Instances where the minimum necessary standard does not apply

There are cases where full access to patient health is necessary, such as for diagnosis or public health purposes. The minimum necessary standard would, at times, result in the limitation of information that could create risks or delays. Some instances carve out exceptions so that healthcare professionals can effectively uphold privacy protections without compromising operational efficiency. 

What is the minimum necessary standard? 

The minimum necessary standard requires covered entities to limit the use, disclosure, and access of protected health information (PHI) to only what is necessary for specific purposes. The standard goes beyond simply requiring that the minimum necessary amount of PHI is shared but requires that organizations evaluate and disclose every request or instance of disclosure carefully to determine what is only aboslutely required for the task.

A study published in Genetics Medicine provides that, “Minimum necessary violations are one of the top five causes of patient complaints investigated by the US Department of Health and Human Services Office for Civil Rights, which administers HIPAA.”

The large number of complaints makes it necessary to understand that its application in a practical situation uses a balance of operational efficiency and privacy protection through policies that provide need to know access. These policies can range from staff access to PHI being limited to the limitation of exposure in cases like third party marketing requests for patient data.  

The exceptions to the minimum necessary standard

The following instances are the exceptions to the requirements of the minimum necessary standard: 

• Disclosures of PHI from other healthcare providers for treatment related purposes. 
• When a patient explicitly authorizes the use or disclosure of their PHI by the Privacy Rule, provided the information is in a designated record set. 
• In situations where PHI is legally required to be disclosed like the mandatory reporting of abuse or neglect. 
• Instances where the PHI is being shared with the patient. 
• Disclosures to the Secretary of the HHS as provided for in 45 CFR Part 160 Subpart C.

It should be noted that as with any communication, especially considering that full medical histories can be shared under these exceptions, secure methods of communication are required. The most effective of these methods remains the use of HIPAA compliant email platforms like Paubox. 

FAQs

What is the Privacy Rule? 

A HIPAA regulation that protects the privacy of patient's health information. 

What is the Treatment, Payment, and Operations exception?

An exception under HIPAA allows healthcare providers to use and disclose patient information without consent for activities like treatment, billing, and healthcare operations. 

What are nonroutine disclosures?

Instances where patient information is shared outside typical purposes.