Understanding HIPAA

HIPPA (Health Insurance and Portability Accountability Act of 1996)

Updated February 2020

  • HIPAA sets rules for health providers
  • ers and health plans about the sharing of personal health information (PHI).
    Most family members run into questions about HIPAA for loved ones over the age of 18. Prior to 18 parents are the ‘personal representative’ for their child and have full access to their child’s PHI.
  • A family member with guardianship or health power of attorney can be viewed as a family member’s personal health representative and would have access to all PHI.
  • A health provider must obtain written permission of the person being treated in order to disclose any PHI that is not for treatment, payment or health care. Typically, a Release of Information (ROI) is signed by the person in treatment allowing the health provider to talk to and share information with family members. The person in treatment may refuse to sign the ROI.
  • If the family member is present, and the person being treated does not object a health care provider can obtain informal consent and share information in the presence of the family member.
  • When an individual is incapacitated, is in an emergency situation or is not present, health care providers may make disclosures they believe to be in the best interest of the individual. There is no definition of what qualifies as an emergency, and this is totally left up to the discretion of the provider.
  • Family members may always communicate to the health care provider with information they think is important for the health provider to know (diagnoses, previous medical history, current family circumstances, etc.) even if consent has not been given It is up to the health care provider whether to tell the person in treatment that a family member has contacted them.
    Additional resources: Brief overview and examples of HIPAA: https://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/understanding/consu

HHS website on HIPAA: https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html