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98 N.C. L. Rev. 1395 (2019-2020)
The Debilitating Scope of Care Coordination under HIPAA

handle is hein.journals/nclr98 and id is 1435 raw text is: The Debilitating Scope of Care Coordination Under HIPAA' Care coordination aims to achieve personalized, high-quality, safe, and efficient patient care through the deliberate organization of patient care activities and sharing of information among all entities providing care. Care coordination utilizes a broad spectrum of tools, combining traditional healthcare clinical services and social welfare service approaches. Implementing care coordination strategies has been shown to improve long-term health outcomes of patients with a variety of health issues, including chronic diseases and conditions, acute health problems, and rehabilitation or long-term care. However, HIPAA's regulatory framework-which involves the minimum necessary principle, security and technical requirements, limitations based on the services provided, and lack ofguidance in regards to care coordination-severely limits the ability of entities to share medical information with social welfare services. As such, healthcare entities are essentially crippled in delivering proper care coordination and high-quality medical care. This is especially stark for people suffering from chronic diseases and the medically indigent, who rely on social welfare services and nonmedical entities in underserved communities. This Comment argues that unless HIPAA regulations are redefined by adding an express provision to allow use and disclosure of electronic protected health information (PHI) for care coordination purposes or expansion of the minimum necessary principle, care coordination cannot help the patients who need it most. INTRODUCTION............................................................................1396 I. HIPAA AND CARE COORDINATION BACKGROUND ............1400 A. Brief Overview of HIPAA ..............................................1400 1. What Is HIPAA? ...................................................1400 2. Who Does HIPAA Cover?......................................1403 3. What Information Does HIPAA Cover?..................1406 4. How Can Entities Use and Disclose PHI Under HIPAA? ...............................................................1407 B. Care Coordination and the Medically Indigent .....................1411 C. Care Coordination Under HIPAA .................................... 1419 II. ADMINISTRATIVE AGENCY GUIDANCES.............................1422 A. The APA Rulemaking Process ..........................................1423 * © 2020 Frank Qin.

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