HIPAA: Minimum Necessary Rule

HIPAA: Minimum Necessary Rule
January 30, 2020 Erica Manhardt

The minimum necessary rule is a key protection of the HIPAA Privacy Rule. It is based on the premise that protected health information should not be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function by the covered entity or business associate. PHI should only be shared minimally in order to satisfy and complete a certain activity. For example, if a person’s name is asked for tracking drug usage, would another type of identifier or tracking be able to complete the same task? As employees, we should always question ourselves as to whether we are sharing what truly is minimally necessary.

The minimum necessary standard requires covered entities and business associates to evaluate their business practices and enhance safeguards as needed to limit unnecessary or inappropriate access to and disclosure of protected health information. The Privacy Rule’s requirements for “minimum necessary” are designed to be sufficiently flexible to accommodate the various circumstances of any covered entity or business associate. However, a covered entity or business associate may not use, disclose, or request the entire medical record for a particular purpose, unless it can specifically justify the whole record as the amount reasonably needed for the purpose.

How the Rule Works

The Privacy Rule generally requires covered entities and their business associates to take reasonable steps to limit the use or disclosure of, and requests for, protected health information to the minimum necessary to accomplish the intended purpose. This provision requires a covered entity and business associates to develop and implement policies and procedures appropriate for its own organization, reflecting the entity’s business practices and workforce.

Exemptions from the Minimum Necessary Standard

Disclosures to or requests by a health care provider for treatment purposes Disclosures to the individual who is the subject of the information
Uses or disclosures made pursuant to an individual’s authorization Uses or disclosures required for compliance with the HIPAA Administrative Simplification Rules
Disclosures to HHS for Privacy Rule enforcement purposes Uses or disclosures that are required by other laws

This content is being provided as an informational tool. It is believed to be accurate at the time of posting and is subject to change. It is recommended that plans consult with their own experts or counsel to review all applicable federal and state legal requirements that may apply to their group health plan. By providing this information, Meritain Health is not exercising discretionary authority or assuming a plan fiduciary role, nor is Meritain Health providing legal advice.