Election may reset the clock on privacy regs
Stark II final regulations and a new advisory opinion statute are more likely to emerge first, experts say
As the clock ticks toward 2001 and the Department of Health and Human Services (HHS) races to beat its latest self-imposed deadline to complete the privacy portion of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, many observers say the election of George Bush will set that process back considerably.
"I’m really hoping it will be held over for the next administration," asserts Mary Grealy, president of the Health Care Leadership Council in Washington, DC. Grealy says there may be little motivation on the part of the current administration to complete in its waning days the mammoth project of sorting through the 150,000 comments it received regarding the draft regulation.
"I don’t want to sound overly optimistic," she warns. "I think there is a possibility it will be released this year simply because it has been hanging around this long."
Roy Bussewitz, vice president of managed care at the National Association of Chain Drug Stores in Alexandria, VA, says, "I think this could throw the whole process back to square one." But he adds that providers should be careful not to overlook activity taking place in various states. Even when the privacy regulations are completed, many of those state laws will be left intact, he points out.
Grealy says the final regs face a constantly moving target because the information providers use to improve treatment, carry out research, and improve patient communication with physicians is changing.
The privacy regulation could seriously impede innovation by requiring repeated authorization from patients and physicians whenever patient information is used, she argues.
On another front, Grealy says she finds it amazing that the Health Care Financing Administration has yet to complete the final regulations for the Stark II self-referral law. "We are approaching a decade since the law was first passed," she points out.
The regulation currently is being scrutinized by the Office of Management and Budget (OMB) as part of the final clearance process. But House Ways and Means spokesman Greg Christ says the OMB may not like what it sees — which could slow the process considerably. "They may be throwing some egg on it," he asserts. "It is tough to write a regulation when you don’t understand the law."
Besides, Christ says, Congress may yet render the entire process moot. He says it’s possible if not likely that House Ways and Means Health Subcommittee Chairman Bill Thomas (R-CA), who is now locked in a tight race to head up the full committee in 00, will next year push already introduced legislation that would reign in key sections of the regulation.
In addition, Christ says, a provision has been included in the current Medicare reform bill that would reauthorize the now-defunct advisory opinion process.
Beyond that, however, the final Medicare legislative package should hold few surprises for health care providers in the area of fraud and abuse, he says.
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