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A covered entity is permitted, but not required, to use and disclose protected health information, without an individuals authorization, for the following purposes or situations: (1) To the Individual (unless required for access or accounting of disclosures); (2) Treatment, Payment, and Health Care Operations; (3)
When Must Patient Authorization be Obtained for Uses and Disclosures of PHI? Authorizations are generally required for psychotherapy notes, substance abuse disorder and treatment records, and for marketing purposes.
Answer: A patient authorization is not required for disclosure of PHI between Covered Entities if the disclosure is needed for purposes of treatment or payment or for healthcare operations. You may disclose the PHI as long as you receive a request in writing.
HIPAA Exceptions Defined To public health authorities to prevent or control disease, disability or injury. To foreign government agencies upon direction of a public health authority. To individuals who may be at risk of disease. To family or others caring for an individual, including notifying the public.
Covered entities may disclose protected health information that they believe is necessary to prevent or lessen a serious and imminent threat to a person or the public, when such disclosure is made to someone they believe can prevent or lessen the threat (including the target of the threat).

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There are a few scenarios where you can disclose PHI without patient consent: coroners investigations, court litigation, reporting communicable diseases to a public health department, and reporting gunshot and knife wounds.
When Can PHI Be Released without Authorization? The major exception to the need for specific authorization for the release of PHI is that medical care providers may release information to other providers and entities who are participating in the patients care, and to business that provide services for those providers.
HIPAA authorization is consent obtained from a patient or health plan member that permits a covered entity or business associate to use or disclose PHI to an individual/entity for a purpose that would otherwise not be permitted by the HIPAA Privacy Rule.

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