HHS/OCR Looking for input on Accounting of Disclosures

Fantastic news, someone in the government wanting to get information BEFORE they make rules. The Federal Register text is only 2 pages, so go and read it. This is not only great news but the information the are looking for is reasonable and will be useful to them.

HHS Releases Request for Information for Accounting of Disclosures Rulemaking

May 3, 2010

The U.S. Department of Health and Human Services Office for Civil Rights (OCR) published a request for information today seeking comments to better inform upcoming rulemaking that will expand an individual's right to receive an accounting of disclosures under the HIPAA Privacy Rule.  Currently, the HIPAA Privacy Rule provides an individual with the right to receive a listing – known as an accounting of disclosures – that provides information about when a HIPAA covered entity discloses the individual's information to others.  The current HIPAA Privacy Rule does not require a covered entity to list disclosures to carry out treatment, payment, and health care operations.

The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009, provides that an individual has a right to receive information about disclosures made through a covered entity's electronic health record for purposes of carrying out treatment, payment, and health care operations.  The HITECH Act requires the Secretary to balance the interests of individuals in learning about these disclosures with the administrative burden on HIPAA covered entities to track the disclosures.

This request for information seeks comments so that OCR can learn more about the interests of individuals and the burden on covered entities with respect to accounting for disclosures for purposes of treatment, payment, and health care operations.  The request for information will be followed by a proposed rule, providing further opportunity for comment.  The request for information is available at: http://edocket.access.gpo.gov/2010/pdf/2010-10054.pdf

The best part of this is found on page 2 . Here are just the first 5... there are far more... Really, go read the text.  The unfortunate part at this point is that the comments received will be made public, and thus no vendor or provider is actually going to put the truth into comments. 

II. Questions
1. What are the benefits to the individual of an accounting of disclosures, particularly of disclosures made for treatment, payment, and health care operations purposes?
2. Are individuals aware of their current right to receive an accounting of disclosures? On what do you base this assessment?
3. If you are a covered entity, how do you make clear to individuals their right to receive an accounting of disclosures? How many requests for an accounting have you received from individuals?
4. For individuals that have received an accounting of disclosures, did the accounting provide the individual with the information he or she was seeking? Are you aware of how individuals use this information once obtained?
5. With respect to treatment, payment, and health care operations disclosures, 45 CFR 170.210(e) currently provides the standard that an electronic health record system record the date, time, patient identification, user identification, and a description of the disclosure. In response to its interim final rule, the Office of the National Coordinator for Health Information Technology received comments on this standard and the corresponding certification criterion suggesting that the standard also include to whom a disclosure was made (i.e., recipient) and the reason or purpose for the disclosure. Should an accounting for treatment, payment, and health care operations disclosures include these or other elements and, if so, why? How important is it to individuals to know the specific purpose of a disclosure— i.e., would it be sufficient to describe the purpose generally (e.g., for ‘‘for treatment,’’ ‘‘for payment,’’ or ‘‘for health care operations purposes’’), or is more detail necessary for the accounting to be of value? To what extent are individuals familiar with the different activities that may constitute ‘‘health care operations?’’ On what do you base this assessment? 
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