When Is a Disclosure Accounting Required?

When Is a Disclosure Accounting Required?

In the ever-evolving healthcare privacy and security landscape, understanding the nuances of the Health Insurance Portability and Accountability Act (HIPAA) can be intricate. One inherent aspect of these regulations is the concept of "disclosure accounting."

Under HIPAA, a "disclosure accounting" is required, which essentially translates into a record of instances where an individual's protected health information (PHI) was disclosed. This requirement aligns with HIPAA Privacy Rules that protect individual health information. But when exactly does this requirement come into play? What triggers the need for disclosure accounting? Let's delve into it.

Understanding Disclosure Accounting

HIPAA disclosure accounting conveys the instances where PHI has been disclosed except for the uses concerning treatment, payment, health care operations, or where the individual authorized use or disclosure. It's crucial to comprehend that the HIPAA Privacy Rules place significant emphasis on maintaining a track of disclosures for six years.

This practice results from an individual’s right to receive a disclosure accounting under the HIPAA, obligating covered entities like healthcare providers, health plans, healthcare clearinghouses, and business associates subject to HIPAA Rules. Such an accounting provides individuals with the transparency they need about their PHI's uses and enhances trust towards healthcare bodies.

When Is Disclosure Accounting in Order?

Under HIPAA, a "disclosure accounting" is required, ideally within 60 days after the individual requests it. The covered entity is responsible for maintaining comprehensive records relating to PHI disclosures, supporting an individual's right to know who had access to their PHI and for what purpose. The mandate is to produce an accounting of disclosures carried out in the previous six years from the date of the request before the individual.

Notably, not all disclosures of PHI require accounting. Primarily, disclosure accounting focuses only on non-routine or unexpected disclosures. Routine disclosures for treatment, payment, and healthcare operations do not have to be included in the disclosure accounting. Similarly, individual authorized disclosures, disclosures to individuals about their PHI, some incidental disclosures, and disclosure for national security or intelligence purposes are not entertained in the accounting either.

Bringing It Down to Implementation

When it comes to actual practice, how should the covered entities proceed? For each disclosure, the covered entity must document the following:

  1. The disclosure date
  2. The recipient’s name and (if known) address
  3. A brief statement of the purpose of the disclosure or a copy of the request for it

It is the responsibility of the covered entity to compile and present an accounting of relevant disclosures upon an individual's request or provide a written denial with appeal rights.

Providing such information to the patient or the individual can often be quite taxing on the covered entities, considering the imposing burden of record maintenance. Thus, the OCR (Office for Civil Rights) is mulling over reforms to the current rule of accounting for the disclosure of PHI, aiming to simplify the process and make it manageable for providers and organizations alike.

Wrapping It Up

Safeguarding an individual's Protected Health Information is a shared obligation for healthcare entities worldwide. One such critical responsibility is ensuring the right to an accounting of disclosure under the HIPAA Privacy Rules. While the process may seem complicated, understanding when and how to process a disclosure accounting accurately can save healthcare entities from potential violations while strengthening the trust and transparency between an individual and the entity.

In conclusion, disclosure accounting essentially stands as a strong wall of defense for individuals, safeguarding their privacy. While healthcare entities might still be figuring out the best way to handle it, it is certainly here to stay and emerge as a vital player in improving healthcare privacy.

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