Does anyone on here have an opinion about the following situation?

In discussions with various individuals, there's a gray area in regards to
who's data is it and at one point in regards to Protected Health Information
(PHI) and so forth.  Here's a situation we're looking at.
As a clearinghouse, we are a Covered Entity (CE).  We are also a Business
Associate (BA)  to providers and some health plans, otherwise a trading
partner (TP) to other health plans.  Our dilemma is this:  Under the Privacy
provisions, to many extents our business of being a Clearinghouse would
enact that we would need to follow CE items.  From my understanding, covered
entities hold onto PHI for a minimum of 6 years in case of a request for
access (164.524), but if we are acting as a BA to the provider, would we be
held responsible to hold that data for the 6 period?  If so, I am assuming
since we are doing this as a service, a reasonable charge can be associated
with this.  Also within the Privacy regulations (164.504) as a BA to
entities, they have the ability upon termination of a contract, request for
return of PHI or Destruction of the PHI if feasible.
So here are my questions:
1       Whose PHI is it at what point that they can ask for destruction or
return if the contract is terminated?  Is it the provider's until they
submit the claims to a health plan and then becomes the health plan's after
the submission?  If so, can we destroy that information if it is now the
health plan's when it is a provider who terminates the contract?  Would this
be considered one of the "not feasible" situations?  What if the health plan
who was once a BA now terminates the agreement?  Same kind of quandary
there.
2       If we are able to destroy or return the data, I can not find
anywhere in the regulations of who covers the cost of returning or
destroying the PHI.  Can the provider or health plan be charged a reasonable
fee for such work?  There is a section that discusses assessing a reasonable
fee to access any PHI.

If anyone has an opinion or can shed some light on this subject it would be
great appreciated.


Thank you in advance.


Suzanne Ronde
Proservices Health Information Technology
HIPAA Project Manager


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present are certain to miss the future. - Kennedy, John F.

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