UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ALABAMA
Choose an item. DIVISION
Plaintiff(s)., )
)
Choose an item., )
)
v. ) Case No. Case Number.
)
Defendant(s)., )
)
Choose an item.. )
QUALIFIED HIPAA PROTECTIVE ORDER
The parties are hereby granted the right, upon compliance with the applicable
discovery provisions of the Federal Rules of Civil Procedure and the orders of this
court, to obtain from any health care provider, health plan, or other entity covered
by the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-
191, 110 Stat. 1936 (1996) (“HIPAA”), any and all information relating to the past,
present, or future medical condition of any individual who is a party to this action
(or the decedent or ward of a party who sues in a representative capacity), as well as
any and all information relating to the provision of health care to such individual and
payment for the provision of such health care.
This order authorizes any third party who is provided with a subpoena
requesting the production of documents or commanding attendance at deposition or
trial to disclose the protected health information in response to such request or
subpoena. This order is intended to authorize such disclosures under the privacy
regulations issued pursuant to HIPAA. 45 C.F.R. § 164.512(e)(1)(i).
The parties are expressly prohibited from using or disclosing the protected
health information obtained pursuant to this order for any purpose other than this
action. Immediately upon the conclusion of this action, the parties are ordered either
to return the protected health information to the covered entity from whom or which
it was obtained or to destroy the protected health information (including all copies
made). See 45 C.F.R. §§ 164.502(b) & 164.512(e)(1)(v).
DONE this ____ day of _______________.
2