New HIPAA Privacy Rule would develop monetary burden

The currently beleaguered U.S. overall health care technique is facing a new and pricey threat that will impact patient care and in the end may perhaps lead to hospital closures: paying for and processing a torrent of health-related record requests.

Although the news media in 2022 focused on hospitals’ billions of dollars of losses, unfavorable operating margins, and other daunting post-pandemic challenges, a set of pricey modifications to the HIPAA Privacy Rule proposed by the Division of Wellness and Human Solutions largely flew below the radar.

These modifications have been outlined in a “Notice of Proposed Rule Making” on Jan. 21, 2021. But it was not a priority till pretty lately, when HHS announced plans to finalize this rule in March 2023. Among January 2021 and now, HHS didn’t concentrate on the modifications, which had currently sat for a number of years. If HHS can constantly shelve this challenge though it focuses on other priorities, it begs the query “Why force it by means of now?”

HHS says the proposed rule modify aims to enhance the sharing of overall health info though easing unnecessary administrative burdens on overall health care providers and lowering expenses for them. But as a overall health info management experienced with 3 decades of encounter, I’m particular this rule modify will do the precise opposite.

HHS’s proposal calls for a number of alterations to HIPAA, formally identified as the Wellness Insurance coverage Portability and Accountability Act of 1996, which aimed to standardize overall health care transactions to defend individual’s overall health info.

None of the alterations would be as problematic as upending the operational and monetary model for releasing patients’ health-related info to third-celebration requestors such as law firms and insurance coverage corporations. These requests typically come at low or no expense to overall health care providers and sufferers, as they are primarily subsidized by the costs the requestors spend to access health-related records for industrial purposes. But the provision would drastically reduce the costs third parties spend to acquire these records.

At the moment, just about 80% of hospitals and other providers outsource record requests to educated pros who perform for release of info to corporations.

Unfettered by larger costs for accessing protected patient records, the new rule would significantly empower industrial third-celebration requestors to ask for as numerous records as they want. The proposed rule would also imply that hospitals and other overall health care providers would have to figure out how to make up for these reduce costs to comply with federally mandated specifications. This unfunded mandate would also supersede state laws that regulate the costs that industrial third-celebration requestors ought to spend.

A study by Hemming Morse, a forensic and monetary consulting firm, located that this would expense providers in excess of $1 billion annually. For most hospitals, specifically neighborhood-primarily based facilities in far more rural locations, any incremental, unplanned expense could be catastrophic. However the reality is that most are largely unaware that the expense for this service is about to shift to their balance sheets for the reason that of the proposed modify. I’m prepared to bet the vast majority of hospital executives haven’t factored this expense into their 2023 budgets.

It is also extremely probably that record requests will boost for the reason that of the policy modify. Improved requests lead to insurmountable challenges for currently overworked overall health info management employees and longer processing occasions for absolutely everyone involved. In my encounter functioning for a conglomerate of hospitals, I saw how a single audit by an insurance coverage corporation can lead to thousands of record requests, temporarily overwhelming a hospital’s records division.

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A hospital with thousands of beds could all of a sudden have hundreds of thousands of patient record requests that it will have to approach and spend for, and these sources ought to come from someplace. Hospitals may perhaps have to have to sacrifice patient care, curtailing neighborhood outreach applications or forgoing the buy of lifesaving technologies.

There is a level of specialized know-how necessary to effectively scrub a health-related record for sensitive or irrelevant info prior to it is released to make sure HIPAA compliance.

When records are not effectively scrubbed, hospitals and providers get reprimanded — or fined — by HHS’s Workplace of Civil Rights. An unmanageable demand for record releases, restricted and untrained employees, and no planned spending budget is a recipe for errors and privacy horror stories, specifically when sensitive info pertaining to sexual abuse, HIV status, substance use, or reproductive overall health is at stake.

Rather of enhancing access and defending privacy, the proposed modify will compromise patient privacy, making a technique whereby patient info becomes far more effortlessly accessible and vulnerable than ever prior to.

There is no plausible purpose to finalize the draft regulation. Lawmakers ought to realize this policy modify from the viewpoint of the hospital administrators and overall health info technologies pros functioning to approach these requests and defend patient privacy.

The answer is straightforward: HHS ought to retract the Notice of Proposed Rule Creating provision that would lead to the catastrophic billion-dollar annual expense shift. It is a prime instance of federal overreach that will foist an very unnecessary operational and monetary crisis on currently stressed hospitals and overall health care providers.

Let’s not develop a crisis in patient access to — and privacy of — their protected overall health info. HHS has not provided an explanation as to how the modify will in fact assistance the market or sufferers. In truth, if it totally understood the implications for our nation’s hospitals, I am confident it wouldn’t push this new rule forward as it is presently written.

I encourage hospital administrators to act urgently to inform lawmakers the policy modify is neither feasible nor advantageous for sufferers or the overall health care market.

Angie Comfort is a overall health info management experienced with far more than 30 years of encounter and a longtime member of the American Wellness Facts Management Association and the Association of Clinical Documentation Integrity Specialists.