Source: https://www.uspharmacist.com/article/hipaa-and-sharing-information-related-to-mental-health
Timestamp: 2019-04-26 14:44:54+00:00

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Note: The information in this article is general in nature and is not intended to provide legal or other professional advice.
The HIPAA Privacy Rule allows a pharmacist to communicate with a patient’s family or other persons involved in the patient’s care. When the patient is present and has the capacity to make healthcare decisions, the pharmacist may communicate with the patient’s family members, friends, or others whom the patient has involved in the patient’s healthcare or in payment for the pharmacy services, as long as the patient does not object. When the patient is not present or is incapacitated, the pharmacist may share the patient’s PHI with those persons as long as the pharmacist determines, based on professional judgment, that doing so is in the best interests of the patient.
1. State or other law does not require the person’s consent before a minor can obtain a particular healthcare service, the minor consents to the healthcare service, and the minor has not requested that the person be treated as a personal representative.
2. Someone other than the parent is authorized by law to consent to the provision of a particular health service to a minor and provides such consent.
HIPAA balances the right of a patient to maintain the privacy of information about the patient’s mental-health condition against disclosure of such information when sharing that information is in the best interest of the patient or to protect the patient or others from imminent harm. The pharmacist should carefully consider these countervailing principles when dispensing medication to treat a mental-health condition and should be aware that these principles may be at issue when the pharmacist is dispensing medication that affects the patient’s mental health.
1. See generally 45 CFR Part 160 and Part 164, Subparts A and E. U.S. Department of Health and Human Services, Office for Civil Rights (HHS), HIPAA Privacy Rule and sharing information related to mental health (hereafter “HHS, Sharing Information Related to Mental Health”). www.hhs.gov/hipaa/for-professionals/special-topics/mental-health/index.html. Accessed October 10, 2018. See also HHS, HIPAA Helps Caregiving Connections: HIPAA helps mental health professionals to prevent harm. www.hhs.gov/sites/default/files/hipaa-helps-prevent-harm.pdf. Accessed October 13, 2018. Also FDA News Release: FDA updates warnings for fluoroquinolone antibiotics on risks of mental health and low blood sugar adverse reactions. www.fda.gov/newsevents/newsroom/pressannouncements/ucm612995.htm. Accessed October 10, 2018.
2. See generally 45 CFR §§164.502(g) and 164.510.
3. See 45 CFR §164.510(b). HHS, Sharing Information Related to Mental Health. Pharmacy practice acts and other applicable law may impose greater restrictions on a pharmacist’s disclosure of PHI related to the patient’s mental health. See also HHS, HIPAA helps family and friends stay connected with loved ones who have a substance use disorder, including opioid abuse, or a mental or behavioral health condition. www.hhs.gov/sites/default/files/hipaa-helps-stay-connected.pdf. Accessed October 13, 2018.
4. See 45 CFR §164.508(a)(2), cited in HHS, Sharing Information Related to Mental Health. A patient’s authorization for disclosure of psychotherapy notes is not necessary for disclosures required by law, including mandatory reporting of abuse and mandatory or permissible “duty to warn” circumstances involving threats of serious and imminent harm made by the patient.
5. See 45 CFR §164.501; HHS, Sharing Information Related to Mental Health.
6. See 45 CFR §164.512(j); HHS, Sharing Information Related to Mental Health.
7. See 45 CFR §164.502(g); HHS, Sharing Information Related to Mental Health. A parent also may not be a personal representative if there are safety concerns. A pharmacist may decide not to treat the parent as the minor’s personal representative if the pharmacist believes that the minor has been or may be subject to violence, abuse, or neglect by the parent or the minor may be endangered by treating the parent as the personal representative; and the pharmacist determines, in the exercise of professional judgment, that it is not in the patient’s best interests to treat the parent as the personal representative. See 45 CFR §164.502(g)(5) and HHS, Sharing Information Related to Mental Health.
8. See 45 CFR §164.502(g)(3)(ii) and HHS, Sharing Information Related to Mental Health.
9. HHS, Sharing Information Related to Mental Health.
10. See 42 USC § 290dd-2; 42 CFR §§2.11, et seq.; and HHS, Sharing Information Related to Mental Health.
11. Message to our nation’s health care providers, letter dated January 15, 2013, HHS. www.hhs.gov/sites/default/files/ocr/office/lettertonationhcp.pdf. Accessed October 10, 2018. See also 45 CFR §164.512(j). Pharmacists should review state law for additional guidance and 42 USC §290dd-2 and 42 CFR Part 2 related to the disclosure of alcohol- and drug-abuse treatment records.
12. HHS, Sharing Information Related to Mental Health.

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