District of Columbia Request for Accounting of Disclosures of Protected Health Information

State:
Multi-State
Control #:
US-3581
Format:
Word; 
Rich Text
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Description

This form is used by an individual to request an accounting of the persons or entities to whom the individual's protected health information has been disclosed. Permitted exclusions from the accounting are also described.
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How to fill out Request For Accounting Of Disclosures Of Protected Health Information?

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FAQ

Under the HIPAA Privacy Rule, an individual, under certain circumstances, has the right to receive an accounting of disclosures HIPAA Accounting of that individual's protected health information (PHI) made by a covered entity in the last six years prior to the date on which the account is requested.

HIPAA provides individuals with the right to request an accounting of disclosures of their PHI. DHA Privacy Office, HHS Secretary, and/or the MTF HIPAA Privacy Officer.

When releases occur that are pursuant to Accounting of Disclosures, the log must include certain elements like: the date of the disclosure; the name and address of the organization / person who received the PHI; a brief description of the PHI disclosed; and.

A covered entity must obtain the individual's written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.

Other instances necessitating Accounting of Disclosures (AOD) include: Those Required by Law (Court Orders, subpoenas, state reporting, emergencies) Public Health Activities (Prevention of disease, public health investigations) Victims of abuse, neglect, or domestic violence.

(1) Except as otherwise provided by paragraph (a) of this section, the accounting must include disclosures of protected health information that occurred during the six years (or such shorter time period at the request of the individual as provided in paragraph (a)(3) of this section) prior to the date of the request

For each disclosure, the accounting must include: (1) The date of the disclosure; (2) the name (and address, if known) of the entity or person who received the protected health information; (3) a brief description of the information disclosed; and (4) a brief statement of the purpose of the disclosure (or a copy of the

Other instances necessitating Accounting of Disclosures (AOD) include: Those Required by Law (Court Orders, subpoenas, state reporting, emergencies) Public Health Activities (Prevention of disease, public health investigations) Victims of abuse, neglect, or domestic violence.

Other instances necessitating Accounting of Disclosures (AOD) include: Those Required by Law (Court Orders, subpoenas, state reporting, emergencies) Public Health Activities (Prevention of disease, public health investigations) Victims of abuse, neglect, or domestic violence.

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District of Columbia Request for Accounting of Disclosures of Protected Health Information