Groups: Revise disclosure rule

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 Association 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.”