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2009/09/29 Patient consent is required before a covered health care provider that has a direct treatment relationship with the patient may use or disclose protected health information (PHI) for purposes of TPO. Exceptions to this standard are shown in the next bullet. Uses and disclosures for TPO may be permitted without prior consent in an emergency, when a provider is required by law to treat the individual, or when there are substantial communication barriers.

2009/09/15 Health care providers must exercise their professional judgment to determine whether obtaining a consent would interfere with the timely delivery of necessary health care. If, based on professional judgment, a provider reasonably believes at the time the patient presents for treatment that a delay involved in obtaining the patient's consent to use or disclose information would compromise the patient's care, the provider may use or disclose PHI that was obtained during the emergency treatment, without prior consent, to carry out TPO. The provider must attempt to obtain consent as soon as reasonably practicable after the provision of treatment. If the provider is able to obtain the patient's consent to use or disclose information before providing care, without compromising the patient's care, we require the provider to do so.