response to each of the two student posts. Proper references must be provided. The study material is provided as a separate file to help with the response Original Discussion Post Question
Student Post 1
Disclosure of protected health information is required when a patient or their designee
requests it and during reviews, investigations, or action enforcement by HHS to ensure
compliance (Foltz & Lankisch, 2018). Patients can request to view and get a copy of their
medical records in any format (Foltz & Lankisch, 2018). HIPAA Omnibus Final Rule allows
patients the right to download their health information and transmit it electronically (Foltz &
Lankisch, 2018). The healthcare industry identifies permitted disclosures as payments,
treatments, and healthcare operations (Foltz & Lankisch, 2018). HIPAA also allows disclosure
without prior authorization for data sets used for public health and research (Foltz & Lankisch,
2018). Protected entities can disclose protected health information as required by law including
warrants and subpoenas (“Summary of the HIPAA Privacy Rule,” 2022). It can also be disclosed
to assist in identifying suspects and fugitives or victims of a crime (“Summary of the HIPAA
Privacy Rule,”2022). Protected entities include healthcare providers, healthcare plans,
healthcare clearinghouses, and business associates (“Health Insurance Portability and
Accountability Act of 1996 (HIPAA),” 2022)
References
Foltz, D., & Lankisch, K. (2022). Electronic Health Record (3rd ed.). Paradigm Education
Solutions. A Division of Kendall Hunt. ISBN 978-1-7924-6564-2.
Health Insurance Portability and Accountability Act of 1996 (HIPAA). (2022, June 28). Centers
for Disease Control and Prevention. https://www.cdc.gov/phip/publications/topic/hipaa.html
Summary of the HIPAA Privacy Rule. (2022, October 19). HHS.gov.
https://www.hhs.gov/hipaa/for-professionals
/privacy/laws-regulations
Student Post 2
In the United States, HIPAA is one of several laws that require the disclosure of sensitive health
information. Here are two examples of HIPAA-required disclosure:
Treatment, payment, and healthcare operations: Health information may be made available to
third parties without patient consent for the purposes of: Providing healthcare treatment
Receiving payment for healthcare services Executing healthcare operations Sharing information
within the healthcare team Billing and insurance purposes Quality improvement activities
Administrative functions
In some cases, healthcare providers are legally obligated to report certain health information to
third-party entities. These third-party reporting requirements vary by state and may include
reporting of certain illnesses, injuries, or allegations of abuse and neglect. The goal of thirdparty reporting is to ensure public health and safety. It is crucial to emphasize that the
disclosure of protected health information needs to adhere to applicable regulations and
policies to safeguard patient privacy and maintain confidentiality.
Reference
Geiderman, J. M., & Marco, C. A. (2020). Mandatory and permissive reporting laws: obligations,
challenges, moral dilemmas, and opportunities. Journal of the American College of Emergency
Physicians Open, 1(1), 38-45.
https://doi.org/10.1002/emp2.12011
Office for Civil Rights (OCR). (2009, January 7). Guidance: Treatment, Payment, and Health Care
Operations.
HHS gov. https://www.hhs.gov/hipaa/for- professionals/privacy/guidance/disclosurestreatment-payment-health-
Study Material
Disclosure of Protected Health Information
Protected health information (PHI) encompasses an individual’s private health and
medical details possessed by healthcare service providers and transferable through paper or
electronic means. Health Insurance Portability and Accountability Act (HIPAA) regulates the
security, privacy, and confidentiality of such data. Still, there is a need to ensure a smooth flow
of health information to facilitate quality care delivery and enhance the well-being of individuals.
HIPAA, therefore, stipulates the exceptions or conditions under which covered entities, including
hospitals and insurance providers, may disclose PHI.
Two Situations in which Disclosure of PHI is Permitted
Although PHI is generally confidential, disclosure may be required for two specific
reasons: when required by the Department of Health and Human Services (HHS) and upon
request by individuals or their representatives (De Simone, 2019). Individuals or their authorized
representatives are entitled to disclosure when they request access to their PHI or an accounting
of disclosed details. In accordance with HIPAA regulations, individuals have a legal right that
pertains to being informed about how their PHI is used and released (Pope, 2020). Such
permissions include the ability for them to view and acquire copies of their health records. This
measure enables the individual to gain a deeper insight into medical history and ensure the
accuracy of information. Furthermore, covered entities must provide an accounting of any nontreatment-related instances that involve sharing an individual’s PHI.
Secondly, a covered entity must divulge PHI to HHS under particular circumstances,
such as when the HHS undertakes an investigation or takes actions related to compliance
measures. Enforcement of HIPAA regulations and adherence to prescribed standards is
facilitated by the disclosure requirement, therefore playing a crucial role in maintaining
healthcare delivery integrity (Edemekong et al., 2018). Compliance investigations or reviews
launched by HHS compel these entities to give relevant PHI for assessment in conformity with
regulations, thereby guaranteeing individual privacy and security concerning health information.
Regulatory and Ethical Implications
When enforcement actions are required, the relevant PHI becomes an instrument for
holding healthcare institutions accountable. Noncompliance to HIPAA regulations may result in
penalties or sanctions imposed by HHS upon covered entities (De Simone, 2019). In enforcing
such actions, information gathering permits HHS to identify areas where compliance is not being
met and introduce corrective measures, thereby cultivating a sense of accountability within
healthcare institutions. Revealing PHI to HHS during compliance activities is a testament to
prioritizing confidentiality and security of health information. This approach upholds the
regulatory framework that ensures healthcare institutions uphold privacy. Also, unauthorized
disclosure or mishandling of PHI can breach the patient’s trust in the healthcare service provider
and damage the organization’s reputation. Ultimately, sharing information with HHS plays an
essential role in maintaining ethical standards by promoting accountability for private data and
respect for patients and their families (De Simone, 2019). Therefore, healthcare professionals
must handle such scenarios prudently by ensuring that any disclosures made are both essential
and lawful under applicable contractual obligations.
Conclusion
The first requirement to reveal PHI or a record of disclosure to individuals or their
representatives elevates an individual’s authority over their medical details. Secondly, disclosing
such data during compliance reviews, investigations, and enforcement measures conducted by
HHS ensures accountability while protecting healthcare’s integrity. Protected health information
must undoubtedly be protected. However, by stipulating the conditions for disclosing PHI,
regulators ensure that essential information still flows through the healthcare system to support
the provision of quality healthcare.
References
De Simone, D. M. (2019). When is accessing medical records a HIPAA breach? Journal of
Nursing Regulation, 10(3), 34-36. https://doi.org/10.1016/S2155-8256(19)30146-2
Edemekong, P. F., Annamaraju, P., & Haydel, M. J. (2018). Health Insurance Portability And
Accountability Act. In StatPearls [Internet]. StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK500019/
Pope, J. (2020). Top five HIPAA lessons learned: a review of HHS resolution
agreements. Innovations in clinical neuroscience, 17(7-9), 45.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839657/
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