Groups: Re­vise dis­clo­sure rule

Modern Healthcare - - The Week In Healthcare - Joseph Conn

Sev­eral in­flu­en­tial as­so­ci­a­tions of health­care pro­fes­sion­als have filed ob­jec­tions with HHS, ask­ing it to ei­ther re­scind or re­vise a pro­posed rule that would ex­pand pa­tients’ rights to ob­tain an ac­count­ing of dis­clo­sures of their med­i­cal records.

The Med­i­cal Group Man­age­ment As­so­cia- tion has called on the Of­fice for Civil Rights at HHS to “with­draw its pro­posed HIPAA ac­count­ing-of-dis­clo­sures rule and en­gage med­i­cal groups and other stake­hold­ers to de­velop a con­sen­sus-driven so­lu­tion be­fore mov­ing for­ward with the reg­u­la­tion.”

The MGMA’s harsh as­sess­ment was based on more than 1,400 re­sponses it re­ceived from its mem­bers in re­cent weeks to a sur­vey of their opin­ions on how much dis­rup­tion to their prac­tices might en­sue if com­pli­ance with the rule as stated is re­quired.

The Col­lege of Health­care In­for­ma­tion Man­age­ment Ex­ec­u­tives said in its com­ments that the pro­posed rule would re­quire “the abil­ity to ag­gre­gate hun­dreds or even thou­sands of ac­cess events in any au­to­mated fash­ion,” adding that “is not re­al­is­tic for most cov­ered en­ti­ties—never mind across cov­ered en­ti­ties and their nu­mer­ous busi­ness as­so­ciates.”

Mean­while, the Amer­i­can Health In­for­ma­tion Man­age­ment As­so­ci­a­tion has asked the civil rights of­fice to tone down the re­quire­ments.

The Fed­er­a­tion of Amer­i­can Hos­pi­tals in­tends to weigh in with com­ments, a spokesman said, but was still vet­ting its re­sponse at dead­line. The Amer­i­can Hos­pi­tal As­so­ci­a­tion also in­tends to sub­mit com­ments but had not done so by dead­line, a spokesman said.

The pro­posed rule, is­sued May 31, mod­i­fies the pri­vacy pro­tec­tions of the Health In­surance Porta­bil­ity and Accountability Act of 1996. The changes are pur­suant to more-strin­gent pri­vacy pro­tec­tions in the health in­for­ma­tion tech­nol­ogy sec­tions of the Amer­i­can Re­cov­ery and Rein­vest­ment Act of 2009. The stim­u­lus law broad­ened the ac­count­ing re­quire­ment to in­clude dis­clo­sures for treat­ment, pay­ment and other health­care op­er­a­tions. The pub­lic com­ment pe­riod ends Aug. 1.

One of the MGMA sur­vey’s ques­tions asked how many times over the past year mem­bers had been asked by their pa­tients for an ac­count­ing of dis­clo­sures, ex­pressed as a rate of re­quests per full-time equiv­a­lent physi­cian. More than half (55.3%) of the re­spon­dents said zero and 21% said they didn’t know. Nearly one quar­ter (24%), how­ever, in­di­cated they had han­dled dis­clo­sure re­quests from pa­tients, rang­ing from just one re­quest per physi­cian per year (10% of sur­vey re­spon­dents) to as high as 10 or more per physi­cian per year (6%).

AHIMA, in its letter, cred­ited the of­fice for “an ex­cel­lent job” up­dat­ing the pri­vacy pro­tec­tions but said its pro­posal to re­quire providers to cre­ate an “ac­count­ing for ac­cess” to a pa­tient’s med­i­cal records by peo­ple within a health­care or­ga­ni­za­tion—not just for re­leases of records to out­sider in­di­vid­u­als or groups— goes “out­side the cur­rent scope of HIPAA, even with the (stim­u­lus-law) amend­ments.”

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