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Workers Compensation, HIPAA, and Accounting of Disclosures

Workers Compensation, HIPAA, and Accounting of Disclosures 2025

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The document outlines the procedures and regulations regarding the release of health information for Workers' Compensation claims, emphasizing the importance of completing specific forms (801 and 827) to authorize the disclosure of medical records. It clarifies that while these forms allow for necessary disclosures to insurers and state agencies, they do not constitute valid HIPAA authorizations. The document also details the accounting requirements for such disclosures, distinguishing between those required for benefit determinations and those related to payment for services, which are exempt from accounting. Additionally, it highlights the need for minimum necessary standards in releasing information.

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How does HIPAA apply to workers compensation?

The Privacy Rule does not require accounting for disclosures: (a) for treatment, payment, or health care operations; (b) to the individual or the individuals personal representative; (c) for notification of or to persons involved in an individuals health care or payment for health care, for disaster relief, or for

Does HIPAA require an accounting of disclosures?

In the final rule, covered entities are not required to include the following disclosures in the accounting: disclosures to the individual, disclosures for facility directories under 164.510(a), or disclosures to persons assisting in the individuals care or for other notification purposes under 164.510(b).

What disclosures do not require accounting?

A covered entity is not required to provide an accounting for a disclosure where the only information disclosed is in the form of a limited data set, and the covered entity has a data use agreement with the public health authority receiving the information.