Can covered entities share patient information without a court order? 

Covered entities can share patient information without a court order for specific purposes like treatment, payment, healthcare operations, or when responding to certain legal and public health requirements.

HIPAA and the judicial process

HIPAA determines how protected health information (PHI) can be accessed, used, or disclosed during legal disputes. In a scenario where a court case necessitates the inclusion of specific health records to resolve a claim or dispute, HIPAA ensures that only necessary information makes its way into the courtroom.

When a court or a legal entity requires sensitive health records, they must secure a court order or a subpoena that adheres to HIPAA. Entities holding the information may also be required to make an effort to inform individuals if their records are requested. The notification allows individuals the opportunity to object to the disclosure or to seek a protective order from the court themselves.

The requirements to share patient information without a court order

According to the HHS, “A covered entity that is not a party to litigation, such as where the covered entity is neither a plaintiff nor a defendant, may disclose protected health information in response to a subpoena, discovery request, or other lawful process, that is not accompanied by a court order,” under certain conditions.  

The requirements include: 

• The entity holding the PHI (such as a hospital or clinic) must ensure that the individual whose information is requested has been notified about the legal request. The notice must be made in good faith, which involves attempting to contact the individual directly or sending a notice to the last known address. 
• After the individual has been notified, they must be given a reasonable amount of time to object. If the individual objects, the objection must be resolved before disclosure occurs. If no objections are raised within the allotted time, or if all objections have been resolved in favor of disclosure, the process moves forward.
• In cases where the information is to be used in litigation or legal proceedings, the party requesting the PHI must obtain a qualified protective order from the court or show that an order has been agreed upon. A qualified protective order ensures that the PHI is used solely for litigation or proceedings and mandates either the return or the destruction of the PHI at the end of the litigation.
• In all cases, the PHI disclosed must be limited to the minimum necessary to fulfill the purpose of the request. This principle ensures that excessive details or unrelated information about the individual are not disclosed, maintaining the integrity of the individual’s privacy as much as possible.

See also: HIPAA Compliant Email: The Definitive Guide

FAQs

What is PHI?

Protected health information is any health information that can be used to identify an individual and was created, used, or disclosed during healthcare services, including diagnosis or treatment.

What is the minimum necessary standard?

The minimum necessary standard is a HIPAA requirement outlining that only the necessary amount of protected health information needed to perform a task is used or disclosed.

When is consent necessary to share patient info?

Consent is necessary to share patient information for purposes not directly related to treatment, payment, or healthcare operations, such as marketing or sharing with third parties not involved in the individual's care.