Official website of the State of California
Official website of the State of California
No, specialized plans are not full-service plans considered health care service plans and disability insurers that provide hospital, medical, or surgical coverage, and therefore, are not required to sign the DSA
The DxF does not require any access, use, or disclosure of Health or Social Services Information (HSSI) that would be unlawful. The DSA requires Participants to share HSSI, which includes Protected Health Information (PHI) and medical information, for Required Purposes, which can be found in the Permitted, Required, and Prohibited Purposes Policy and Procedure, and subject to applicable law. If sharing HSSI is not permitted under applicable law, a Participant must respond to the requestor in accordance with the Requirement to Exchange Health and Social Services Information Policy and Procedure, Section III.1. A refusal to share HSSI because it is unlawful under applicable law is not information blocking under the draft California Information Blocking Prohibitions Policy and Procedure.
CDII encourages Participants to request patient authorization to share HSSI wherever possible when applicable law does not permit sharing for a Required Purpose in the Permitted, Required, and Prohibited Purposes Policy and Procedure. Nothing in the DxF, DSA, or the Policies and Procedures limits a patient’s right to decline to sign an authorization to share their information. When it is unlawful to share information without patient authorization and the patient did not sign an authorization, the Participant must not share HSSI under the DSA. In such instances, the DxF Participant would respond to the request for HSSI consistent with Requirement to Exchange Health and Social Services Information Policy and Procedure, Section III.1.
The DxF requires Participants to share HSSI in accordance with federal and state law, the DSA, and its Policies and Procedures. This includes any patient/individual consent requirements and an individual’s right to request restrictions on how their information is used and disclosed that are applicable under federal and state law. The DxF does not change or supersede a Participant’s responsibility to comply with an individual’s privacy rights under applicable law or a Participant’s requirements to obtain an individual’s consent to share or access HSSI when required by applicable law. If an individual’s consent is required under applicable law for a Participant to share the individual’s data, the individual can refuse to provide such consent. Similarly, if an individual has the right under applicable law to require a Participant not to share their information, the individual can work with the Participant to exercise that right by reaching out to the Participants who maintain their HSSI to make that request. Each Participant is responsible for ensuring all HSSI that the Participant shares through the DxF complies with applicable law
HSC section 130290 does not allow required entities listed in HSC section 130290(f) to opt out of signing the DSA.
IPAs are required signatories to the DSA and, as Participants, are required to exchange the HSSI they maintain like any other Participant. If they host or manage an EHR or other system that maintains HSSI on behalf of their members, they are required to share HSSI with other Participants and may use any system or solution to exchange that information in accordance with the DSA and its Policies and Procedures. If a Participant does not maintain any HSSI, the Participant is not required to share HSSI under the DSA but must still follow any applicable Policies and Procedures, including but not limited to the DxF Requirement to Exchange Health and Social Services Information Policy and Procedure.