The following proposed sections are intended to facilitate individual understanding of and involvement in the handling of their protected health information. Four basic individual rights would be created under this section: the right to a notice of information practices; the right to obtain access to protected health information about them; the right to obtain access to an accounting of how their protected health information has been disclosed; and the right to request amendment and correction of protected health information.
The rights described below would apply with respect to protected health information held by health care providers and health plans. We are proposing that clearinghouses not be subject to all of these requirements. We believe that as business partners of covered plans and providers, clearinghouses would not usually initiate or maintain direct relationships with individuals. The contractual relationship between a clearinghouse (as a business partner) and a covered plan or provider would bind the clearinghouse to the notice of information practices developed by the plan or provider and it will include specific provisions regarding inspection, copying, amendment and correction. Therefore, we do not believe the clearinghouses should be required to provide a notice or provide access for inspection, copying, amendment or correction. We would require clearinghouses to provide an accounting of any disclosures for purposes other than treatment, payment and health care operations to individuals upon request. See proposed § 164.515. It is our understanding that the vast majority of the clearinghouse function falls within the scope of treatment, payment, and health care operations and therefore we do not believe providing this important right to individuals will impose a significant burden on the industry. We invite comment on whether or not we should require clearinghouses to comply with all of the provisions of the individual rights section.