The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) issued a frequently asked question (FAQ) that explains how under the HIPAA Privacy Rule, health plans are permitted to share protected health information (PHI) in a manner that furthers the HHS Secretary's goal of promoting coordinated care.
According to the FAQ, when a 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.
We are expecting HHS to provide additional FAQs this year due to HHS' focus on access to PHI and to ensure there isn't an unreasonably delay when information that is needed for continuity of care.
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