Under the HIPAA minimum necessary standard, only the specific elements of protected health information (PHI) required to achieve the intended purpose can be disclosed. That means that treatment requires relevant medical history and test results; payment involves diagnosis codes and treatment details; healthcare operations need procedure-specific data; public health activities use information for disease control; and research prefers de-identified or limited data sets.
Understanding the minimum necessary standard
The minimum necessary standard mandates that when using or disclosing PHI, or when requesting PHI from another entity, covered entities must make reasonable efforts to limit the information to the minimum necessary to accomplish the intended purpose. This principle helps protect patient privacy by ensuring that sensitive information is not unnecessarily exposed. The HHS states that " The minimum necessary standard requires covered entities to evaluate their practices and enhance safeguards as needed to limit unnecessary or inappropriate access to and disclosure of protected health information. The Privacy Rule’s requirements for minimum necessary are designed to be sufficiently flexible to accommodate the various circumstances of any covered entity."
Scope of the minimum necessary standard
The minimum necessary standard governs various routine healthcare activities such as treatment, payment processing, and healthcare operations like quality assessment and training. It ensures that only essential PHI is disclosed to facilitate these functions, maintaining patient privacy and compliance with HIPAA regulations. However, exceptions exist where the standard does not apply, including disclosures directly to patients, disclosures authorized by patients themselves, or disclosures mandated by law. These exceptions allow information sharing while maintaining patient autonomy and legal compliance in critical healthcare situations.
Read more: Exceptions to the Minimum Necessary Standard
Information you can disclose under the minimum necessary standard
For treatment purposes, healthcare professionals can disclose relevant medical history, test results, and treatment plans needed for diagnosis and care coordination. That ensures that only the information necessary to provide care is shared, safeguarding the patient’s broader medical details.
In the context of payment, diagnosis codes, treatment details, and service dates can be disclosed to process claims and billing. That ensures insurers have the information they need to validate claims without accessing unnecessary personal details.
For healthcare operations, data necessary for activities like quality assessment, training, and operational reviews can be disclosed. That includes specific procedural data and quality metrics, ensuring operational efficiencies and improvements are based on relevant information.
Public health activities require disclosure of information needed for disease prevention or control. That includes data pertinent to public health reporting and disease control efforts, ensuring that public health authorities have the information they need to manage public health risks effectively.
In research, the minimum necessary standard allows for the disclosure of data needed for scientific studies and analyses. Whenever possible, this data should be de-identified or provided in limited data sets to protect patient identities while facilitating valuable medical research.
Implementing the minimum necessary standard
- Access controls: Implement role-based access to ensure staff access only the necessary information. Establish policies for routine disclosures and evaluate non-routine requests on a case-by-case basis.
- Training and education: Regularly train staff on the principles of the minimum necessary standard. Topics should include understanding what constitutes necessary information and how to apply the standard in various scenarios.
- Audit and monitoring: Conduct regular audits of access to PHI. Monitor compliance with policies and procedures to ensure adherence to the minimum necessary standard.
FAQs
How does the minimum necessary standard apply to electronic health records (EHRs)?
Implement role-based access controls in EHR systems to ensure that healthcare workers access only the PHI necessary for their job functions.
Does the minimum necessary standard apply to business associates of covered entities?
Yes, business associates must also comply with the minimum necessary standard when using, disclosing, or requesting PHI on behalf of covered entities.
How does the minimum necessary standard affect the sharing of PHI during emergencies?
In emergencies, the standard is relaxed to allow for necessary disclosures to ensure the health and safety of individuals. However, reasonable efforts should still be made to limit the information shared.
Liyanda Tembani
