HIPAA Minimum Necessary Standard 2 — Questions and Answers
Question 1: Which scenario represents a violation of the Minimum Necessary Standard?
- A nurse accessing only the medication records needed to administer a patient's prescription
- A billing specialist accessing a patient's full psychiatric history to process an insurance claim (Correct answer)
- A physician reviewing a patient's complete record prior to surgery
- A privacy officer auditing access logs across all departments
Correct answer: A billing specialist accessing a patient's full psychiatric history to process an insurance claim
A billing specialist does not need access to a patient's full psychiatric history to process a claim; providing this exceeds the minimum necessary for the billing function.
Question 2: What is a 'limited data set' under HIPAA, and how does it relate to the Minimum Necessary Standard?
- A complete medical record with all identifiers removed, used only for treatment
- PHI with most direct identifiers removed, used for research, public health, or healthcare operations under a data use agreement (Correct answer)
- A summary of PHI provided to patients upon request
- A subset of PHI shared with law enforcement under a court order
Correct answer: PHI with most direct identifiers removed, used for research, public health, or healthcare operations under a data use agreement
A limited data set is PHI stripped of most direct identifiers and may be used for research, public health, or operations under a data use agreement, representing one way to apply the Minimum Necessary Standard.
Question 3: Under the Minimum Necessary Standard, how should a covered entity respond to a request for an entire medical record?
- Always provide the entire record to avoid liability for omitting relevant information
- Evaluate whether the entire record is actually needed or if a subset would suffice (Correct answer)
- Provide the record only after obtaining written patient authorization
- Automatically deny the request until a court order is obtained
Correct answer: Evaluate whether the entire record is actually needed or if a subset would suffice
Covered entities must evaluate whether the entire record is genuinely necessary or whether a subset of PHI would be sufficient for the stated purpose.
Question 4: How does the Minimum Necessary Standard apply to business associates handling PHI?
- Business associates are not required to comply with the Minimum Necessary Standard
- Business associates must limit their use and disclosure of PHI to what is specified in the Business Associate Agreement (Correct answer)
- Business associates may use any PHI they receive for their own business purposes
- Business associates must obtain patient consent before using any PHI
Correct answer: Business associates must limit their use and disclosure of PHI to what is specified in the Business Associate Agreement
Business associates must limit their use, disclosure, and requests for PHI to what is permitted by the Business Associate Agreement and necessary to perform contracted services.
Question 5: Which of the following is a proper way for a covered entity to implement the Minimum Necessary Standard for workforce access?
- Grant all staff access to all PHI to prevent delays in care
- Require staff to sign a confidentiality agreement and grant unrestricted access
- Identify classes of workforce members who need certain PHI and limit their access accordingly (Correct answer)
- Allow workforce members to self-select the PHI they need for their duties
Correct answer: Identify classes of workforce members who need certain PHI and limit their access accordingly
Covered entities must identify workforce classes, the PHI each class needs, and then implement policies limiting access to that specific PHI.
Question 6: Which of the following disclosures to public health authorities is subject to the Minimum Necessary Standard?
- Mandatory disease reporting required by state law
- Voluntary sharing of patient data beyond what is legally required for a public health investigation (Correct answer)
- Any reporting done at the request of the CDC
- All public health disclosures are fully exempt from the standard
Correct answer: Voluntary sharing of patient data beyond what is legally required for a public health investigation
While mandatory public health reporting required by law is generally exempt, voluntary or excess disclosures beyond what the law requires must still meet the Minimum Necessary Standard.
Question 7: What must a covered entity do to satisfy the Minimum Necessary Standard when responding to a subpoena for PHI?
- Provide the complete medical record to ensure compliance with the subpoena
- Refuse to disclose any PHI without a full court order
- Disclose only the PHI specifically identified in the subpoena or the minimum needed to comply (Correct answer)
- Notify HHS before responding to any subpoena involving PHI
Correct answer: Disclose only the PHI specifically identified in the subpoena or the minimum needed to comply
When responding to a subpoena, covered entities should limit PHI to what is specifically requested or the minimum necessary to comply with the legal process.
HIPAA Minimum Necessary Standard 2
Which scenario represents a violation of the Minimum Necessary Standard?