Understanding the Importance of Accounting of Disclosures of PHI

Introduction

Accounting of Disclosures of PHI (Protected Health Information) is a crucial aspect of HIPAA (Health Insurance Portability and Accountability Act) compliance. It ensures transparency and accountability in the handling of personal health information outside of Treatment, Payment, and Operations (TPO). In this blog post, we will explore the requirements, implications, and best practices related to accounting of disclosures of PHI.

What is Accounting of Disclosures?

Accounting of Disclosures is the process of documenting and tracking the instances where PHI is shared with external entities. It provides individuals with a comprehensive record of who has accessed their health information and for what purpose.

Legal Basis: 45 CFR § 164.528

The legal foundation for accounting of disclosures of PHI is outlined in 45 CFR § 164.528 of the HIPAA Privacy Rule. This rule mandates covered entities to maintain a record of certain disclosures, including the date, description, and purpose of each disclosure.

Key Requirements

• Incidental Disclosures: Covered entities are required to document incidental disclosures, which are unintentional disclosures that occur as a byproduct of a permitted use or disclosure.
• Access to Individual Information: Business associates, under HIPAA, must provide individuals with access to their own information, including disclosures made by the business associate.
• Documentation of Oral Communications: The Privacy Rule does not require covered entities to document all oral communications. However, certain oral disclosures, such as those made to public health authorities, need to be documented.
• Access by Public Health Authority: Covered entities must document each medical record that may be accessed by a public health authority, as required by law.
• Accounting for Date of Access: If the date of access is uncertain, covered entities should employ reasonable measures to account for the date to the best of their ability.
• Accounting for Limited Data Sets: A covered entity must provide an accounting for disclosures even if the only information disclosed is a limited data set. A limited data set excludes specific identifiers but may still contain identifiable information.
• Business Associate Involvement: Covered entities may hire business associates to create limited data sets. However, the covered entity remains responsible for accounting for any disclosures made using the limited data set.
• Disclosures during Litigation: Covered entities must account for disclosures of PHI made during the course of litigation. This ensures transparency and compliance with legal requirements.

Importance of Accounting of Disclosures

Accounting of Disclosures plays a vital role in protecting the privacy and security of individuals' health information. It serves several important purposes:

1. Transparency: By providing individuals with a record of who has accessed their health information, accounting of disclosures promotes transparency and allows individuals to monitor the use and disclosure of their PHI.
2. Accountability: Maintaining a detailed record of disclosures ensures that covered entities and business associates are accountable for their actions regarding PHI. It helps prevent unauthorized disclosures and facilitates audits and investigations.
3. Legal Compliance: HIPAA's Privacy Rule requires covered entities to provide individuals with an accounting of certain disclosures upon request. By complying with this requirement, organizations can demonstrate their commitment to legal and ethical standards.
4. Enhanced Trust: Transparent and accountable handling of PHI through accounting of disclosures builds trust between individuals, healthcare providers, and other entities involved in the healthcare ecosystem.

Best Practices for Accounting of Disclosures

To ensure effective accounting of disclosures and HIPAA compliance, organizations should consider the following best practices:

• Implement Robust Record-Keeping Systems: Utilize secure electronic systems to document and store disclosures, ensuring accessibility, accuracy, and protection against unauthorized access.
• Train Staff: Provide comprehensive training to employees regarding the importance of accounting of disclosures, relevant legal requirements, and proper documentation procedures.
• Establish Clear Policies and Procedures: Develop and communicate policies and procedures to guide employees in documenting and reporting disclosures consistently.
• Regularly Review and Update Documentation: Conduct periodic reviews of accounting of disclosures processes to identify any gaps or areas for improvement. Update documentation practices to reflect changes in regulations or organizational policies.
• Ensure Timely Response to Requests: Promptly respond to individuals' requests for an accounting of their disclosures, adhering to the timelines specified by HIPAA.
• Secure PHI: Implement strong security measures to protect the confidentiality and integrity of PHI, minimizing the risk of unauthorized disclosures.

Conclusion

Accounting of Disclosures is a critical aspect of HIPAA compliance that ensures transparency, accountability, and privacy protection for individuals' health information. By maintaining detailed records of disclosures and following best practices, covered entities can meet legal requirements, enhance trust, and safeguard the confidentiality of PHI.