Can an individual restrict disclosure of certain PHI to a health plan under the proposed modifications?
Yes. The proposed modifications would require a covered entity, upon request from an individual, to agree to a restriction on the disclosure of PHI to a health plan if: (A) the disclosure is for the purposes of carrying out payment or healthcare operations and is not otherwise required by law; and (B) the PHI pertains solely to a health care item or service for which the individual, or person on behalf of the individual other than the health plan, has paid the covered entity in full. In cases where an individual has exercised his or her right to have such a restriction placed, the covered entity is also prohibited from making such disclosure to a business associate of the health plan. HHS notes its belief that the HITECH Act provides the individual with the right to determine for which health care items or services the individual wishes to pay out of pocket and restrict, and therefore does not believe a covered entity could require individuals who wish to restrict disclosures about onl
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