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(2k$ ,!  ($'dxdC<< c  +g'   @  XX   %#X#XDX &##XDXXXDE#XDXXXD##9%# XXD#  #   #XDX # XXDO#XDX # XXDCRHI#XDX # XXDPAA#XDX # XXDPrivacy   @  @ #XDX P# XXDKK:%##XDX # XXDDecember3,2002 r  @  @  @   #XDX # XXDRevisedApril3,2003 4  @  @   ?+ ` hp x %#?#XDX ##XDXXXD;#XDXXXD 9 k)   (#(#(#(# XX  #XDX 6##XDXXXDU#XDXXXD XXD#  #  WGCz h p @X@E'##!  (#(#  (#(##XDX ##XDXXXD#XDXXXD XXD#  `#  #XDX ##XDXXXD#XDXXXD @  XXD#  &#  QA=x h p @XE!  & k"   @  & k"   @ http://answers.hhs.gov/cgi-bin/hhs.cfg/php/enduser/std_alp.phphttp://answers.hhs.gov/cgi-bin/hhs.cfg/php/enduser/std_alp.php?p_sid=f47XY6Gg&p_lva=&p_li=&p_page=1&p_cat_lvl1=7&p_cat_lvl2=%7Eany%7E&p_search_text=&p_new_search=1_   8DXXdd8USESANDDISCLOSURESFORTREATMENT,PAYMENT,ANDHEALTHCARE  OPERATIONS   [45_CFR_Ԁ164.506]   ( Background  n    The_HIPAA_ԀPrivacyRuleestablishesafoundationofFederalprotectionforpersonal F  healthinformation,carefullybalancedtoavoidcreatingunnecessarybarrierstothedeliveryof 2t qualityhealthcare.Assuch,theRulegenerallyprohibitsacoveredentityfromusingor ` disclosingprotectedhealthinformationunlessauthorizedbypatients,exceptwherethis  L  prohibitionwouldresultinunnecessaryinterferencewithaccesstoqualityhealthcareorwith 8  certainotherimportantpublicbenefitsornationalpriorities. $    Readyaccesstotreatmentandefficientpaymentforhealthcare,bothofwhichrequireuse   anddisclosureofprotectedhealthinformation,areessentialtotheeffectiveoperationofthe   healthcaresystem.Inaddition,certainhealthcareoperations"suchasadministrative,financial,   legal,andqualityimprovementactivities"conductedbyorforhealthcareprovidersandhealth ~ plans,areessentialtosupporttreatmentandpayment.Manyindividualsexpectthattheirhealth j informationwillbeusedanddisclosedasnecessarytotreatthem,billfortreatment,and,tosome V extent,operatethecoveredentityshealthcarebusiness.Toavoidinterferingwithan B individualsaccesstoqualityhealthcareortheefficientpaymentforsuchhealthcare,the .p PrivacyRulepermitsacoveredentitytouseanddiscloseprotectedhealthinformation,with \ certainlimitsandprotections,fortreatment,payment,andhealthcareoperationsactivities. H  HowtheRuleWorks      WhatareTreatment,Payment,andHealthCareOperations?Thecorehealthcare  activitiesof Treatment, Payment,and HealthCareOperationsaredefinedinthePrivacy   Ruleat45_CFR_Ԁ164.501. !       ' "0 `   Treatmentgenerallymeanstheprovision,coordination,ormanagementof f# healthcareandrelatedservicesamonghealthcareprovidersorbyahealthcare R$ providerwithathirdparty,consultationbetweenhealthcareprovidersregardinga >%  patient,orthereferralofapatientfromonehealthcareprovidertoanother. ' N ݌*&l!` (#` (# Ќ        @ "0 `   Paymentencompassesthevariousactivitiesofhealthcareproviderstoobtain (D # paymentorbereimbursedfortheirservicesandofahealthplantoobtain (0!$ premiums,tofulfilltheircoverageresponsibilitiesandprovidebenefitsunderthe )"% plan,andtoobtainorprovidereimbursementfortheprovisionofhealthcare. @ g ݌*#&` (#` (# Ќ   +#'   0 ` Inadditiontothegeneraldefinition,thePrivacyRuleprovidesexamplesof  commonpaymentactivitieswhichinclude,butarenotlimitedto:` (#` (#  |(x3"3"     ` 323  0   Determiningeligibilityorcoverageunderaplanandadjudicatingclaims;3 ݌  (# (# Ќ     ` "3"  323  0   Riskadjustments;3"݌n  (# (# Ќ    0 ` "3"  323  0 ` (#` (#  Billingandcollectionactivities;3݌Z  (# (# Ќ     ` "3"  323  0   Reviewinghealthcareservicesformedicalnecessity,coverage, F  justificationofcharges,andthelike;3݌2t (# (# Ќ   |(xx|"3"     ` 3~23  0   Utilizationreviewactivities;and3~݌` (# (# Ќ   |(xx|"3"     ` 323  0   Disclosurestoconsumerreportingagencies(limitedtospecified  L  identifyinginformationabouttheindividual,hisorherpaymenthistory, 8  andidentifyinginformationaboutthecoveredentity).34݌$  (# (# Ќ        "0 `   Healthcareoperationsarecertainadministrative,financial,legal,andquality   improvementactivitiesofacoveredentitythatarenecessarytorunitsbusiness   andtosupportthecorefunctionsoftreatmentandpayment.Theseactivities,   whicharelimitedtotheactivitieslistedinthedefinitionof healthcare ~ operationsat45_CFR_Ԁ164.501,include: ݌j` (#` (# Ќ  0   (#(# ! ! |(xx|"3"    0 ` 323  0 ` (#` (#  Conductingqualityassessmentandimprovementactivities,population B basedactivitiesrelatingtoimprovinghealthorreducinghealthcarecosts, .p andcasemanagementandcarecoordination;3-݌\ (# (# Ќ   |(xx|"3"    0 ` 3%23  0 ` (#` (#  Reviewingthecompetenceorqualificationsofhealthcareprofessionals, H evaluatingproviderandhealthplanperformance,traininghealthcareand 4 nonhealthcareprofessionals,accreditation,certification,licensing,or   credentialingactivities;3%j݌  (# (# Ќ  ! ! |(xx|"3"    0 ` 323  0 ` (#` (#  Underwritingandotheractivitiesrelatingtothecreation,renewal,or  replacementofacontractofhealthinsuranceorhealthbenefits,and   ceding,securing,orplacingacontractforreinsuranceofriskrelatingto ! healthcareclaims;3 ݌z" (# (# Ќ  ! ! |(xx|"3"    0 ` 3r"23  0 ` (#` (#  Conductingorarrangingformedicalreview,legal,andauditingservices, f# includingfraudandabusedetectionandcomplianceprograms;3r""݌R$ (# (# Ќ  ! ! |(xx|"3"    0 ` 3$23  0 ` (#` (#  Businessplanninganddevelopment,suchasconductingcostmanagement >%  andplanninganalysesrelatedtomanagingandoperatingtheentity;and3$$݌*&l! (# (# Ќ  ! ! |(xx|"3"    0 ` 3&23  0 ` (#` (#  Businessmanagementandgeneraladministrativeactivities,including 'X" thoserelatedtoimplementingandcomplyingwiththePrivacyRuleand (D # otherAdministrativeSimplificationRules,customerservice,resolutionof (0!$ internalgrievances,saleortransferofassets,creatingdeidentifiedhealth )"% informationoralimiteddataset,and_fundraising_Ԁforthebenefitofthe *#& coveredentity.3&&݌+#' (# (# Ќ    GeneralProvisionsat45_CFR_Ԁ164.506.Acoveredentitymay,withouttheindividuals  authorization:         9*"0 `   Useordiscloseprotectedhealthinformationforitsowntreatment,payment,and n  healthcareoperationsactivities. 9*`*݌Z ` (#` (# Ќ     ` Forexample: 2t ! ! |(xx|"3"  0   ` 35,23  0 (#(#  Ahospitalmayuseprotectedhealthinformationaboutanindividualto  L  providehealthcaretotheindividualandmayconsultwithotherhealth 8  careprovidersabouttheindividualstreatment.35,z,݌$  (# (# Ќ  ! ! |(xx|"3"    0 ` 3.23  0 ` (#` (#  Ahealthcareprovidermaydiscloseprotectedhealthinformationaboutan   individualaspartofaclaimforpaymenttoahealthplan.3..݌  (# (# Ќ  ! ! |(xx|"3"    0 ` 3023  0 ` (#` (#  Ahealthplanmayuseprotectedhealthinformationtoprovidecustomer   servicetoitsenrollees.300݌  (# (# Ќ        1"0 `   Acoveredentitymaydiscloseprotectedhealthinformationforthetreatment j activitiesofanyhealthcareprovider(includingprovidersnotcoveredbythe V PrivacyRule). 12݌B` (#` (# Ќ       ` Forexample: \   ! ! |(xx|"3"     ` 3R423  0   Aprimarycareprovidermaysendacopyofanindividualsmedicalrecord 4 toaspecialistwhoneedstheinformationtotreattheindividual.3R44݌  (# (# Ќ  ! ! |(xx|"3"     ` 3e623  0   Ahospitalmaysendapatientshealthcareinstructionstoanursinghome   towhichthepatientistransferred.3e66݌ (# (# Ќ  0  0` (#(# ` (#` (#       7"0 `   Acoveredentitymaydiscloseprotectedhealthinformationtoanothercovered ! entityorahealthcareprovider(includingprovidersnotcoveredbythePrivacy z" Rule)forthepaymentactivitiesoftheentitythatreceivestheinformation. 78݌f#` (#` (# Ќ       ` Forexample: >%  ! ! |(xx|"3"  0   ` 3:23  0 (#(#  Aphysicianmaysendanindividualshealthplancoverageinformationto 'X" alaboratorywhoneedstheinformationtobillforservicesitprovidedto (D # thephysicianwithrespecttotheindividual.3::݌(0!$ (# (# Ќ  ! ! |(xx|"3"  0  0` (#(#3<23  0 ` (#` (#  Ahospitalemergencydepartmentmaygiveapatientspayment )"% informationtoanambulanceserviceproviderthattransportedthepatient *#& tothehospitalinorderfortheambulanceprovidertobillforitstreatment +#' services.3<6=݌ (# (# Ќ        >"0 `   Acoveredentitymaydiscloseprotectedhealthinformationtoanothercovered   entityforcertainhealthcareoperationactivitiesoftheentitythatreceivesthe   informationif: > ?݌n ` (#` (# Ќ    ! ! |(xx|"3"  0  0` (#(#3A23  0 ` (#` (#  Eachentityeitherhasorhadarelationshipwiththeindividualwhoisthe F  subjectoftheinformation,andtheprotectedhealthinformationpertainsto 2t therelationship;and3ARA݌` (# (# Ќ  ! ! |(xx|"3"  0  0` (#(#3[C23  0 ` (#` (#  Thedisclosureisforaqualityrelatedhealthcareoperationsactivity(i.e.,  L  theactivitieslistedinparagraphs(1)and(2)ofthedefinitionof health 8  careoperationsat45_CFR_Ԁ164.501)orforthepurposeofhealthcare $  fraudandabusedetectionorcompliance.3[CC݌  (# (# Ќ  0  0` (#(#Forexample: ` (#` (#  |(xx|"3"     ` 3sF23  0   Ahealthcareprovidermaydiscloseprotectedhealthinformationtoa ~ healthplanfortheplansHealthPlanEmployerDataandInformationSet j (_HEDIS_)purposes,providedthatthehealthplanhasorhadarelationship V withtheindividualwhoisthesubjectoftheinformation.3sFF݌B (# (# Ќ        H"0 `   Acoveredentitythatparticipatesinanorganizedhealthcarearrangement \ (_OHCA_)maydiscloseprotectedhealthinformationaboutanindividualtoanother H coveredentitythatparticipatesinthe_OHCA_Ԁforanyjointhealthcareoperations 4 ofthe_OHCA_. HH݌ ` (#` (# Ќ    0 ` Forexample:` (#` (#   ! ! |(xx|"3"  0   ` 3K23  0 (#(#  Thephysicianswithstaffprivilegesatahospitalmayparticipateinthe ! hospitalstrainingofmedicalstudents.3KL݌z" (# (# Ќ    UsesandDisclosuresofPsychotherapyNotes.Exceptwhenpsychotherapynotesare R$ usedbytheoriginatortocarryouttreatment,orbythecoveredentityforcertainotherlimited >%  healthcareoperations,usesanddisclosuresofpsychotherapynotesfortreatment,payment,and *&l! healthcareoperationsrequiretheindividualsauthorization.See45_CFR_Ԁ164.508(a)(2). 'X"   MinimumNecessary.Acoveredentitymustdeveloppoliciesandproceduresthat (0!$ reasonablylimititsdisclosuresof,andrequestsfor,protectedhealthinformationforpaymentand )"% healthcareoperationstotheminimumnecessary.Acoveredentityalsoisrequiredtodevelop *#& rolebasedaccesspoliciesandproceduresthatlimitwhichmembersofitsworkforcemayhave +#' accesstoprotectedhealthinformationfortreatment,payment,andhealthcareoperations,based  onthosewhoneedaccesstotheinformationtodotheirjobs.However,coveredentitiesarenot  requiredtoapplytheminimumnecessarystandardtodisclosurestoorrequestsbyahealthcare   providerfortreatmentpurposes.Seethefactsheetandfrequentlyaskedquestionsonthisweb   siteabouttheminimumnecessarystandardformoreinformation. n    Consent.Acoveredentitymayvoluntarilychoose,butisnotrequired,toobtainthe F  individualsconsentforittouseanddiscloseinformationabouthimorherfortreatment, 2t payment,andhealthcareoperations.Acoveredentitythatchoosestohaveaconsentprocesshas ` completediscretionunderthePrivacyRuletodesignaprocessthatworksbestforitsbusiness  L  andconsumers. 8    A consentdocumentisnotavalidpermissiontouseordiscloseprotectedhealth   informationforapurposethatrequiresan authorizationunderthePrivacyRule(see45CFR   164.508),orwhereotherrequirementsorconditionsexistundertheRulefortheuseordisclosure   ofprotectedhealthinformation.     RighttoRequestPrivacyProtection.Individualshavetherighttorequestrestrictionson j howacoveredentitywilluseanddiscloseprotectedhealthinformationaboutthemfortreatment, V payment,andhealthcareoperations.Acoveredentityisnotrequiredtoagreetoanindividuals B requestforarestriction,butisboundbyanyrestrictionstowhichitagrees.See45CFR .p 164.522(a). \     Individualsalsomayrequesttoreceiveconfidentialcommunicationsfromthecovered 4 entity,eitheratalternativelocationsorbyalternativemeans.Forexample,anindividualmay   requestthatherhealthcareprovidercallheratheroffice,ratherthanherhome.Ahealthcare   providermustaccommodateanindividualsreasonablerequestforsuchconfidential  communications.Ahealthplanmustaccommodateanindividualsreasonablerequestfor   confidentialcommunications,iftheindividualclearlystatesthatnotdoingsocouldendanger ! himorher.See45CFR164.522(b). z"   Notice.Anyuseordisclosureofprotectedhealthinformationfortreatment,payment,or R$ healthcareoperationsmustbeconsistentwiththecoveredentitysnoticeofprivacypractices.A >%  coveredentityisrequiredtoprovidetheindividualwithadequatenoticeofitsprivacypractices, *&l! includingtheusesordisclosuresthecoveredentitymaymakeoftheindividualsinformationand 'X" theindividualsrightswithrespecttothatinformation.Seethefactsheetandfrequentlyasked (D # questionsonthiswebsiteaboutthenoticestandardformoreinformation. (0!$  ^4 O  5        XDXXXFrequentlyAskedQuestions#XDXXXD}_#XDXXXD *#&  +#'  0  ToseePrivacyRuleFAQs,clickthedesiredlinkbelow:6Y(#(# #XDXXXD_#XDXXXD X#XDXXXD`# O  k`O^   6^   7^XDXXXD4O  5  FAQsonTreatment/Payment/HealthCareOperations6bO0b  7 ^b#XDXXXDa#XDXXXD      X#XDXXXDc#dXDXXXDd#XDXXXDc# X9%4 4 <DLX94 O  5  O  dXDXXXDFAQsonALLPrivacyRuleTopics dO;d   #XDXXXDd#XDXXXD6'dO   7 idd XXDԀ   #XDX e##XDXXXDMe#mF8DXXdXXd8<( ` hp x 44X<XDXXXD XXD(Y#XDX 0g##XDXXXDg#XDXXXDoucanalsogotod#XDXXXDg#4 2 O  5  O  XDXXXDhttp://_answers.hhs.gov_/cgibin/_hhs.cfg_/_php_/_enduser_/_std_alp.php_h   #XDXXXDkh#XDXXXD6g   7 !3hd XXD,#XDX =j##XDXXXDi#XDXXXDthen R ` select"PrivacyofHealthInformation/HIPAA"fromtheCategorydropdownlistand >L clicktheSearchbutton.d#XDXXXDj#XDXXXD) XXD#  k#   *8   #  k##XDX k#  _