6/5/2025
Wellcare health plan is partnering with Healthmap Solutions, Inc. (Healthmap) to provide care coordination services within our kidney health management (KHM) program, including patients under your care. Your office may be contacted by Healthmap to receive or share protected health information (PHI) about patients to facilitate care coordination services and to close open interventions/care gaps. These communications are authorized by your health plan and permissible without patient authorization under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Specifically, HIPPA permits a covered entity, such as your practice or your health plan, to share PHI with another covered entity or its business associate for the purpose of care coordination. See 45 C.F.R.§ 164.501 and 45 C.F.R. § 164.506(c)(4). To assist providers, the Department of Health and Human Services, Office for Civil Rights (OCR) released guidance on this topic in 2016.
To ensure best practices and compliance with HIPAA, your health plan and Healthmap have entered into a Business Associate Agreement.
If you have any questions or concerns, visit healthit.gov and search “Permitted Uses and Disclosures: Exchange for Health Care Operations” or contact your Provider Services Representative.
