Standards for Privacy of Individually Identifiable Health Information. Final Privacy Rule Preamble.. Content of the Accounting


We proposed in the NPRM to require the accounting to include all disclosures as described above, including disclosures authorized by the individual. The accounting would have been required to contain the date of each disclosure; the name and address of the organization or person who received the protected health information; a brief description of the information disclosed; and copies of all requests for disclosures. For disclosures other than those made at the request of the individual, the accounting would have also included the purpose for which the information was disclosed.

We generally retain the proposed approach in the final rule, but do not require covered entities to make copies of authorizations or other requests for disclosures available with the accounting. Instead, we require the accounting to contain a brief statement of the purpose of the disclosure. The statement must reasonably inform the individual of the basis for the disclosure. In lieu of the statement of purpose, a covered entity may include a copy of the individual's authorization under § 164.508 or a copy of a written request for disclosure, if any, under § 164.502(a)(2)(ii) or § 164.512. We also clarify that covered entities are only required to include the address of the recipient of the disclosed protected health information if the covered entity knows the address.

We add a provision allowing for a summary accounting of recurrent disclosures. For multiple disclosures to the same recipient pursuant to a single authorization under § 164.508 or for a single purpose under §§ 164.502(a)(2)(ii) or 164.512, the covered entity may provide a summary accounting addressing the series of disclosures rather than a detailed accounting of each disclosure in the series. In this circumstance, a covered entity may limit the accounting of the series of disclosures to the following information: the information otherwise required above for the first disclosure in the series during the accounting period; the frequency, periodicity, or number of disclosures made during the accounting period; and the date of the most recent disclosure in the series. For example, if under § 164.512(b), a covered entity discloses the same protected health information to a public health authority for the same purpose every month, it can account for those disclosures by including in the accounting the date of the first disclosure, the public health authority to whom the disclosures were made and the public health authority's address, a brief description of the information disclosed, a brief description of the purpose of the disclosures, the fact that the disclosures were made every month during the accounting period, and the date of the most recent disclosure.