APPENDIX I
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF ALABAMA
________ DIVISION
AAA, )
)
Plaintiff(s), )
)
vs. ) Civil Action No. ___
)
BBB, )
)
Defendant(s). )
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. Further, the parties are ordered to either
return to the covered entity from whom or which such protected health
information was obtained, or to destroy the protected health information
(including all copies made), immediately upon conclusion of this action.
See 45 C. F. R. §§ 163.502(b); 164.512(e)(1)(v).
DONE and ORDERED this ________ day of __________, 20__.
__________________________
United States District Judge
