a. Military Healthcare Providers and Military Treatment Facilities (MTFs)

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may provide information to the command pursuant to this exception without the Soldier’s consent. If a commander believes that he or she needs to know about a Soldier’s PHI, the commander should immediately contact the healthcare provider. Commanders must understand, however, that this exception is limited. Commanders do not have unrestricted access to a Soldier’s PHI. Military Treatment Facilities and healthcare providers will provide timely and accurate information to support a commander’s decisions regarding a Soldier’s health risk, medical fitness, and readiness. To access a Soldier’s PHI, a commander (or the commander’s proper designee) must have a need to access the Soldier’s PHI in order to carryout an activity under the authority of the commander. This exception applies only to Soldiers and does NOT apply to dependent family members, retirees, or civilians.
b. Civilian Medical Facilities
In circumstances where a Soldier’s treatment was provided by a civilian healthcare provider, and if the commander needs the PHI for an official purpose, a commander may request the Soldiers PHI from the civilian healthcare provider. However, HIPAA provides that it is within the civilian healthcare provider’s discretion whether to disclose the relevant PHI since disclosure is generally permissible, but not required. Commanders having difficulty obtaining PHI from civilian healthcare providers should seek the assistance of the MTF’s Patient Administration Division PAD) and their servicing judge advocate.
2. The Minimum Necessary Rule
The HIPAA Privacy Rule requires covered entities, such as MTFs and Unit Surgeons, to take reasonable steps to limit the use or disclosure of, and requests for, PHI to the minimum necessary to accomplish the intended purpose. Inmost cases, commanders who request PHI pursuant to the military exception will typically not receive all of the Soldier’s PHI, since all of the Soldier’s PHI is not necessary to accomplish the specific intended purpose. Disclosure may include the Soldiers diagnosis a description of the treatment prescribed or planned impact on duty or mission recommended/applicable duty restrictions the prognosis and implications for the safety of self or others.

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