Background

As required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Public Law 104-191), the Department of Health and Human Services (HHS) adopted uniform standards for the privacy of individually identifiable health information (the “Privacy Rule”). This law imposes national rules for the protection and dissemination of individuals' health records. Compliance with the final Privacy Rule is required beginning April 14, 2003. SSA developed and implemented a revised HIPAA-compliant Form SSA-827 (2-2003) (Authorization to Disclose Information to the Social Security Administration (SSA)).

Explanation of Content and Changes

This transmittal revises section I-2-5-14 (Obtaining Medical Evidence From a Treating Source or Other Medical Source ) to reflect that the HIPAA-compliant SSA-827 (2-2003 edition or later) must be used. In addition, the obsolete term “source of record” has been replaced in the title and throughout the section by “other medical source” (see 20 CFR 404.1502 and 416.902).

I-2-5-14 A. is revised to reflect that the HO is authorized to pay certain providers for the reasonable cost of providing SSA with existing medical evidence that we need and request. (20 CFR 404.1514 and 416.914). In addition, to facilitate receiving evidence that the ALJ has requested the claimant/beneficiary or representative to obtain from a treating or other medical source, the ALJ or HO staff should provide SSA-827s (2-2003 edition or later), to be presented to the source(s) to be contacted.

I-2-5-14 B. and C. were revised to instruct HO staff to provide a signed and dated HIPAA-compliant consent form, SSA-827 (2- 2003 edition or later) when requesting evidence from a treating source or other medical source either by telephone or in writing or through the State agency.

Date: June 23, 2003