Health care is changing, but is it for the better?

HIPPA - The Health Insurance Portability and Accountability Act was passed by Congress in 1996. The law was designed to make health insurance portable for employees, to improve health process accountability by eliminating fraud and abuse, and provide some administrative simplification for providers and payers.

The privacy standard was implemented in 2003, seven years later and covers oral individually identifiable healthcare information (IIHI), as well as both the written and electronic form. This standard continues to be the most challenging for doctors and hospitals to follow.

The security standard was implemented in 2005. It requires doctors and hospitals to guarantee that all electronic transfer of IIHI is secure. The basic premise of HIPAA is computers are good and paper is bad in providing quality healthcare. Computers create efficiency, decrease cost, and improve patient safety. Paper is wasteful, increases medical errors, and encourages fraud and abuse.

However, HIPAA has been weakly enforced because of its funding and the need for a cumbersome complaint requiring enforcement structure. But, 2009 brought a dramatic change. Congress passed the infamous American Recovery and Reinvestment Act.

Physicians are closely watching the $19.2 billion provided for the Health Information Technology Economic Health Act (HITECH) subsection of the stimulus plan. HITECH establishes the electronic medical record as the gold standard for quality healthcare but also significantly increases enforcement of HIPAA and as a result the act markedly enlarges the investigative and regulatory areas of the Office of Civil Rights (OCR) which is responsible for assuring HIPAA compliance.

As an example, CVS, the nation’s largest pharmacy chain, has been ordered to pay 2.5M for violating HIPAA policy. Of interest all monies collected for noncompliance will substantially be returned to the Office of Civil Rights causing an “exponential effect” on enforcement of doctors and hospitals.

One might say that HIPAA enforcement is now on legally prescribed steroids and is quickly becoming the incredible Hulk in size and strength. Indeed, change has come but is it for the better?

William T. Choctaw MD JD is a healthcare leadership expert, He lectures nationally on many medical legal issues for hospital medical staffs, hospital executives, and managers. He recently authored the book, “Avoiding Medical Malpractice: A Physician’s Guide to the Law.” Dr. Choctaw continues to practice general surgery in Southern California.

 

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