The Health Insurance Portability and Accountability Act (HIPAA) is designed to balance privacy, efficiency, and quality. A covered entity generally does not need your permission to share your protected health information (PHI) with another covered entity for treatment, payment, or healthcare operations, commonly referred to as TPO. For example, a doctor will generally not ask your permission before:
- Sending your records to a second doctor for a second opinion (treatment);
- Consulting with another health care provider regarding your medical status (treatment);
- Asking TRICARE for reimbursement for the services you received (payment);
- Sharing medical services provided for coverage and justification of charges (payment);
- Reviewing your records to conduct MHS provider training programs, including certification and licensing (health care operations); and
- Reviewing your records to see if your doctor followed protocol (health care operations).
However, HIPAA does give you the right to:
- Learn how the Military Health System (MHS) will use and disclose your PHI;
- Request to limit who can access your PHI;
- Find out when a covered entity discloses your PHI to others;
- Request to view and receive a copy of your PHI; and
- Request to amend your PHI if incorrect or incomplete.
HIPAA also requires the MHS to:
- Make sure your PHI is stored securely if maintained electronically;
- Make sure your PHI is available when you need healthcare; and
- Notify you if your PHI is lost or stolen.
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Last Updated: March 20, 2019