HIPAA Minimum Necessary Standard 4 — Questions and Answers
Question 1: A hospital billing department receives a request for PHI from a health plan. Under the Minimum Necessary Standard, what should the hospital do?
- Send the complete medical record to ensure nothing is missed
- Provide only the information reasonably necessary to fulfill the billing request (Correct answer)
- Deny the request until the plan provides written justification
- Forward the request to the treating physician for approval
Correct answer: Provide only the information reasonably necessary to fulfill the billing request
Covered entities must make reasonable efforts to limit disclosures to only the PHI needed for the specific purpose, such as billing.
Question 2: Which of the following disclosures is EXEMPT from the Minimum Necessary Standard under HIPAA?
- Disclosures to a business associate for data analytics
- Disclosures to a health plan for payment purposes
- Disclosures to the patient themselves (Correct answer)
- Disclosures to a public health authority
Correct answer: Disclosures to the patient themselves
Disclosures made directly to the individual who is the subject of the PHI are explicitly exempt from the Minimum Necessary Standard.
Question 3: A covered entity's workforce member accesses PHI of a family member who is also a patient. This most likely violates which standard?
- The Notice of Privacy Practices requirement
- The Minimum Necessary Standard and workforce access controls (Correct answer)
- The Business Associate Agreement requirement
- The Breach Notification Rule
Correct answer: The Minimum Necessary Standard and workforce access controls
Accessing PHI beyond one's job role violates the Minimum Necessary Standard, which requires limiting access to those who need it for their work functions.
Question 4: Under the Minimum Necessary Standard, how should a covered entity treat routine or recurring requests for PHI?
- Each request must be individually reviewed by the Privacy Officer before release
- Entities may develop standard protocols identifying what PHI is typically needed for such requests (Correct answer)
- Routine requests are exempt from the Minimum Necessary Standard
- All routine requests must be approved by the patient before release
Correct answer: Entities may develop standard protocols identifying what PHI is typically needed for such requests
HIPAA allows covered entities to develop reasonable standard protocols for routine, recurring disclosures to avoid reviewing every individual request.
Question 5: A research team requests a dataset with full patient identifiers for a study. The Privacy Officer determines that de-identified data would satisfy the research purpose. What should the covered entity do?
- Provide the full identifiers since researchers have IRB approval
- Provide only de-identified data since it meets the research need (Correct answer)
- Provide identifiers but require the researchers to sign a confidentiality agreement
- Defer to the treating physician's judgment on what to release
Correct answer: Provide only de-identified data since it meets the research need
If the research purpose can be accomplished with de-identified data, the Minimum Necessary Standard requires providing that lesser amount of information.
Question 6: How does the Minimum Necessary Standard apply to a covered entity's own workforce members who use PHI in their daily work?
- All workforce members must have access to all PHI to function effectively
- Access must be limited based on each member's role and what they need to do their job (Correct answer)
- Only licensed clinical staff are subject to the Minimum Necessary Standard
- Workforce access policies are set solely by the entity's Human Resources department
Correct answer: Access must be limited based on each member's role and what they need to do their job
Covered entities must implement policies and procedures limiting PHI access for workforce members to the minimum necessary for their specific job functions.
Question 7: A covered entity receives a public health disclosure request from a state health department. Under Minimum Necessary, the entity should:
- Provide all available PHI since government entities are trusted partners
- Rely on the public health authority's representation of what is needed for the activity (Correct answer)
- Require the health department to obtain a court order before any disclosure
- Provide only aggregate, non-identifiable statistics regardless of what is requested
Correct answer: Rely on the public health authority's representation of what is needed for the activity
For public health disclosures permitted under HIPAA, covered entities may reasonably rely on the public health authority's representation of the minimum necessary information needed.
HIPAA Minimum Necessary Standard 4
A hospital billing department receives a request for PHI from a health plan.
Under the Minimum Necessary Standard, what should the hospital do?