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So what has to be reported?Covered entities must notify patients, the government HHS, and sometimes the media when they discover breaches of PHI that were not properly secured through encryption or destruction. 26 Similarly, business associates must notify covered entities of breaches involving the covered entities PHI. A breach is defined as the unauthorized acquisition, access, use, or disclosure of PHI. 27 Unsecured PHI means information that is not rendered unusable, unreadable, or indecipherable to unauthorized individuals through the use of technology and methodology specified in the HHS Guidance. If PHI has been properly de identified, inadvertent or unauthorized disclosure will not be considered a breach and thus does not trigger the breach notification mandates. Health information is considered de identified if it does not identify an individual, if there is no reasonable basis to believe the information can be used to identify an individual, and if the covered entity or business associate complies with the privacy rule specifications for de identifying information. Disclosure of properly secured data through use of accepted encryption techniques is exempted from the notification mandates. Encryption means the use of an algorithmic process to transform data into a form in which there is a low probability of assigning meaning to the data without use of a confidential process or encryption key. It is important to understand that if the confidential process or encryption key is discovered or improperly disclosed, this would constitute a breach if any PHI were improperly accessed. The Guidance suggests that encryption breaches are best avoided if the confidential process or encryption key is kept on devices or at locations separate from where the PHI is stored. Destruction of hard copy PHI is accomplished by shredding or destroying the data in such a manner that it cannot be read or otherwise reconstructed.

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