Are health care providers required to seek a prior authorization before discussing a product or service with a patient, or giving a product or service to a patient, in a face-to-face encounter?
No. In face-to-face encounters, the HIPAA Privacy Rule allows covered entities to give or discuss products or services, even when not health-related, to patients without a prior authorization. This exception prevents unnecessary intrusion into the doctor-patient relationship. Physicians may give out free pharmaceutical samples, regardless of their value. Similarly, hospitals may give infant supplies to new mothers. Moreover, the face-to-face exception would allow providers to leave general circulation materials in their offices for patients to pick up during office visits. Is it marketing for a covered entity to describe products or services that are provided by the covered entity to its patients, or to describe products or services that are included in the health plans plan of benefits? No. The HIPAA Privacy Rule excludes from the definition of “marketing” communications made to describe a covered entitys health-related product or service (or payment for such product or service) that
Related Questions
- Are health care providers required to seek a prior authorization before discussing a product or service with a patient, or giving a product or service to a patient, in a face-to-face encounter?
- Do we still need to seek patients authorization on M-450 I prior to providing information to health insurance company to support claim for reimbursement?
- Who is responsible for notifying BCN when I seek services out of network if a service requires a prior authorization?
