What is the Minimum Necessary Standard?

The Minimum Necessary Standard (45 CFR 164.502(b), 164.514(d))is part of the HIPAA Privacy Rule. It requires healthcare organizations to make reasonable efforts to limit protected health information to the minimum amount necessary for a task. The minimum necessary standard applies to covered entities and business associates when they use or disclose Protected Health Information (PHI), and when they request PHI from other covered entities or business associates. The minimum necessary standard does not apply to the following:

  1. Disclosures to or requests by a health care provider for treatment purposes. 

  2. Disclosures to the individual who is the subject of the information. 

  3. Uses or disclosures made pursuant to an individual’s authorization. 

  4. Uses or disclosures required for compliance with HIPAA Administrative Simplification Rules. 

  5. Disclosures to HHS when disclosure of information is required under the Privacy Rule for enforcement purposes. 

  6. Uses or disclosures that are required by other law

Patient records contain sensitive personally identifiable information, much of which will not be needed to address a given medical, billing, or other task. For example, it would be inappropriate for a billing specialist to access to the entirety of your medical records. It would also be inappropriate for your physician to access your social security number or credit card information. That’s why healthcare organizations are generally required to limit access to PHI as much as possible. The standard is vague, given that  the terms “reasonable efforts” and “minimum amount necessary” have not been defined in the law or by HHS. However, the minimum necessary standard would benefit from some clarification under proposed changes to the Privacy Rule, which would add certain exemptions to the standard.

 How would proposed changes to the Privacy Rule affect the HIPAA Minimum Necessary Standard?

In December 2020, the HHS published their proposal that would make sweeping changes to the HIPAA Privacy Rule. The proposal includes a modification to the minimum necessary standard. If this proposal becomes an amendment, this change will reduce barriers to information sharing by adding an exception for disclosures to or requests from a health plan or covered health care provider for care coordination and case management. So, covered entities or business associates will no longer need to consider minimum necessary requirements in making such disclosure, which should help address recent issues regarding disclosure of PHI to support social services.

HIPAA’s mandate that healthcare organizations guard the privacy, integrity, and accessibility of protected health information remains intact. The minimum necessary standard will still apply for most disclosures and uses of PHI. Because there is still no specific guidance on implementation of the standard, it remains important that all covered entities have strong policies and procedures that outline when and how your organization will use and disclose PHI. Regularly train employees on these policies to maintain a culture of HIPAA compliance.