Comment: One comment asserted that the proposed privacy regulation conflicts with the Freedom of Information Act ("FOIA"). The comment argued that the proposed restriction on disclosures by agencies would not come within one of the permissible exemptions to the FOIA. In addition, the comment noted that only in exceptional circumstances would the protected health information of deceased individuals come within an exemption because, for the most part, death extinguishes an individual's right to privacy.
Response: Section 164.512(a) below permits covered entities to disclose protected health information when such disclosures are required by other laws as long as they follow the requirements of those laws. Therefore, the privacy regulation will not interfere with the ability of federal agencies to comply with FOIA, when it requires the disclosure.
We disagree, however, that most protected health information will not come within Exemption 6 of FOIA. See the discussion above under "Relationship to Other Federal Laws" for our review of FOIA. Moreover, we disagree with the comment's assertion that the protected health information of deceased individuals does not come within Exemption 6. Courts have recognized that a deceased individual's surviving relatives may have a privacy interest that federal agencies may consider when balancing privacy interests against the public interest in disclosure of the requested information. Federal agencies will need to consider not only the privacy interests of the subject of the protected health information in the record requested, but also, when appropriate, those of a deceased individual's family consistent with judicial rulings.
If an agency receives a FOIA request for the disclosure of protected health information of a deceased individual, it will need to determine whether or not the disclosure comes within Exemption 6. This evaluation must be consistent with the court's rulings in this area. If the exemption applies, the federal agency will not have to release the information. If the federal agency determines that the exemption does not apply, may release it under § 164.512(a) of this regulation.
Comment: One commenter expressed concern that our proposal to protect the individually identifiable health information about the deceased for two years following death would impede public interest reporting and would be at odds with many state Freedom of Information laws that make death records and autopsy reports public information. The commenter suggested permitting medical information to be available upon the death of an individual or, at the very least, that an appeals process be permitted so that health information trustees would be allowed to balance the interests in privacy and in public disclosure and release or not release the information accordingly.
Response: These rules permit covered entities to make disclosures that are required by state Freedom of Information Act (FOIA) laws under 164.512(a). Thus, if a state FOIA law designates death records and autopsy reports as public information that must be disclosed, a covered entity may disclose it without an authorization under the rule. To the extent that such information is required to be disclosed by FOIA or other law, such disclosures are permitted under the final rule. In addition, to the extent that death records and autopsy reports are obtainable from non-covered entities, such as state legal authorities, access to this information is not impeded by this rule.
If another law does not require the disclosure of death records and autopsy reports generated and maintained by a covered entity, which are protected health information, covered entities are not allowed to disclose such information except as permitted or required by the final rule, even if another entity discloses them.
Comment: One comment sought clarification of the relationship between the Freedom of Information Act, the Privacy Act, and the privacy rules.
Response: We have provided this analysis in the "Relationship to Other Federal Laws" section of the preamble in our discussion of the Freedom of Information Act.