Is It a Violation? Patient Records Release for Treatment

You and your team work hard every day. Your top priority is, of course, patient care. But there is a confusing area that could affect every healthcare organization. The key issue is HIPAA Patient Records Release. This topic deals with when we can share Protected Health Information (PHI) with other providers. Specifically, can we share it for patient treatment without a signed authorization? This is a question facing healthcare support staff daily.

What is PHI Release for Treatment?

The heart of this matter is “continuity of care.” This means making sure a patient’s care continues smoothly between different doctors. You may get a request for a patient’s records or studies. The request comes from a new specialist the patient is seeing. Your team knows the patient is getting treatment. Consequently, you feel obligated to send the records immediately. However, you do not have a signed consent form.

You are right to question this disclosure. The Health Insurance Portability and Accountability Act (HIPAA) is the federal law. It protects patient information. However, HIPAA has specific exceptions. One major exception allows disclosure for treatment, payment, and healthcare operations (TPO). The key here is “treatment.”

The “Treatment” Exception

HIPAA’s Privacy Rule allows PHI disclosure for treatment. This is explicitly stated in 45 CFR §164.506(c). Therefore, covered entities, like your facility, can share records. The sharing must be for coordinating or managing the patient’s care. Sharing is allowed without the patient’s written authorization. This is a vital rule for patient safety. Doctors must consult and coordinate care quickly.

This applies even when the requesting provider did not order the initial service. For instance, a specialist requests studies for a patient’s cancer care. They need those studies to treat the patient. This request is for coordination of care. Thus, it falls under the “treatment” exception. This rule promotes seamless care for all patients.

Furthermore, many state laws align with HIPAA on this. For example, Florida lawpermits releasing records for continuity of care. You are not required to get a patient’s written authorization.

The Consequences of an Error

This is a scenario that could happen to all of us. Imagine a records clerk sharing a patient’s entire chart. The request was only for a single lab test. This is a HIPAA violation of the “minimum necessary” rule. This rule applies to disclosures for payment and healthcare operations. While “treatment” is exempt, over-disclosing is risky.

Unauthorized record release can bring serious consequences. Violations are investigated by the HHS Office for Civil Rights (OCR). Penalties are substantial. For example, some facilities faced millions of dollars in fines. Another organization paid a large settlement. This was due to a stolen, unencrypted laptop. The theft disclosed patient data.

These consequences include financial penalties. There may also be a corrective action plan to follow. Worst of all, patient trust is damaged. This is a critical asset to your organization. You can see examples of HIPAA enforcement actions from the government.

Protocols to Protect Your Organization

We are all responsible for protecting PHI. Therefore, your organization needs strong protocols. These steps protect both the provider and the patient. Taino Consultants can help you. They offer resources to ensure compliance.

1. Verify the Request: Always confirm the request is from a legitimate provider. Make sure they are involved in the patient’s care.
2. Document Everything: Keep a clear record of every disclosure. Log what information was sent, when, and to whom.
3. Train Your Team: Staff must be well-educated on the “treatment” exception. They also must understand the “minimum necessary” rule.
4. Use Encryption: Use encryption for all electronic PHI (ePHI) transmissions. This is now a mandatory security measure.
5. Conduct a Risk Analysis: Regularly assess your system for security weaknesses. This is a fundamental HIPAA Security Rule requirement.

You can visit the HHS Office for Civil Rights website for further guidance on disclosure rules. Seek expert support for all your compliance needs.

Upcoming 2025 HIPAA Changes

The regulatory landscape is always changing. New proposed changes to HIPAA are expected around 2025. These modifications focus on improving care coordination. The changes also aim to strengthen patient access rights. For now, the “treatment” exception remains a core principle. This is not expected to change. In fact, a proposed new rule helps care coordination further. It would create a “minimum necessary” exception for individual-level care coordination. This helps streamline patient care even more.

Conclusion

You can fulfill a request for records from another treating provider. This is allowed under the HIPAA “treatment” exception. A separate patient authorization is not required. Just remember to document the disclosure. You must also maintain appropriate safeguards. Your due diligence protects the patient and your organization. For expert assistance with compliance, contact EPI Compliance today.