Which entity may not have access to PHI without authorization?

The patient's employer does not have access to protected health information (PHI) without specific authorization from the patient. Under HIPAA regulations, PHI refers to any individually identifiable health information that is transmitted or maintained in any form or medium. Employers typically do not have a role in the patient's healthcare and, thus, are not considered a legitimate recipient of PHI unless the patient explicitly gives consent for their employer to access this information.

In contrast, medical staff involved in the patient's care, family members (when appropriate and allowed), and health insurers generally have a legitimate need for access to PHI for treatment, payment, or healthcare operations. This need is recognized in the HIPAA Privacy Rule, which allows disclosures of PHI in these cases without necessarily obtaining separate authorization from the patient, as long as the disclosures are appropriate and necessary for the patient's care and management.