What is an example of an exception under the Privacy Rule requiring a written agreement to disclose protected health information?

The correct choice is the situation where a physician sends a treatment plan to a marketing pharmaceutical company. Under the Privacy Rule, particularly as outlined in the Health Insurance Portability and Accountability Act (HIPAA), there are specific circumstances under which protected health information (PHI) can be disclosed without a patient's written consent. However, disclosing patient information to a third party for marketing purposes is not one of those circumstances.

In this case, the act of sending a treatment plan to a pharmaceutical company lies outside of the permissible disclosures for treatment, payment, or healthcare operations. This type of disclosure typically requires a written agreement or authorization from the patient. The Privacy Rule safeguards patients' rights to control their personal health information, especially when such information could be used for commercial purposes, which makes it critical to have a written agreement in these instances.

In contrast, sharing patient information with a family member (the first option), sharing necessary information within the medical team for treatment (the third option), and allowing patients to access their own medical records (the fourth option) generally fall under situations that do not require a written agreement or authorization, since they are either consented to by the patient or permissible disclosures as a part of treatment and care.