Group wants changes to privacy rule requirement
The Confidentiality Coalition, a group of hospitals, health plans, drug companies, medical device manufacturers, biotech firms, health product distributors, pharmacies, employers, medical teaching colleges, and others, is asking Health and Human Services Secretary Mike Leavitt to use his authority to change the HIPAA privacy rule’s accounting of disclosures requirement.
Under the privacy rule, the group said, all covered entities must track and account for disclosure of patient health information, with certain exceptions, and maintain records on all patients in such a way that the records can be used to furnish accounting of disclosures on demand, even when such disclosures are required by law, regulation, or request of a regulatory agency. The rule permits individuals to request an accounting of disclosures made over a six-year period.
"This regulation has been extremely burdensome and costly," the coalition wrote to Leavitt. "In fact, one hospital estimated that compliance with this requirement meant the hiring of two full-time employees whose sole job consists of HIPAA-related paperwork. While only a small percentage of patients will ask for a list of disclosure accountings after their care, the hospital must maintain a specific record of each disclosure in case a former patient should happen to request an accounting of disclosures."
The coalition also noted that state insurance departments routinely require health plans to turn over thousands of records every year for claim verification and auditing functions. And health plans and providers sometimes are required to report immunization, birth, death, and other records to state authorities. "Tracking millions of records every year because of government requests is extremely costly," the letter explained. "In addition to the cost of tracking, there is an enormous storage cost as health plans and providers must secure gigabytes and terabytes of computer storage for this very significant level of records."
The coalition said it had noted with interest a September 2004 report from the Government Accountability Office recommending a reduction in the administrative burden created by the accountability of disclosures requirement. The group recommended HHS modify the rule to exempt mandatory disclosures to public health authorities from those that must be reported under the accounting of disclosures requirement.
The Government Accountability Office report expressed serious concern that the rule’s requirements regarding accounting of mandatory disclosures to public health authorities do not support the rule’s goal of ensuring effective patient privacy protections without imposing unnecessary costs or barriers, the coalition said.
It added that while it supports the recommended change regarding disclosure to public health authorities, it is important to clarify that the exemption also includes disclosures to other government entities such as state insurance departments. "In our view, this should not be limited to mandatory disclosures, but should be expanded to cover routine disclosures to government entities. Further, the burdens associated with the accounting of disclosures provision grow more complex when considered in the context of a national health information infrastructure and interoperable electronic health records — an important goal of President Bush. It will be extremely costly and administratively complex to maintain these records, thereby discouraging entities from participating in a regional information exchange."
Given that the act gives the HHS secretary the ability to modify requirements as deemed appropriate, but not more than once every 12 months, and the last modifications of the HIPAA privacy rule were incorporated into the final rule published Aug. 14, 2002, the group said additional modifications would be allowed at any time and thus urged Leavitt to take immediate steps to modify the requirements for all mandatory and routine disclosures to government entities, since such a change is consistent with the law’s goal and would provide important cost savings.
The Confidentiality Coalition, a group of hospitals, health plans, drug companies, medical device manufacturers, biotech firms, health product distributors, pharmacies, employers, medical teaching colleges, and others, is asking Health and Human Services Secretary Mike Leavitt to use his authority to change the HIPAA privacy rules accounting of disclosures requirement.
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