HIPAA Administrative Simplification Regulation Text
March 2013
88
(A) Consistent with a prior expressed
preference of the individual, if any,
that is known to the covered health
care provider; and
(B) In the individual's best interest as
determined by the covered health
care provider, in the exercise of
professional judgment.
(ii) The covered health care provider
must inform the individual and
provide an opportunity to object to
uses or disclosures for directory
purposes as required by paragraph
(a)(2) of this section when it become
practicable to do so.
(b) Standard: Uses and disclosures
for involvement in the individual's
care and notification purposes
(1) Permitted uses and disclosures.
(i) A covered entity may, in
accordance with paragraphs (b)(2),
(b)(3), or (b)(5) of this section,
disclose to a family member, other
relative, or a close personal friend of
the individual, or any other person
identified by the individual, the
protected health information directly
relevant to such person's involvement
with the individual's health care or
payment related to the individual's
health care.
(ii) A covered entity may use or
disclose protected health information
to notify, or assist in the notification
of (including identifying or locating),
a family member, a personal
representative of the individual, or
another person responsible for the
care of the individual of the
individual's location, general
condition, or death. Any such use or
disclosure of protected health
information for such notification
purposes must be in accordance with
paragraphs (b)(2), (b)(3), (b)(4), or
(b)(5) of this section, as applicable.
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(2) Uses and disclosures with the
individual present. If the individual is
present for, or otherwise available
prior to, a use or disclosure permitted
by paragraph (b)(1) of this section
and has the capacity to make health
care decisions, the covered entity
may use or disclose the protected
health information if it:
(i) Obtains the individual's
agreement;
(ii) Provides the individual with the
opportunity to object to the
disclosure, and the individual does
not express an objection; or
(iii) Reasonably infers from the
circumstances, based on the exercise
of professional judgment, that the
individual does not object to the
disclosure.
(3) Limited uses and disclosures
when the individual is not present. If
the individual is not present, or the
opportunity to agree or object to the
use or disclosure cannot practicably
be provided because of the
individual's incapacity or an
emergency circumstance, the covered
entity may, in the exercise of
professional judgment, determine
whether the disclosure is in the best
interests of the individual and, if so,
disclose only the protected health
information that is directly relevant
to the person's involvement with the
individual's care or payment related
to the individual's health care or
needed for notification purposes. A
covered entity may use professional
judgment and its experience with
common practice to make reasonable
inferences of the individual's best
interest in allowing a person to act on
behalf of the individual to pick up
filled prescriptions, medical supplies,
X-rays, or other similar forms of
protected health information.
(4) Uses and disclosures for disaster
relief purposes. A covered entity may
use or disclose protected health
information to a public or private
entity authorized by law or by its
charter to assist in disaster relief
efforts, for the purpose of
coordinating with such entities the
uses or disclosures permitted by
paragraph (b)(1)(ii) of this section.
The requirements in paragraphs
(b)(2), (b)(3), or (b)(5) of this section
apply to such uses and disclosures to
the extent that the covered entity, in
the exercise of professional
judgment, determines that the
requirements do not interfere with
the ability to respond to the
emergency circumstances.
(5) Uses and disclosures when the
individual is deceased. If the
individual is deceased, a covered
entity may disclose to a family
member, or other persons identified
in paragraph (b)(1) of this section
who were involved in the individual's
care or payment for health care prior
to the individual's death, protected
health information of the individual
that is relevant to such person's
involvement, unless doing so is
inconsistent with any prior expressed
preference of the individual that is
known to the covered entity.
[65 FR 82802, Dec. 28, 2000, as
amended at 67 FR 53270, Aug. 14,
2002; 78 FR 5699, Jan. 25, 2013]
§ 164.512 Uses and disclosures for
which an authorization or
opportunity to agree or object is
not required.
A covered entity may use or disclose
protected health information without
the written authorization of the
individual, as described in § 164.508,
or the opportunity for the individual
to agree or object as described in
§ 164.510, in the situations covered
by this section, subject to the
applicable requirements of this
section. When the covered entity is
required by this section to inform the
individual of, or when the individual
may agree to, a use or disclosure