‘Accounting of disclosures’ rule too burdensome

By Molly Merrill
04:19 PM

The Medical Group Management Association (MGMA) called on the Department of Health and Human Services in July to withdraw its proposed HIPAA “accounting of disclosures” rule, due to the burden it would put on practices to provide such a report – and the possibility that it might deter them from implementing new technology.

The accounting of disclosures regulation was mandated as part of the Health Information Technology and Clinical Health Act of 2009 (HITECH). If enacted as proposed, the rule would require medical practices that maintain electronic patient information to have the capability to produce a detailed report of every instance a patient’s information was accessed by any staff member for any reason, including submitting claims for payment.

The final omnibus HIPAA rule is expected to come out this month, but the Office of Civil Rights did not anticipate that the proposed rule for the accounting of disclosures from electronic records would be released at the same time, although Sue McAndrew, deputy director for health information privacy at OCR, told Government Health IT that the timing would be close.

MGMA requested that HHS engage with medical groups and other stakeholders to develop a consensus-driven solution before moving forward with the regulation.

MGMA conducted a Legislative and Executive Advocacy Response Network (LEARN) study to gauge the impact of this proposed rule on physician group practices. The study received one of the largest responses in LEARN history, with more than 1,400 participants.

The vast majority of survey participants condemned the rule as burdensome and unnecessary. More than 90 percent said it would be “very” or “extremely” burdensome to produce a report upon a patient’s request that would meet the strict government requirements. When asked how many patient requests for disclosure reports they had received in the past 12 months, 65.1 percent responded “0 or 1 per [full-time-equivalent] physician.”

“Considering how infrequently physician practices receive these requests from patients, the proposed rule fails to meet the statutory requirement to balance the needs of patients with the burden on providers,” said William F. Jessee, MD, president and CEO of MGMA. “These reports, which would be required to show all electronic access to a patient’s health information for up to three years, could be hundreds or even thousands of pages long, making them extremely challenging for physician practices to produce and of little practical value to the patient receiving them.”

“We will continue to engage HHS in a constructive dialogue to achieve workable, effective implementation of this proposal to meet the needs of both patients and their physicians, “Jessee said. “Our concern is that if this proposal moves forward, the report requirement could have the unintended consequence of discouraging physician practices from investing in new technology and undermine efforts to enhance patient care and improve efficiency through EHRs.”