A behind-the-scenes tug-of-war is underway over whether the final privacy regulations established by the Health Insurance Portability and Accountability Act (HIPAA) will be implemented -- or whether various healthcare industry segments will succeed in rewriting the rule's provisions.
Health and Human Services Secretary Tommy Thompson said in a statement Feb. 23 that an unexpected 60-day delay in putting HIPAA privacy's rule into effect would be used to solicit more public comment and to "determine whether changes in the final rule are needed."
In a March 6 letter to Thompson, House Majority Leader Dick Armey (R-TX) asked for the delay, saying, "far from protecting privacy, the proposed regulation actually provides the federal government with more access to people's personal medical information," according to a report by ReutersHealth.
Meanwhile, at a Senate hearing that same day, Thompson said he is committed to medical records privacy, but defended his decision to reopen the regulations for another 30-day comment period.
Key provisions of the HIPAA data privacy requirements call for a national key for encryption of patient information to help standardize electronic medical records, and for new standards for the electronic storage, access, and transmission of medical data -- including that of radiologists and hospitals.
The insurance portability part of the regulations is already in effect. Consumer groups are suspicious that the new administration is friendlier to the insurance and managed care industries and may try to change the rule. During the Clinton administration, the Health and Human Services Department received more than 50,000 public comments over a 60-day period last year, and the rule as written is supposed to be "final."
"We are concerned the secretary could use the comment period as the first step in further delaying the regulations or dismantling them completely," said Joanne Hustead, senior counsel for the Health Privacy Project of the Institute for Health Care Research and Policy at Georgetown University in Washington, DC.
The healthcare industry has pushed the new Bush administration to delay or change the HIPAA privacy rules, saying they would create a complicated and costly burden on the industry.
Thompson seems to be sympathetic. In a speech before an industry group the day before announcing the delay, he said that although his department was committed to protecting patients' privacy, its greatest concern was "that these regulations not unwittingly block needed care."
The delay kicked in because of a Clinton administration oversight. Before major regulations can take place, a federal agency must submit them to Congress. Generally, the regulations become effective 60 days after the date of submission. Although it was published as required Feb. 28 in the Federal Register, due to an administrative error the rule was not sent to Congress until Feb. 12, pushing the effective date to mid-April.
As written, the rule will allow patients access to their own records. Healthcare providers will have to allow this, while monitoring the process to ensure confidentiality on site and via the Internet.
Industry sources have frequently said that the rule would perhaps create barriers to healthcare delivery by imposing costly obligations on their operations. Hospitals and other providers will have to keep track of everyone who receives medical information from their files, and they will be required to hire a "privacy official" to develop policy.
"The purpose for the delay is to take another look, to allow solicitation of additional comments on the regulations, which changed substantially from the draft regulations (of November 1999)," said Susan Pisano, vice president for communications for the American Association of Health Plans. "The December 2000 draft had changed significantly from the draft rule one-and-a-half years earlier."
"It's possible nothing will happen if there is no action taken before April 14 (the end of the 60-day delay)," Hustead said. "It's also possible the secretary might take steps to delay, weaken, or reopen the rule. He could be laying the groundwork, but it's politically very difficult to take away people's privacy rights. We don't know which path he will take."
By Robert BruceAuntMinnie.com contributing writer
March 12, 2001
Related Reading
House leader asks for delay of medical privacy rules, March 7, 2001
Thompson expresses sympathy with managed care's privacy rules concerns, February 27, 2001
What impact will the HIPAA privacy and security regulations have on PACS?, March 20, 2001
HHS updates HIPAA regulatory plans, February 9, 2001
IT veteran offers advice on real-world HIPAA implementation, February 7, 2001
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