication to the individual, and (2) complies with any business associate agreement(s), where applicable.”

While there are only two questions in this FAQ, HHS constantly provides guidance about HIPAA as more questions arise.  Their site is a great resource if you need additional information.

If you feel the language is difficult to understand, remember that we at HIPAAgps are here to make it easier.  Sign up for the 7-day risk-free trial and check out our engaging training videos to get an understanding of how we break things down to make them simpler.