Employee Handbook

14.11 Restrictions on Use or Disclosure of PHI Requested by Individual

14.11.1 Policy Statement

Individuals have the right to request restrictions on uses and disclosures of protected health information (PHI) relative to treatment, payment, or health care operations (TPO).

14.11.2 Policy Interpretation and Implementation

Request for Restriction on use or Disclosure of PHI

A request for restriction of use or disclosure of information must be submitted in writing to the HIPAA Privacy Officer. Such request must specify the type of information to be included in the restriction and to whom the restriction applies. The Health Plan may develop a form for this purpose.




Upon receipt of an individual's request that a restriction be placed on the use or disclosure of PHI, the HIPAA Privacy Officer will:

  • Determine the reasonableness of the request based on the administrative capability of the Health Plan to comply with such request;
  • Identify the means and location the individual wishes the information to be communicated; and
  • Notify the individual whether or not the Health Plan agrees to the restriction within sixty (60) days of the date of such request unless an extension is necessary. Such extension will not exceed thirty (30) days.



Exceptions to Restrictions

Should the Health Plan agree to the restriction, the Health Plan and its business associates will honor such request except when:

  • The restriction is terminated by the Health Plan or the individual, and/or
  • There is an emergency treatment situation.

The Privacy Officer will be responsible for notifying any impacted business associates.



Emergency Treatment

When emergency treatment is necessary, the provider of the treatment may not use or disclose PHI or information which a restriction has been placed, except for what is necessary to provide appropriate emergency care for the individual. The emergency health treatment provider may not further disclose the restricted information beyond what is needed for the emergency treatment.



Termination of a Restriction

The Health Plan may terminate a restriction:

  • When the individual requests the termination; and/or
  • When the Health Plan informs the individual of the termination.



Termination Notices

Termination notices must be in writing and must indicate the effective date such termination and the reason(s) for such termination.



Record Retention

A copy of all HIPAA covered information and any revisions shall be maintained for a period of at least six (6) years. Such retention may be in printed or electronic format, or both.



Privacy Officer

The Privacy Officer is responsible for the development and implementation of the HIPAA policies and procedures. The Privacy Officer is also the contact person for any questions or complaints regarding HIPAA. Questions or concerns about HIPAA rights should be directed to the Privacy Officer during regular business office hours Monday through Friday, except holidays, at (651) 696-6280.




Violations of this policy will be subject to discipline.

Effective Date: April 14, 2004