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LAW ENFORCEMENT EXCEPTION TO HIPAA: WHAT PROVIDERS NEED TO KNOW

The following article is from the MagMutual Learning center. MagMutual, an A rated healthcare liability insurance company, is the malpractice insurance carrier used by Wapiti Medical Staffing.

As a healthcare organization, you may receive a verbal or written request for protected health information (PHI) or copies of medical records from law enforcement officials as part of their investigation process. For example, law enforcement may need to follow-up on a Division of Family & Children Services (DFCS) referral for suspected child abuse, or they may be investigating an altercation that resulted in a crime.

The HIPAA Privacy Rule contains an exception for law enforcement purposes (45 CFR § 164.512(f)), which permits a covered entity to disclose PHI to law enforcement officials without patient authorization under the following circumstances:

  • Court orders, court-ordered warrants, subpoenas, and administrative requests
  • To identify or locate a suspect, fugitive, material witness, or missing person
  • To answer a law enforcement official’s request for information about a victim or suspected victim of a crime
  • To alert law enforcement of a person’s death, if the organization suspects that criminal activity caused the death
  • When an organization believes that PHI is evidence of a crime that occurred on its premises
  • In a medical emergency not occurring on its premises, when it is necessary to inform law enforcement about the commission and nature of a crime, the location of the crime or crime victims, and the perpetrator of the crime

For purposes of this exception, “law enforcement official” is defined broadly and means an officer or employee (state or federal) who investigates or conducts an official inquiry into a potential violation of law or prosecutes or otherwise conducts a criminal, civil, or administrative proceeding arising from an alleged violation of law. Some examples of law enforcement officials include officers, investigators, or detectives from the Sheriff’s Office, the FBI, and state detectives or investigators … continue reading

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