(6) Covered entities that are government programs providing public benefits.
(i) A health plan that is a government program providing public benefits may disclose protected health information relating to eligibility for or enrollment in the health plan to another agency administering a government program providing public benefits if the sharing of eligibility or enrollment information among such government agencies or the maintenance of such information in a single or combined data system accessible to all such government agencies is required or expressly authorized by statute or regulation.
(ii) A covered entity that is a government agency administering a government program providing public benefits may disclose protected health information relating to the program to another covered entity that is a government agency administering a government program providing public benefits if the programs serve the same or similar populations and the disclosure of protected health information is necessary to coordinate the covered functions of such programs or to improve administration and management relating to the covered functions of such programs.
Audit Inquiry
Is the covered entity a health plan that is a government program providing public benefits, or is it a government agency administering a government program providing public benefits?
If yes. does the covered entity have policies and procedures consistent with the established performance criterion in place to disclose PHI for the purposes listed? Obtain and review the policies and procedures.
Obtain and review a sample of such disclosures.