To whom can a healthcare provider disclose patient information without obtaining patient authorization?

A healthcare provider can disclose patient information without obtaining patient authorization to consulting specialists for patient care because this type of disclosure falls under the permissible purposes defined by HIPAA (Health Insurance Portability and Accountability Act). When a provider refers a patient to a specialist, sharing relevant medical information is essential for continuity of care and effective treatment planning. This type of communication among healthcare providers is considered necessary to provide appropriate medical services and is typically understood as being in the best interest of the patient.

Others may not qualify for disclosure without authorization. Family members, for instance, may require consent from the patient or confirmation of the patient's wishes about sharing information. Similarly, while insurance companies can receive patient information for payment purposes, this typically requires that the patient is informed or has given consent as part of the insurance processing protocols. Disclosing information to any third party without proper authorization is generally not permissible under HIPAA regulations, as it does not meet the criteria of being necessary for the patient's care or service provision.