Health Information Management

OCR posts new FAQ on releasing PHI to people acting on behalf of others

HIPAA Weekly Advisor, March 20, 2006

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The privacy rule allows a health plan-or other covered entities-to disclose PHI to a person who calls the plan on the beneficiary's behalf, according to a frequently asked question (FAQ) the OCR posted March 14 on its Web site.

You may disclose relevant PHI in this manner if the patient/beneficiary does not object or you can reasonably infer that the he or she does not object. If the individual is not present or is incapacitated, you can make the disclosure if it is in the best interests of the individual.

For example, a health plan may disclose relevant PHI to a beneficiary's daughter who has called to assist her hospitalized, elderly mother in resolving a claims or other payment issue.

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