How can patients impose restrictions on disclosures, and in what situation should a covered entity consider such restrictions?

• A. Disclosures restrictions are never allowed by patients.
• B. Patients may request restrictions on disclosures; covered entities may agree or not; restrictions are especially relevant for disclosures to health plans when patient paid out-of-pocket for the service.
• C. Disclosures restrictions apply only to disclosures to researchers.
• D. Disclosures restrictions apply only to marketing disclosures.

Answer: (B)

Patients can request that a covered entity limit how their protected health information is disclosed. The entity may agree to that restriction or may decide not to honor it. The situation where these restrictions are most relevant is when the patient pays for a service entirely out of pocket; in that case, the patient can request that information about that service not be shared with their health plan, since the plan typically does not need the details for payment or coverage. If the entity agrees, it should not disclose that information to the health plan, unless required by law or otherwise necessary. Restrictions are not limited to researchers or marketing, and a provider is not obligated to accept every restriction, but the possibility exists and is most commonly applied in the out-of-pocket payment scenario.