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Military Command Exception

The guidance below may be relied upon by private sector and governmental health providers and health plans outside the Military Health System (MHS).

Providers and health plans who disclose protected health information to military commanders must make reasonable efforts to limit the disclosure to the "minimum necessary" for assuring proper execution of the military mission. See DoD 6025.18-R , paragraph C8.2; 45 CFR 164.502(b), 164.514(d).

Military command authorities receiving protected health information are not covered entities subject to the HIPAA Privacy Rule, but they are subject to the Privacy Act of 1974 and DoD 5400.11-R , "DoD Privacy Program," May 14, 2007.

To “dispel the stigma of seeking mental health care and/or substance misuse education services,” DoD requires the following:

    Healthcare providers shall follow a presumption that they are not to notify a Service member’s commander when the Service member obtains mental health care or substance abuse education services. … Unless this presumption is overcome by one of the notification standards listed in Enclosure 2 of this Instruction, there shall be no command notification. [DoDI 6490.08, paragraph 3.b]

Military commanders who receive protected health information, particularly when it involves mental health or substance abuse education, have special responsibilities to safeguard the information received and limit any further disclosure in accordance with the Privacy Act. See DoDI 6490.08 (Enclosure 2, paragraph 3), which provides:

    COMMANDERS. Commanders shall protect information provided pursuant to this Instruction and DoD Directive 5400.11 …, as they should with any other health information. Information provided shall be restricted to personnel with a specific need to know; that is, access to the information must be necessary for the conduct of official duties. Such personnel shall also be accountable for protecting the information. Commanders must also reduce stigma through positive regard for those who seek mental health assistance to restore and maintain their mission readiness, just as they would view someone seeking treatment for any other medical issue.

Department of Health and Human Services (HHS) Guidance

DoD Guidance

Information on Service policies is available at the following Web pages:

“On October 1, 2013, the Department of Defense established the Defense Health Agency (DHA) to manage the activities of the Military Health System. These activities include those previously managed by TRICARE Management Activity (TMA), which was disestablished on the same date. During the next several months, all TMA websites will change to reflect the new DHA. We appreciate your patience during this transition."
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