6543 University Dr.

Hospital, Ohio 45255

(555)555-1234

HollandHospitalHR@Hr.hos

Policy for Release of Information

Policy-
It is the policy of Holland Hospital to safeguard Protected Health Information
(PHI) from unauthorized use, access, or disclosure. Any PHI received or
obtained, fashioned or maintained by Holland Hospital shall be held to the
highest standard of confidentiality and security measures.

PURPOSE-
To make certain that all Holland Hospital personnel understand
Policies and Procedures For Release of Information For Protected Health
Information, disclosing only PHI according to Holland Hospitals rules and
regulations, and State, Federal Laws.

HIPPA Rule & General Guidelines for Release of Information -

According to the HIPPA Rule Section 164.508 of the final privacy rule states
that covered entities may not use or disclose protected health information
(PHI) without a valid authorization, except as otherwise permitted or required
in the privacy rule. Stated in the HIPPA rule a valid authorization must be
written in plain language. It also states that the general authorization must
contain certain core elements.
 The Following are the core elements required by
Holland Hospital and HIPPA Rules for Release of Information:

The Release must contain a significant description of the PHI that will be disclosed.

The name of the person(s) who is Authorized to use or release the PHI.

Identification is required for the person(s) or covered entity that is authorized to

make use of the requested information.

An explanation of the reason for the requested PHI.

An expiration date in relation to the individual and/or the purpose for use.

An Authorized individual must sign and date the authorization. In the event the
authorization must be signed by an Authorized Representative, the individual must
provide an explanation of their authority to acquire the PHI on that particular
individuals behalf.

A declaration that tells the individuals right to withdraw, how it can be withdrawn
and references on their rights and actions that can be taken to be withdrawn.
 Requests for Specific Types of PHI

Research-

An authorization for the use o PHI for a research study must be authorized in

written form allowing permission. Authorization must include approval to

contribute in the research along with approval to divulge PHI from the research.

Psychotherapy notes-

In the event a request is made for psychotherapy notes Holland Hospital requires

the authorization to expressly identify the psychotherapy notes on a separate form

with valid authorization form signed and dated.

Alcohol and Drug Abuse PHI Records-

The Confidentiality of Alcohol and Drug Abuse Patient Records Rule applies to

federally assisted alcohol and drug abuse programs as defined by 42 CFR, part 2,

section 2.12.3 Holland Hospital shall follow all guidelines set forth in this rule for

Release of Protected Health Information of Alcohol and Drug Abuse Patient

Records.
 Invalid Authorizations

Holland Hospital shall at no time release PHI without a valid Authorization. HIPPA

declares an authorization to be invalid if any of the following are found to be true-

The document contains an date that is expired

An item that is required to be found within the authorization is missing

or incomplete
The authorization has been deemed revoked
Any part of the authorization violates HIPPA Privacy Rules and

Regulations in any manner

Any information contained in within the authorization is found to have

been falsified

PHI is considered to be the property of Holland Hospital and shall never be

sold in exchange for monetary value of any kind, unless and until Holland

Hospital obtains a valid authorization and authorization is obtained by

Holland Hospital Administration.

Acknowledgment Signature Date:

References

AHIMA Practice Brief. (2013 update)" (Updated November 2013) "Authorization Requirements
for the Disclosure of Protected Health Information Retrieved From http://library.ahima.org/doc?
oid=107284#.WLBYmfId3iQ

UNIVERSITY OF PITTSBURGH POLICY. (2002, February 02). Retrieved from

https://www.cfo.pitt.edu/policies/policy/07/07-02-02.html
You have been assigned the responsibility to develop policies and procedures for
release of information. Create a Microsoft Word Document, stating the name of your
healthcare facility and the policies and procedures you would like to implement for
the HIM Department in regards to release of information. Submit your assignment
here