The HITECH Breach Notification Rules: Ensuring Compliance with the New Obligations

On February 17, 2009, Congress enacted theperson authorized to access PHI to another
Health Information Technology for Economic andperson also authorized to access PHI within the
Clinical Health (HITECH) Act as part of thesame covered entity, business associate, or
American Recovery and Reinvestment Act oforganized health care system; and 3) situations in
2009.  In response to a mandate in the HITECHwhich the covered entity or business associate
Act, the Department of Health and Humanhas a good faith belief that an unauthorized
Services (HHS) issued an interim final rule withperson receiving the PHI could not reasonably
request for comments for Breach Notification forhave been able to retain the information.
Unsecured Protected Health Information (theWhat Are the Notification Requirements?
“Rule”) on August 19, 2009. Individual Notice
The Rule establishes significant new notificationIn situations in which a covered entity or business
obligations for covered entities and businessassociate has a reasonable belief that the breach
associates that are subject to HIPAA. involved an individual’s PHI, the entity must
Specifically, the new regulations establish guidelinesprovide written notice to each affected individual. 
for determining when a breach of unsecured PHISuch notice must be provided without
occurs; dictates who must notify of such a“unreasonable delay,” but in no case later
breach and to whom notification must be made;than sixty days after discovery of the breach. 
and establishes the timeframe and contents ofTo the extent possible, the notice should include
such notification. the following information: 1) a brief description of
The Rule became effective on September 23,what happened; 2) the types of information that
2009.  However, HHS has requested additionalwere involved in the breach; 3) steps that
comments that were due on October 23, 2009affected individuals should take to protect
and that may ultimately result in furtherthemselves from potential harm; 4) a description
modifications to the notification obligations. of what the entity is doing to investigate the
Covered entities and business associates must beincident, mitigate harm, and protect against
aware of the new obligations under the Rule andfurther breaches; and 5) contact procedures by
should begin taking steps immediately to ensurewhich affected individuals may learn additional
compliance.  In addition, these entities mustinformation.  In certain situations, such as when
remain cognizant of additional changes andthe covered entity or business associate
modifications that may develop and must bedetermines that misuse of the PHI is imminent or
prepared to alter their compliance efforts withwhen the entity has insufficient contact
these additional potential changes in mind. information for the affected individuals, additional
When Are the Notification Requirementsor substitute notice by alternative means may be
Triggered?made.
The Rule only requires notification if the incidentMedia Notice
qualifies as a “breach” of unsecured PHI. Covered entities and business associates must
The Rule defines “breach” as thealso notify a prominent media outlet within the
“acquisition, access, use or disclosure ofsame timeframe as required for individual notice in
protected health information in a manner notsituations in which a breach involves the PHI of
permitted under [the HIPAA Privacy Rule] whichmore than 500 individuals within a state or
compromises the security or privacy ofjurisdiction.
[PHI].”  Therefore, a use or disclosure thatWhen Must an Entity Report Breaches to HHS?
violates the HIPAA Privacy Rule is a prerequisite,Finally, covered entities and business associates
and any uses or disclosures that do not violatemust track and report all breaches to HHS. 
the Privacy Rule cannot constitute aBreaches involving the PHI of more than 500
“breach” requiring notification under theindividuals (in any state or jurisdiction) must be
Rule.reported “immediately.”  All other
In addition, an incident will only qualify as abreaches must be recorded and annually reported
“breach” if it meets a certain “harmno later than sixty days after the end of each
threshold.”  In other words, the use orcalendar year. 
disclosure must “pose a significant risk ofSummary
financial, reputational, or other harm to theThe Rule establishes significant new breach
individual.”  To determine whether this harmnotification obligations for covered entities and
threshold has been met, covered entities andbusiness associates covered by HIPAA.  In sum,
business associates must conduct and documentthe Rule requires such entities to provide individual
a fact specific “risk assessment.”  Theand/or media notice when there has been a
risk assessment should take into account thebreach of unsecured PHI and to track and report
following factors: (1) the identity of the entity orsuch breaches to HHS. 
individual that impermissibly used the informationAffected entities should review HIPAA compliance
or to whom the information was impermissiblyefforts with these new obligations in mind.  For
disclosed; (2) the steps taken to mitigate harmexample, entities should ensure that policies are in
and the immediacy with which such steps wereplace requiring workforce members to
taken; (3) whether the information was returnedimmediately report any potential privacy violations
before being accessed; and (4) the type andor security incidents so that they can effectively
amount of information disclosed.and promptly evaluate the incident to determine
Finally, the Rule also contains three statutorywhether notification obligations are triggered. 
exceptions to the “breach” definition. Entities should also establish policies and conduct
These exceptions are as follows: 1) uses ortraining to communicate what notification will be
disclosures by persons acting under the authorityrequired and should maintain accurate records to
of the covered entity or business associate thatprepare required reports to HHS.  Affected
are made in good faith, that fall within the scopeentities must remain aware of potential changes
of the disclosing individual’s authority, and thatto these requirements in the future, and be
do not result in further violations of the HIPAAprepared to revise policies and procedures
Privacy Rule; 2) inadvertent disclosures from oneaccordingly.