HIPAA Disclosure Rule Comments Highlight Provider Opposition

Margaret Dick Tocknell, for HealthLeaders Media , August 1, 2011

The University of California has five medical centers that receive more than 3.9 million patient visits annually. The university echoed other comments that challenged the expansion of the right conferred under HITECH to an access report from the electronic designated record set. John Stobo, senior vice president for health sciences and services at UC, said in a letter that "Covered entities should not be required to provide an access report for anything other than access that would constitute a disclosure of PHI for treatment, payment and operations. If the right to an access report is retained in the regulation then such a right should be limited to the EHR and not expanded to the much broader electronic designated record set. The expansion of the requirement to provide access logs from the electronic designated record set is a much broader requirement than is mandated under the HITECH Act, will impose a significant administrative burden on health care facilities and providers at a time when they are focused on implementation of EHRs to promote the nation's health, and provides little patient benefit."

Stobo also cited some special circumstances in recommending that employee names not be included in access reports. He noted that with UC's public mission its hospitals serve a variety of patient, including prisoners and other criminals. "With these unique patient populations in mind, the disclosure of employee names in an access report presents a significant and real employee safety concern."

The New York Department of Health made a plea to exclude computer programmers from the access rules. Jason Helgerson, the Medicaid director wrote "…the department's Medicaid data warehouse will be accessed by scores of individuals on an hourly basis as they write computer programs. All of these queries will be accessing thousands and in many cases millions of claims records. While keeping track of these inquiries can be done technologically, we question whether an access report listing the names of anyone who wrote a program that used claims data to create a report will provide any useful information."

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