NRPM: Standards for Privacy of Individually Identifiable Health Information. ii. Proposed requirements.


We are proposing to exempt the DOS from the requirement to obtain individual authorization (§ 164.508) in order to use or disclose protected health information maintained by its health care program in certain cases. Specifically, the exemption would apply to the disclosure or use of protected health information of the following individuals for the following purposes:

(1) of applicants to the Foreign Service for medical clearance determinations of physical fitness to serve in the Foreign Service on a worldwide basis, including: medical and mental conditions limiting assignability abroad; conformance to occupational physical standards, where applicable; and suitability;

(2) of members of the Foreign Service and other United States Government employees assigned to serve abroad under Chief of Mission authority, for (a) medical clearance determinations for assignment to posts abroad, including: medical and mental conditions limiting such assignment; conformance to occupational physical standards, where applicable; continued fitness for duty, suitability, and continuation of service at post (including decisions on curtailment); (b) separation medical examinations; and (c) determinations of eligibility of members of the Foreign Service for disability retirement (whether on application of the employee or the Secretary);

(3) of eligible family members of Foreign Service or other United States Government employees, for medical clearance determinations like those described in (2) above to permit such family members to accompany employees to posts abroad on Government orders, as well as determinations regarding family members remaining at post and separation medical examinations.

The proposed exemption is intended to maintain the DOS’s procedures regarding internal of medical information in conformance with the Privacy Act of 1974, as amended, and 42 CFR Part 2, which would continue to apply to the DOS. The verification requirements of § 164.518(c) would apply to these disclosures.

The DOS is considering the need to add national security determinations under Executive Order 10450, as amended, and other suitability determinations to the exempted purposes listed above. We therefore request comment as to the purposes for which use or disclosure of protected health information without individual authorization by the DOS would be appropriate.