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HIPAA Path
Category: Uses and Disclosures

Fundraising Communications

Also known as: Fundraising Communication, Donor Communications
Simply put

In a healthcare compliance context, fundraising communications are messages a healthcare organization sends to encourage financial support, such as donations to a hospital foundation. Because these messages can involve information about patients, the HIPAA Privacy Rule places specific limits on when and how protected health information (PHI) may be used for fundraising, and generally requires that recipients be given a way to opt out. The general marketing and donor-engagement evidence available here describes fundraising communications in the nonprofit sense; it does not address the specific HIPAA regulatory constraints, which readers should verify against the current Privacy Rule text.

Formal definition

Fundraising communications, in the general nonprofit and donor-engagement sense described by the available evidence, are strategically planned messages and interactions designed to inform, inspire, and prompt donors and supporters to give financially. In HIPAA practice, however, this term carries a specific regulatory meaning under the HIPAA Privacy Rule, which governs whether and how a covered entity (or a business associate acting on its behalf under a business associate agreement) may use or disclose protected health information (PHI, in any form) for fundraising purposes; the evidence packet does not contain the operative regulatory provisions, so the precise permitted data elements, notice-of-privacy-practices disclosure requirements, and mandatory opt-out mechanisms should be confirmed against the current Privacy Rule and applicable HHS OCR guidance. Note that the Security Rule (which addresses only ePHI safeguards), the Breach Notification Rule, and the Enforcement Rule are out of scope for this term, and that the HITECH Act and state law may impose additional or stricter requirements on fundraising uses of PHI. The evidence sources here reflect general nonprofit communications best practices rather than HIPAA compliance obligations.

Why it matters

For healthcare organizations, fundraising is a common and legitimate activity, hospital foundations, for example, routinely solicit donations to support facilities, research, and patient care programs. What makes fundraising communications distinctive in a HIPAA context is that they can involve protected health information (PHI), such as the fact that an individual received treatment at a particular facility. Because of this, the HIPAA Privacy Rule imposes specific limits on when and how PHI may be used or disclosed for fundraising purposes, and it generally requires that recipients be given a clear way to opt out of future fundraising messages.

The compliance risk here is subtle: a message that would be entirely permissible for a general-purpose nonprofit can become a Privacy Rule concern when the sender is a covered entity using patient information to identify or reach recipients. Because fundraising sits at the intersection of well-established marketing best practices and specialized regulatory constraints, organizations that apply only their general communications playbook, without layering in HIPAA-specific requirements around permitted data elements, notice-of-privacy-practices disclosures, and opt-out mechanisms, may create compliance exposure.

Who it's relevant to

Privacy Officers
Privacy officers are typically responsible for ensuring that any use or disclosure of PHI for fundraising complies with the HIPAA Privacy Rule, including confirming which data elements may be used, that the notice of privacy practices contains the required disclosures, and that a functioning opt-out mechanism is in place. They should verify current requirements against the operative Privacy Rule text rather than relying on general nonprofit communications guidance.
Hospital Foundation and Development Staff
Development and foundation teams design and send donor communications and are most likely to draw on general fundraising best practices around storytelling, data, and donor engagement. When their campaigns rely on patient information supplied by the covered entity, they should coordinate closely with the privacy office so that general marketing approaches are reconciled with HIPAA's specific constraints on fundraising uses of PHI.
Compliance and Legal Teams
Compliance and legal professionals help interpret how the Privacy Rule applies to a given fundraising program and assess whether business associate arrangements are needed when third parties support fundraising on the covered entity's behalf. They should also evaluate whether the HITECH Act or state law imposes requirements beyond baseline HIPAA obligations for fundraising communications.
Business Associates Supporting Fundraising
Vendors that handle PHI to support a covered entity's fundraising activities generally do so as business associates under a business associate agreement, which is the mechanism through which relevant Privacy Rule obligations flow to them. Such vendors should confirm the specific permitted uses and safeguards with the covered entity and against current regulatory guidance.

Inside Fundraising Communications

Permitted PHI for Fundraising
Under the HIPAA Privacy Rule, a covered entity may use or disclose to a business associate or institutionally related foundation certain categories of PHI for fundraising purposes without individual authorization. These generally include demographic information (such as name and contact information), dates of health care provided, department of service information, treating physician, outcome information, and health insurance status. Uses beyond these categories typically require individual authorization. Practitioners should verify the current regulatory text for the precise permitted data elements.
Opt-Out Requirement
The Privacy Rule generally requires that any fundraising communication provide the individual with a clear and conspicuous opportunity to opt out of receiving further fundraising communications. The method to opt out may not cause the individual undue burden or more than a nominal cost.
Notice of Privacy Practices (NPP) Disclosure
A covered entity that intends to contact individuals to raise funds must generally include a statement in its Notice of Privacy Practices informing individuals that they may be contacted for fundraising and that they have the right to opt out.
Honoring the Opt-Out
Once an individual opts out, the covered entity generally may not send further fundraising communications to that individual. The opt-out functions as a suppression obligation that must be operationally enforced across relevant systems and campaigns.
Business Associate and Foundation Involvement
Fundraising activities may involve a business associate or an institutionally related foundation. Where a business associate is used, obligations attach through a business associate agreement, and PHI may only be used or disclosed as permitted for fundraising. The relationship, not mere data access, defines the applicable obligations.

Common questions

Answers to the questions practitioners most commonly ask about Fundraising Communications.

Does HIPAA prohibit covered entities from using PHI for fundraising?
No. The HIPAA Privacy Rule generally permits covered entities to use or disclose certain limited protected health information for fundraising purposes without a prior authorization, provided specific conditions and safeguards are met. The rule does not ban fundraising; rather, it defines which categories of PHI may be used, what notices must be provided, and how individuals may opt out. Because the applicable requirements are set out in the Privacy Rule, and state law may impose additional restrictions, readers should verify the current regulatory text before relying on any specific permission.
If a patient opts out of fundraising communications once, do they need to opt out again for each new campaign?
Generally, no. The Privacy Rule treats an individual's decision to opt out as a decision not to receive further fundraising communications, and covered entities are expected to honor that election rather than requiring it to be renewed for every campaign. The mechanism must make it clear and simple for individuals to opt out, and the covered entity must not condition treatment or payment on whether an individual chooses to receive fundraising communications. Specific operational details should be confirmed against the current regulation.
What information generally must be included in fundraising materials or the opt-out mechanism?
Fundraising communications typically must include a clear and conspicuous opportunity for the individual to opt out of receiving further fundraising communications, and the method for opting out generally should not cause the individual to incur an undue burden or more than nominal cost. Covered entities should also address fundraising in their Notice of Privacy Practices, stating that PHI may be used for this purpose and that individuals have the right to opt out. Exact wording and formatting requirements should be verified against the current Privacy Rule text.
Which categories of PHI can generally be used for fundraising, and which require authorization?
The Privacy Rule permits, without authorization, the use of certain limited data elements for fundraising, which may include demographic information, dates of service, and similar limited categories described in the regulation. Uses of more sensitive information beyond the permitted categories generally require a valid HIPAA authorization from the individual. Because the precise list of permissible elements is defined in the regulatory text and is easy to misapply, covered entities should confirm the current categories against the applicable Privacy Rule provisions before designing a campaign.
How should a covered entity handle fundraising when using a business associate such as an outside fundraising firm?
When a covered entity engages an outside firm or foundation to conduct fundraising on its behalf and that arrangement involves access to PHI, the entity generally needs a business associate agreement (or other appropriate arrangement) that limits how the PHI may be used and requires compliance with applicable Privacy Rule obligations, including honoring opt-outs. HIPAA obligations flow to the vendor through this defined relationship rather than attaching automatically. The specific contractual terms and any institutionally related foundation considerations should be verified against current guidance.
How does fundraising compliance fit into a broader control framework such as the HITRUST CSF?
A control framework like the HITRUST CSF may include controls that support privacy governance, authorization management, and honoring individual preferences, which can help operationalize fundraising-related obligations. However, HITRUST certification is a private certification and is not a legal requirement, and it does not by itself establish HIPAA compliance. Covered entities remain responsible for meeting the fundraising provisions of the HIPAA Privacy Rule as enforced by HHS OCR, and should treat any framework mapping as a supporting tool rather than a substitute for verifying the current regulatory requirements.

Common misconceptions

A covered entity can use any PHI it holds to solicit donations as long as it is for a good cause.
The Privacy Rule generally limits fundraising uses and disclosures to specific categories of PHI without authorization. Using information outside those permitted categories, such as detailed diagnosis or treatment information, typically requires individual authorization. Practitioners should confirm the permitted elements against the current regulatory text.
Providing an opt-out is optional or a courtesy.
The Privacy Rule generally requires that each fundraising communication include a clear and conspicuous opportunity to opt out, and that opting out not impose undue burden or more than nominal cost. Once an individual opts out, further fundraising communications generally may not be sent.
HITRUST certification or a general compliance program automatically covers fundraising communication obligations.
HITRUST is a private organization and the HITRUST CSF is a certifiable control framework; certification does not by itself establish HIPAA compliance. Fundraising communication requirements arise under the HIPAA Privacy Rule enforced by HHS OCR and must be addressed directly regardless of any certification status.

Best practices

Limit PHI used for fundraising to the categories generally permitted without authorization, and obtain individual authorization before using data elements that fall outside those permitted categories; verify permitted elements against the current regulatory text.
Include a clear and conspicuous opt-out mechanism in every fundraising communication, ensuring the method imposes no undue burden or more than a nominal cost on the individual.
Update the Notice of Privacy Practices to disclose that individuals may be contacted for fundraising and that they may opt out.
Implement operational controls, such as suppression lists synchronized across systems and campaigns, to reliably honor opt-out requests and prevent further fundraising communications to individuals who have opted out.
Where business associates or institutionally related foundations are involved, ensure obligations are addressed through appropriate business associate agreements and that PHI is used only as permitted for fundraising.
Confirm whether applicable state law or other frameworks impose additional fundraising or solicitation requirements beyond the HIPAA Privacy Rule, as these may be more restrictive.