Restriction Requests
Drexel University Clinical Covered Entities
Privacy Program Policies and Procedures
Policy Title: Restriction Requests
Policy Number: PPS-14
Effective Date: April 14, 2003; September 23, 2013
Last Revision: September 1, 2017
Responsible Officer: Executive Vice President, Treasurer and Chief Operating Officer
Table of Contents
Applicability
This policy applies to all Covered Entities within Drexel University.
Covered entities are defined in the HIPAA rules as (1) health plans, (2) health care clearinghouses, and (3) health care providers who electronically transmit any health information in connection with transactions for which HHS has adopted standards.
I. Policy
Drexel University (DU) supports the patient right to request a restriction or limitation on the medical information we use or disclose for treatment, payment or health care operations. The patient may also request a limit on the medical information we disclose to someone who is involved in patient care or the payment for care (a family member or friend). For example, a patient could ask that we not use or disclose information about a particular treatment received.
Other than as set forth in this policy, we are not required to agree to any request and we may not be able to comply with the patient request. If we do agree, or are required to agree, then we must comply with the request except that we need not comply, even with a written request, if the information is otherwise required to be disclosed by law.
A patient has the right to request that that his/her health care information not be disclosed to a health plan for payment or health care operations if the requested health care information pertains solely to a health care item or service for which DU has been paid in full. Unless otherwise restricted by law, this request must be honored. This restriction applies to payment for services, health plan audits, as well as health care operations, such as quality reviews. In the event that the request relates to a service that is one of a number of bundled services provided in a single encounter, then the patient should be counseled about the ability or inability to unbundle such services and if the services are unable to be unbundled, the patient should be given the opportunity to pay for the entire bundle out of pocket. DU is not required to inform downstream providers of such requested restriction but should counsel the patient about his/her obligation inform downstream providers.
II. Procedure
To request restrictions, the patient must make the request in writing. In the request, the patient must indicate:
- what information to limit;
- whether there is limit to our use, disclosure or both; and
- to whom you want the limits to apply, (e.g., disclosures to your children, parents, spouse, etc.)
The treating clinician must decide on granting the restriction (other than required restrictions) and recognize that strict adherence to the restriction is required if granted.
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