Bill That Changes HIPAA Passes House'21st Century Cures' Measure Advances
The U.S. House of Representatives on July 10 passed a bill aimed at accelerating the advancement of medical innovation that contains a controversial provision calling for significant changes to the HIPAA Privacy Rule.
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The House approved the 21st Century Cures bill by a vote of 344 to 77. Among the 309-page bill's many provisions is a proposal that the Secretary of Health and Human Services "revise or clarify" the HIPAA Privacy Rule's provisions on the use and disclosure of protected health information for research purposes.
Under HIPAA, PHI is allowed to be used or disclosed by a covered entity for healthcare treatment, payment and operations without authorization by the patient. If the proposed legislation is eventually signed into law, patient authorization would not be required for PHI use or disclosure for research purposes if only covered entities or business associates, as defined under HIPAA, are involved in exchanging and using the data.
That provision - as well as many others in the bill - aim to help fuel more speedy research and development of promising medical treatments and devices.
"The act says ... if you're sharing [patient PHI] with a covered entity [or a BA], you don't necessarily need the individual's consent prior to sharing - and that's something our members have been receptive too," notes Leslie Krigstein, interim vice president of public policy at the College of Healthcare Information Management Executives, an organization that represents 1,600 CIOs and CISOs.
"The complexity of consent has been a barrier [to health information sharing] ... and the language [contained in the bill] will hopefully move the conversation forward," she says.
Some privacy advocates, however, have opposed the bill's HIPAA-altering provision.
Allowing the use of PHI by researchers without individuals' consent or knowledge only makes the privacy and security of that data less certain, says Deborah Peel, M.D., founder of Patient Privacy Rights, an advocacy group,.
"Researchers and all those that take our data magnify the risks of data breach, data theft, data sale and harms," she says. "Researchers are simply more weak links in the U.S. healthcare system which already has 100s of millions of weak links."
If the legislation is signed into law in its current form, healthcare entities and business associates would need to change their policies related to how they handle PHI.
"If the bill is enacted, it will not place additional responsibilities on covered entities and business associates. Rather, it will provide them with greater flexibility to use and disclose protected health information for research," says privacy attorney Adam Greene, partner at law firm Davis Wright Tremaine. "Covered entities and business associates who seek to take advantage of these changes would need to revise their policies and procedures accordingly." For instance, some covered entities also may need to revise their notices of privacy practices if their notices get into great detail on research, Greene notes.
In addition to the privacy provisions, the bill also calls for penalizing vendors of electronic health records and other health IT systems that fail to meet standards for interoperable and secure information exchange.The bill calls for HHS to develop methods to measure whether EHRs and other health information technology are interoperable, and authorizes HHS to penalize EHR vendors with decertification of their products if their software fails to meet interoperability requirements.
In addition, the bill also contains provisions for "patient empowerment," allowing individuals to have the right to "the entirety" of their health information, including data contained in an EHR, whether structured and unstructured. An example of unstructured data might include physician notes, for instance, although that is not specifically named in the legislation.
"Healthcare providers should not have the ability to deny a patient's request for access to the entirety of such health information," the bill says.
A House source tells Information Security Media Group that the Senate has been working on an "Innovation Agenda" for the past few months calling for policies similar to those contained in the 21st Century Cures bill. House leaders say it's their goal to have a bill sent to the president's desk by the end of the year, the source says.