Health Insurance Portability and Accountability Act (HIPPA) Practice Exam

Authorization is not required to disclose protected health information (PHI) in which of the following scenarios?

1. Research studies

2. Patient treatment and payment purposes

3. Marketing purposes

4. Employment-related disclosures

The correct answer is: Patient treatment and payment purposes

The scenario of patient treatment and payment purposes is a situation where authorization is not required to disclose protected health information (PHI). Under the Health Insurance Portability and Accountability Act (HIPAA), covered entities are permitted to share PHI as necessary to provide treatment to a patient and to obtain payment for those services. This provision facilitates efficient health care delivery by allowing healthcare providers to communicate about a patient’s care without needing to secure explicit consent for every individual interaction. For instance, a doctor can share relevant information with a specialist for the purpose of coordinating care, or a healthcare provider can send a bill to an insurance company without patient authorization. In contrast, disclosing PHI for research studies, marketing purposes, or employment-related disclosures generally requires specific authorization from the individual, as these uses are not directly related to the treatment or payment involved in healthcare delivery. This distinction helps protect patients' privacy while still enabling essential healthcare operations to proceed efficiently.