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Protected Health Information (PHI)

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What circumstances are health care providers required to report protected health information and to whom?

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Solution Summary

This is an overview of the circumstances that health care providers are required to report protected health information (PHI) and to whom. Supplemented with an article on of the final standards for PHI.

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RESPONSE:

1. What circumstances are health care providers required to report protected health information and to whom?

HIPAA regulations define health information as "any information, whether oral or recorded in any form or medium" that

· "[i]s created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse"; and

· "[r]elates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual."

However, protected health information (PHI) under HIPAA includes any individually identifiable health information. Identifiable refers not only to data that is explicitly linked to a particular individual (that's identified information). It also includes health information with data items, which reasonably could be expected to allow individual identification
(http://privacy.med.miami.edu/glossary/xd_protected_health_info.htm). HIPAA differentiates between required and permitted uses and disclosures of PHI (see attached resource).

However, there are also other exceptions, where the organization may be required by law to disclose information to certain government and law facilities, which include:

(1) In Connection With Judicial And Administrative ...

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