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Healthcare Data Breaches: PHI beyond the Scope of HIPAA


January 20, 2016



In quick summary of the discussions through the blog series so far, PHI is individually identifiable health information that is held or transmitted by a Covered Entity or Business Associate. PHI can be any form or medium: electronic, paper, or oral and can include demographic information and relate to an individual’s past, present, or future physical or mental health or condition, the individual’s health care services received, or the payment status for those health care services.

Now, let’s discuss what PHI falls outside the scope of the HIPAA/HITECH requirements.

Although the HIPAA/HITECH requirements only apply to Covered Entities and Business Associates, it’s important to note that PHI may be redefined as personally identifiable information (PII) that applies to MANY different types of entities and different scenarios in which this information is used or disclosed for business purposes.

Exclusions to the definition of PHI as stated above, are education records (covered by the Family Educational Rights and Privacy Act), records as described at 20 U.S.C. 1232g(a)(4)(B)(iv), and employment records held by a Covered Entity in its role as an employer.

PHI also ceases to be considered PHI, and thus not protected under HIPAA, when certain elements are removed from this sensitive information. This is called de-identification of protected health information. There are two scenarios in which this occurs:

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Topics: Protected Health Information, HIPAA, Covered Entities, Business Associates, Health Information, Privacy, PHI, HITECH, Data Breach, Security, HIMSS16, Personally Identifiable Information, De-identification, Health care, PII

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