Michigan Request for Accounting of Disclosures of Protected Health Information

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Multi-State
Control #:
US-3581
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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

Information must be provided to the data subject upon request for accounting of disclosures made within the past six years. This includes a detailed list of disclosures that require accounting, helping the individual understand how their protected health information has been shared. Utilizing resources like USLegalForms can simplify completing the Michigan Request for Accounting of Disclosures of Protected Health Information.

HIPAA Disclosure Accounting or Accounting of Disclosures (AOD) is the action or process of keeping records of disclosures of PHI for purposes other than Treatment, Payment, or Healthcare Operations. You are required by law to provide patients a list of all the disclosures of their PHI that you have made outside of TPO.

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.

Under the HIPAA Privacy Rule, a covered entity must act on an individual's request for access no later than 30 calendar days after receipt of the request.

The Privacy Rule at 45 CFR 164.528 requires covered entities to make available to an individual upon request an accounting of certain disclosures of the individual's protected health information made during the six years prior to the request.

Under the HIPAA Privacy Rule, a covered entity must act on an individual's request for access no later than 30 calendar days after receipt of the request.

Patients (or their Personal Representatives see Yale Policy 5038 - Personal Representatives) may request an accounting of disclosures by submitting a request in writing using the Request for Accounting of Disclosures of Protected Health Information form, or other sufficient written documentation requesting the

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.

How do I track disclosures? The PI should track and maintain a record of any disclosures that includes the date of the disclosure, name of person/entity that received the PHI, description of what PHI was disclosed and brief statement regarding the purpose of the disclosure.

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Michigan Request for Accounting of Disclosures of Protected Health Information