Section 112 accounting for disclosures

[James Love <love@tap.org>]

Deirdre Mulligan has explained to me what the Sec. 112 accounting for 
disclosures.  This is my understanding of what the bill says, 
followed by some questions.

Section 112, states that health information trustee's shall create and 
maintain records of disclosures of information not related to treatment.

Section 101 gives individuals rights to see and copy the Sec. 112 
disclosures, except for several exceptions (which I will not go into here).
Section 202 (d) requires the health information trustee to maintain 
records of authorizations of disclsoures.  These are the provisions on 
record keeping.

   So, I apparently have rights to ask for these items.


     How does this work?  My doctor has my records, and they give them to 
my insurance company.  Say my insurance company then gives the records to 
someone else, say a government agency or a company like equifax, or 
someone i have given consent to, like my life insurance company, or 
anyone else who qualifies as a health care trustee. 

health care trustees include:

    health care providers, health plan, health oversight agency, health 
researcher, public health authority, employer, insurer, school or 
university, or health information service insofar as it creates, 
receives, obtains maintains, uses, or transmits protected health 
information, or any persons who obtains protected health care information 
under sections 206, 207, 208, 209, 210, 211, or 212 or the bill, or any 
employee, agent, or contractor who "creates, receives, obtains, 
maintains, uses, or transmits" protected health information.



       This is my question.  hundreds of health care trustees may have 
had access to my medical records.  Do I have to ask each one for my sec. 
112 info?  If I don't know who to ask, do I have to ask everyone?
What if my companies gives a record to someone for "administrative" 
purposes (A Sec. 101 exception), and they disclosue the information to
one of the groups that is not required to obtain notice or consent?
Won't this be very difficult if not impossible to track?

jamie


----------------------------------------------------------------------
James Love, love@tap.org
P.O. Box 19367, Washington, DC 20036; v. 202/387-8030; f. 202/234-5176
Consumer Project on Technology; http://www.essential.org/cpt/cpt.html
Taxpayer Assets Project; http://www.essential.org/tap/tap.html