Proposed Regulations on HIPAA Accounting of Disclosures

New Rules and Regulations for Covered Healthcare Entities


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Proposed regulations regarding HIPAA accounting of disclosures have been recently published and are open for public comments.  If enacted in their current form, the new regulations will require Covered Entities to make significant revisions to their current HIPAA procedures and may require modifications to current computer systems.  


Under the HITECH Act, regulations must be enacted that allow individuals to receive a much expanded accounting of disclosures of electronic health information, including disclosures made for treatment, payment and health care operations. 

In order to accomplish this, the proposed regulations differentiate between “accountings of disclosures” and “access reports.”  Accountings will continue to be a list of certain limited types of disclosures.  Access reports will be similar to “audit trails” and must include information regarding each access to an individual’s electronic health information.  Covered Entities must be able to provide, upon request, both accountings and access reports.

Covered Entities

The proposed regulations also include specific requirements, including the following:

  • Accountings and access reports must be available in regard to disclosures or access, as applicable, for 3 years and must be provided within 30 days of the request. 
  • Accountings and access reports will be required only for health information maintained in designated record sets (e.g., medical records, billing records).
  • Accountings and access reports must include information about disclosures of, and access to, information maintained by business associates.
  • There are additional exceptions to the types of disclosures that must be included on an accounting (e.g., exceptions will include disclosures about abuse and to medical examiners).


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