Challenges navigating the federal patient data privacy law known as HIPAA are often front-and-center in conversations between health care and community-based organizations (CBOs) interested in partnering to address health-related social needs. Many common questions about HIPAA come up: Under what circumstances can a health care organization share patient information with a CBO? Is the CBO subject to HIPAA? What privacy policies and protocols are expected of the CBO? In many instances, the answers to these questions exist in a “gray area,” meaning the answers are not clear; the “right” way forward is subject to interpretation. And assessments are getting even more complicated as CBOs increasingly experiment with network-based models of service delivery.
What is a network-based model of service delivery? As opportunities to support HRSN as part of health care continue to grow, many states, health care organizations, and CBOs providing social care supports are looking to networked HRSN service delivery. This approach involves coordination and collaboration between CBOs to perform under one or more contracts with health care organizations and utilizes a hub-and-spoke design in which certain responsibilities, technologies, and processes are situated in a central organization or hub that supports participating service providers, each a “spoke.”
It is important to think carefully about how a CBO network will approach compliance with HIPAA requirements and for everyone involved to understand their respective obligations under the law. CHLPI’s new resource, “Network Contracting to Address Health-Related Social Needs: Considerations for HIPAA Compliance,” was developed to aid organizations by kickstarting conversations on some of the unique legal and regulatory considerations.
Please remember that the resource does not and should not be construed as providing legal advice— organizations are encouraged to conduct and document their own analyses through the lens of their own specific facts and circumstances. For specific legal questions, please consult an attorney.