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2009/10/01 For uses of PHI, the policies and procedures must identify the persons or classes of persons within the covered entity who need access to the information to carry out their job duties, the categories or types of PHI needed, and conditions appropriate to such access. For example, hospitals may implement policies that permit doctors, nurses, or others involved in treatment to have access to the entire medical record, as needed. Case-by-case review of each use is not required. Where the entire medical record is necessary, the covered entity's policies and procedures must state so explicitly and include a justification.

2009/08/25 We understand that medical information must be conveyed freely and quickly in treatment settings, and thus understand the heightened concern that covered entities have about how the minimum necessary standard applies in such settings. Therefore, we are taking the following steps to clarify the application of the minimum necessary standard in treatment settings. First, we clarify some of the issues here, including the application of minimum necessary to specific practices, so that covered entities may begin implementation of the Privacy Rule. Second, we will propose corresponding changes to the regulation text, to increase the confidence of covered entities that they are free to engage in whatever communications are required for quick, effective, high quality health care. We understand that issues of this importance need to be addressed directly and clearly to eliminate any ambiguities.