When must PHI be disclosed without patient authorization?

The requirement for disclosing Protected Health Information (PHI) without patient authorization is rooted in specific provisions under the HIPAA Privacy Rule. In particular, certain situations necessitate the release of PHI for the public good or legal compliance.

When an investigation is conducted by the Department of Health and Human Services (HHS), covered entities must provide requested PHI as part of their compliance obligations. This is significant because HHS oversees adherence to HIPAA regulations, and full cooperation is required to investigate potential violations. Therefore, disclosure in the context of HHS investigations fulfills legal obligations and public interest without the need for patient consent.

On the other hand, when requested by the patient or their authorized representative, the disclosure of PHI is required as patients have rights pertaining to their own health information. This empowerment ensures they can access their health records and manage their health care effectively.

Thus, both situations—compliance with HHS investigations and fulfilling patient requests—require the disclosure of PHI without the need for further authorization. This understanding underlines HIPAA's balancing act between patient rights and public health requirements.