HHS wanted to know what people thought of the proposed privacy and security regulations for HIPAA.
It's an example of being careful what you ask for.
Providers and payers--along with hundreds of others--have flooded HHS with thousands of comments on the proposed regulations.
While few dispute the importance of maintaining and improving patient confidentiality, many have characterized the proposed regulations as burdensome and unwieldy.
"We believe in protecting confidentiality as a corner of healthcare," says Mohit Ghose, spokesman for the American Association of Health Plans. "We commend the administration for coming out with the comprehensive set of rules on protecting confidentiality. At the same time, we believe there are a few issues that need to be worked out."
In its comments to HHS, the AAHP expressed concern about whether the regulations would limit allowing health plans to remind patients about preventive screenings such as mammograms. Additionally, the AAHP says the guidelines don't address those issues, and that raises "the concern that such activities, some of which are required by law and private accreditation standards, could require separate authorizations."
AAHP officials also were concerned about the provisions making health plans liable for disclosure of information by business partners, including clearinghouses.
The AMA expressed concerns about who would ultimately be responsible for disclosure of information. The AMA doesn't think physicians should shoulder the responsibility. But the AMA also is concerned that the regulations don't go far enough to protect patient information.
"Patients' confidential information could be disclosed without their consent for a broad array of purposes unrelated to patient's individual treatment or payment and extending far beyond the necessary disclosures and uses patients would expect when they seek healthcare," the AMA said in its letter.
Like many others who submitted comments, the AMA is concerned about the costs of implementing the regulations. But its overarching theme was that of regulations not going far enough. "The confidential relationship at stake is between the patient and his or her physician . . . not between the patient and the healthcare system," the AMA said.