The HIPAA Minimum Necessary Standard requires covered entities and business associates to limit the use, disclosure, and request of protected health information (PHI) to the minimum amount necessary to accomplish the intended purpose. Codified in 45 CFR 164.502(b), this principle embodies the data minimization concept applied specifically to healthcare information.
Covered entities must implement policies and procedures that identify the persons or classes of persons within their workforce who need access to PHI, the categories of PHI to which each person needs access, and the conditions under which access is appropriate. For routine disclosures, organizations establish standard protocols that limit the PHI disclosed for each type of request. For non-routine disclosures, individual review criteria ensure that only the minimum necessary PHI is released. Role-based access controls in electronic health record (EHR) systems enforce minimum necessary by restricting users to patient data relevant to their role -- a billing clerk sees insurance and procedure codes but not clinical notes, while a treating physician sees the full record. The standard applies to uses within the organization, disclosures to external parties, and requests to other entities. Notable exceptions include disclosures to the individual, treatment purposes, disclosures required by law, and uses required for HIPAA compliance.
HHS Office for Civil Rights (OCR) enforces the minimum necessary standard aggressively, with violations contributing to multi-million dollar settlements. Anthem's $16 million HIPAA settlement cited failure to implement minimum necessary access controls. Healthcare organizations that provide broad database access to all employees -- a common legacy practice -- violate minimum necessary even if no breach occurs. The standard also applies to business associates, meaning technology vendors serving healthcare must implement role-based data access in their products.
CDA addresses the minimum necessary standard within the Data Protection and Sovereignty domain for healthcare-vertical C-BUILD campaigns. Our missions implement role-based access matrices, configure EHR access controls, establish disclosure review procedures, and audit access patterns to identify and remediate minimum necessary violations.