The HIPAA Privacy Rule and Military Health Care: What Parents of Minors Need to Know

FALLS CHURCH, Va. Are you the parent or legal guardian of a minor child? If so, there are things you should know about what access you have to your child’s health care records and choices. The Health Insurance Portability and Accountability Act Privacy Final Rule protects the privacy of minors regarding their health care choices and treatment. To protect your child’s health records, this rule limits your access to your child’s protected health information (PHI).

The HIPAA privacy rule provides clear guidance to ensure that Americans’ private health information is protected, said Dr. Anmarie Widener, chief of the Defense Health Agencies Office of Privacy and Civil Liberties. The HIPAA Privacy Rule extends this protection to minors. It is important for parents and legal guardians to understand what they can and cannot access about their children’s health care information.

The Defense Health Agency (DHA) complies with the HIPAA privacy policy regarding how parents and legal guardians access their children’s PHI. These policies apply in the United States. The Privacy Rule defines minors as people who are:
Under the care, custody and support of their parents or legal sponsor until the child turns 18
Students under the age of 21 who are still under the care, custody or support of their parent or legal sponsor
Under 18 who are not or have not been married
Not a member of the US uniformed services
Under 18 years of age and not self-sufficient or living separately from their parents or legal sponsor

Abroad, a minor can request reproductive health services. This includes telehealth services received from a provider located in a military hospital or clinic. If your health care provider determines that the child is mature enough, the child may receive care without the consent of the parent or legal guardian.

Key points for accessing PHI in the United States
In the United States, all Americans have access to electronic and paper medical records.

So what are the limitations on accessing your child’s PHI?

Within the military health system, you can access your and your family’s electronic health records (EHR) through MHS GENESIS. MHS GENESIS offers each beneficiary a secure patient portal. This portal allows you to consult health records and prescriptions. You can also use it to make and track appointments, send messages to your provider, and more.

According to the Memorandum on Parental Access to Protected Health Information of Unemancipated Minors, access to EHRs is as follows:
Children 12 and under: Parents and legal guardians can access EHRs and all PHI online.
Minors 13-17: Parents and legal guardians have access to their child’s online patient portal to view only appointments, messages, shots and allergy care.

You may also access paper medical records under certain circumstances:

Children 17 and under: Parents and legal guardians can still obtain their children’s health records. To obtain paper records, you must go through the medical records department of the hospital or clinics.

Please note that you can only obtain paper and electronic records when your child:
They did not give their own consent for the visit, or
He consented to care and gave his written permission to allow you access to his PHI for this visit only.

Informed consent is when a patient is competent to make a voluntary decision about whether to undergo an interventional procedure. Minors can give informed consent for certain types of care. This includes mental health, pregnancy and sexually transmitted disease care. In these cases, state and federal HIPAA laws protect your privacy. Each of the 50 states, US territories, and the District of Columbia have their own rules about when a minor can consent to the care they receive. The DHA observes these rules on a state-by-state basis in all circumstances. Check your state laws for details.

Key points for accessing PHI abroad
Things are different overseas with access to PHI related to your children’s reproductive health services. The DHA cannot enforce state or federal laws abroad. For this reason, military hospitals and clinics must follow the instructions provided by the Reproductive and Children’s Health Care Services (Overseas) Memorandum. This guide helps military providers overseas decide whether a minor is mature enough to make their own decisions about reproductive health care.

As defined in this note:
A minor is a patient 18 years of age or younger.
A mature minor is a patient 15 years of age or older.

Some countries may interpret these terms differently. Check with your overseas TRICARE contractor for more information.

Informed consent of minors to receive care at a military hospital or clinic overseas determines parental access to PHI overseas. If the child consents to a health care visit, you cannot access the child’s health records for that visit unless the child has consented to provide you with such access.

As defined in the note, reproductive care may include:
Prescription drugs and treatment to prevent pregnancy.
Tests to diagnose and treat reproductive health conditions.
Tests related to reproductive health, including sexually transmitted diseases.

There are situations, however, where a provider may be required to notify the minors’ parents or legal guardians. This includes:
Life-threatening conditions
Conditions that may require the removal of reproductive organs
Changes in behavior that may cause harm to themselves or others.

For more information, see the Memorandum on Parental Access to Protected Health Information of Unemancipated Minors. If you are overseas, go to the Reproductive Health Care and Children’s Services (Overseas) Memorandum. Call your military hospital or clinic to speak with their records department if you have questions about accessing your child’s PHI.

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Date taken: 03/21/2024
Publication date: 21/03/2024 17:50
Story ID: 466790

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