Health Information Management

Healthcare operations: How to approach HIPAA privacy rule ambiguity

HIM-HIPAA Insider, March 3, 2009

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When the OCR revised the HIPAA privacy rule in 2003, it specified accepted uses and disclosures for what it termed "treatment, payment, and healthcare operations [TPO]." The intent was to establish protection for protected health information (PHI) and avoid unnecessary obstacles when delivering care.

"The rule generally prohibits a covered entity from using or disclosing [PHI] unless authorized by patients, except where this prohibition would result in unnecessary interference with access to quality healthcare or with certain other important public benefits or national priorities," the revision states.

It sounds simple enough, but the fine print is vague, especially concerning what constitutes healthcare operations. The revision leaves discretion to the covered entity and creates confusion regarding when the provider must obtain an authorization from the patient and when it is not required, says John C. Parmigiani, HIPAA security and privacy consultant and president of John C. Parmigiani & Associates, LLC, in Ellicott City, MD.

Editor’s note: For more information about the privacy rule or to purchase a copy of this article for $10, visit the HCPro Web site. Subscribers to Health Information Compliance Insider have access to this article in the March issue.

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