HIPAA GENERAL OPERATING POLICY #13
DISCLOSURES TO FAMILY MEMBERS
I. General Rule
Except as otherwise provided in HIPAA General Operating Policies 8, 44 and 45, a HCC may, in accordance with paragraphs (a) or (b) below, use or disclose to a family or household member of the individual, the PHI directly relevant to such person's involvement with the individual's care or payment for that care, unless expressly prohibited by the individual or the personal representative.
A HCC may, in accordance with paragraphs (a), (b) or (c) below, use or disclose PHI to notify or assist in notifying a family or household member of the individual of a brief confirmation of the individual's general health status, unless expressly prohibited by the individual or the personal representative.
(a) If the individual is present or otherwise available prior to the use or disclosure permitted above and has the capacity to make health care decisions, the HCC may use or disclose the PHI if it obtains the individual's agreement, it provides the individual with the opportunity to object and the individual does not express an objection, or reasonably infers from the circumstances that the individual does not object.
(b) If the individual is not present or the opportunity to object cannot practicably be provided because of incapacity or emergency, the HCC may disclose only the PHI directly relevant to such person's involvement with the individual's care if the HCC has determined that the disclosure is in the individual's best interest. A HCC may use its professional experience and common practice to make reasonable inferences of the individuals best interest in allowing a person to act on behalf of the individual to pick up filled prescriptions, medical supplies, X-rays, and other similar forms of PHI.
(c) A HCC may use or disclose to emergency services, health care and relief agencies, a brief confirmation of the individual's health status for the purpose of coordinating with such entities uses or disclosures of PHI to notify or assist in the notifying a family or household member of the individual. The requirements of (a) and (b) apply to such uses and disclosures to the extent the HCC determines they do not interfere with the ability to respond to the emergency circumstances.
Revised 09/04/03