This phrase refers to a group of records maintained by or for a covered entity under the Health Insurance Portability and Accountability Act (HIPAA). These records comprise the medical records and billing records about individuals maintained by or for a covered healthcare provider; the enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan; or used, in whole or in part, by the covered entity to make decisions about individuals. An example would be a hospital’s electronic health record system containing patient medical histories, diagnoses, treatment plans, and billing information.
Understanding this term is crucial for maintaining patient privacy and complying with HIPAA regulations. It ensures individuals have the right to access, review, and request corrections to their health information. Failure to properly manage and protect these records can result in significant legal and financial penalties for healthcare organizations. Its development represents a key step towards ensuring patient autonomy and data security in the healthcare sector, building on previous legislation and evolving alongside technological advancements in medical record keeping.
