DEPARTMENT OF HEALTH 8: HUMAN SERVICES OFFICE OF THE SECRETARY Office for Civil Rights, Region 111 1deioe? (215} 861?4441 150 5. Independence Hall West Too (215) 361-4440 FAX - (215} 361-4431 Public Ledger Building, Suite 3.72 1 Philadelphia, PA isles?3499 Reference: 12-140500 Investigator: Ralph Balsamo Contact Telephone: 215-861-4444 May 6, 2013 (blotted: On March 15, 2012, the LLS. Department of Health and Human Services (HI-IS), Of?ce for Civil Rights (OCR), Region H1 received your complaint alleging that the United States Air Force (covered entity) has violated the Federal Standards for Privacy of Individually Identi?able Health Information (45 C.F.R. Parts 160 and 164, Subparts A and E, the Privacy Rule). Speci?cally, you allege that, on September 20, 2011, the United States Air Force released your protected health information to your spouse This allegation could re?ect a violation of 45 C.F.R. 164.510 and Thank you for bringing this matter to attention. Your complaint plays an integral part in enforcement efforts. OCR enforces the Privacy, Security, and Breach Noti?cation Rules, and also enforces the Federal civil rights laws which prohibit discrimination in the delivery of health and human services because of race, color, national origin, disability, age, and under certain circumstances, sex and religion. A covered entity may not use or disclose protected health information except as permitted or required by the Privacy Rule. As long as an individual does not object, a covered entity is allowed to share or discuss with the individual?s family, friends, or other persons identi?ed by the individual the protocted health information that is directly relevant to such person?s involvement with the individual?s care or payment for care. The covered entity may ask the individual?s permission, may tell the individual that the covered entity plans to discuss the information and give the individual an opportlmity to object, or may decide, using the covered entity?s professional judgment, that the individual does not object. However, in any of these cases, the covered entity may discuss only the information that the person involved needs to know about the individual?s care or payment for their care. The minimum necessary provision of the Privacy Rule also requires the covered entity to limit access to protected health information by identifying the persons or classes of persons within the covered entity who need access to the information to carry out their job duties, the categories or types of protected health information needed, and conditions appropriate to such access. Finally, a covered entity must provide a process for individuals to make complaints concealing the covered entity?s policies and procedures required by the Privacy Rule or its compliance with such policies and procedures or with the requirements of the Privacy Rate. 45 C.F.R. 164.530 We have carefully reviewed your complaint against the covered entity and have determined to resolve this matter informally through the provision of technicai assistance to the covered entity. Should OCR receive a similar allegation of noncompliance against the covered entity in the ?rture, OCR may initiate a formal investigation of that matter. Based on the foregoing, OCR is closing this case without further action, effective the date of this letter. determination as stated in this letter applies only to the allegations in this complaint that were reviewed by OCR. Under the Freedom of Information Act, we may be required to release this letter and other information about this case upon request by the public. In the event OCR receives such a request, we will make every effort, as permitted by law, to protect information that identi?es individuals or that, if released, could constitute a clearly unwarranted invasion of personal privacy. If you should have any questions, please do not hesitate to contact Mr. Ralph Balsamo of my staff at (215) 861-4444 or (215) 861-4440 (TTY). Sincerely, Barbara J. Holland Regional Manager a! m; ?lulu. DEPARTMENT OF HEALTH HUMAN SERVICES OFFICE OF THE SECRETARY Of?ce for Civil Rights, Region 151:1 5. Independence Hall West Public Ledger Building, Suite 3?2 Philadelphia, PA 19105-3499 Voice- (215} 851?4441 TDD (215} 851444!) FAX [215} 351-4431 12- 140500 Ralph Balsamo 21 5-861-4444 Reference Investigator: Contact Telephone: May 6, 2013 Director Tricare ent Activity Privacy Of?ce Skyline 5, 51 1 1 Pike Falls Church, Virginia 22041 i On March 14, 2012, the U.S. Department of Health and Human Services Office for Civil Rights (OCR), Region received a complaint alleging that the United States Air Force (covered entity) has violated the Federal Standards for Privacy of Individually Identi?able Health Information 45 C.F.R. Parts 160 and 164, Subparts A and a, the Privacy Rule). Speci?cally, the complainant, libi'EBJ-ibimici alleges th on - ember 20, 2011, the covered entity released his protected health information to his spouse, This allegation could re?ection a? violation of 45 can. 164.510 and OCR enforces the Privacy, Security, and Breach Noti?cation Rules, and also enforces the Federal civil rights laws nirich prohibit discrimination in the delivery of health and human services because of race, color, national origin, disability, age, and under certain circumstances, sex and religion. Pursuant to the Privacy Rule, a covered entity may not use or disclose protected health information (PHI) except as permitted or required by the Privacy Rule. As long as an individual does not object, a covered entity is allowed to share or discuss the individual?s health information with the individual?s family, friends, or others involved in the individual?s care or payment for their care. The covered entity may ask the individual?s permission, may tell the individual that the covered entity plans to discuss the information and give the individual an opportunity to object, or may decide, using the covered entity?s professional judgment, that the individual does not object. However, in any of these cases, the covered entity may discuss the information that the person involved needs to know about the individual?s care or payment for their care. The minimum necessary provision of the Privacy Rule also requires the covered entity to limit access to protected health information by identifying the persons or classes of persons within the covered entity who need access to the information to carryr out their job duties, the categories or types of promoted health information needed, and conditions appropriate to such access. Finally, a covered entity must provide a process for individuals to make complaints concerning the covered entity?s policies and procedures required by the Privacy Rule or its compliance with such policies and procedures or with the requirements of the Privacy Rule. 45 CIR, In this matter, the complainant alleges that the complainant?s PHI was impermissiny disclosed to a member of the complainant?s family or to an acquaintance of the complainant or that the complainant?s PHI was otherwise impennissibly used by an employee of the covered entity. Pursuant to its authority under 45 C.F.R 160.304{a) and OCR has determined to resolve this matter informally through the provision of technical assistance to the covered entity. To that end, OCR has enclosed material explaining the Privacy Rule provisions related to Disclosures to Family and Friends, the Minimum Necessary Requirement, and Reasonable Safeguards. It is our expectation that you will review these materials closely and share them with your staff as part of the Health Insurance Portability and Accountability Act (I-IIPAA) training you provide to your workforce. It is also our expectation that you will assess and determine whether there may have been an incident of noncompliance as alleged by the complainant in this matter, and, if so, to take the steps necessary to ensure such noncompliance does not occur in the ?rture. Please contact OCR if you need further information regarding the allegations in this matter. Should OCR receive a similar allegation of noncompliance against the covered entity in the future, OCR may initiate a formal investigation of that matter. . Based on the forgoing, OCR is closing this case without further action, effective the date of this letter. determination as stated in this letter applies only to the allegations in this complaint that were reviewed by OCR. Under the Freedom of Information Act, we may be required to release this letter and other information about this case upon request by the public. In the event OCR receives such a request, we will make every effort, as permitted by law, to protect information that identi?es individuals or that, if released, could constitute a clearly unwarranted invasi0n of personal privacy. If you should have any questions, please do not hesitate to contact Mr. Ralph Balsamo of my staff at (215) 861-4444 or (215) 861-4440 (TTY). Sincerely, Barbara I. Hollan Regional Manager Disclosures to Family and Friends The Minimum Necessary Requirement Reasonable Safeguards Enclosures: