So, I got this announcement today:
http://i-newswire.com/pr51753.html
And while reading it, these items caught my eye:
New rules governing how you dispose of patient records.
What happens when there's not enough money to pay for record storage?
Step-by-step procedures for legally disposing patient records while meeting
all HIPAA confidentiality rules
Recognized costs of closing a healthcare business - what you can expect the
courts to approve and disapprove
Important new role of the Healthcare Ombudsman - qualifications, duties and
powers of this new patient advocate
How to meet your new duties to relocate or transfer patients
In light of the fact that the discussions are related to records, albeit
healthcare and more specifically patient records, and with all of the
discussions recently about the DHHS pushing for national EHR/EMR I found
this pretty interesting.
The teleconference is supposedly dealing with "Healthcare Bankruptcy
Reforms", but overall it's dealing with the BAPCPA of 2005 and specifically
what the implications are to healthcare practices and professionals related
to records. Text of the BAPCPA can be found here:
http://thomas.loc.gov/cgi-bin/query/F?c109:6:./temp/~c109i6w7Ps:e520484
And the text/sections addressing healthcare are in Title XI, beginning with
Section 1101. 1101(b) clearly defines what "patient records" are, and that
seems consistent to what I've become familiar with the definition being.
However, Section 1102, Section 351 is where I start having problems with
this new Act. Here's where the problems start for me:
"....If a health care business commences a case under chapter 7, 9, or 11,
and the trustee does not have a sufficient amount of funds to pay for the
storage of patient records in the manner required under applicable Federal
or State law, the following requirements shall apply...."
The problem is when it states that if there's not enough money, they don't
have to do what is required by applicable Federal or State law!! So, all
you need to do is declare bankruptcy and you're no longer subject to either
HIPAA or any privacy laws of the various States any more???
But it gets worse... this section goes on to talk about the notification
process [Section 351(1)(a)(b)(2)], blah, blah, blah and then it says that
after all of that is over, the bankrupt agency can apply to turn over the
records to a Federal agency...Oh..okay, so they're protected,
right? WRONG... if the Agency decides they don't want them, then the records
get destroyed [Section 351(3)(1)(a)(b)] !
And while Section 1105 provides a provision for the transfer of the patients
to another healthcare business, it doesn't speak at all of the obligation
for transfer of the records. And no, it shouldn't be assumed that this
would be included, because if the records are stored with a commercial
service provider and the storage costs haven't been paid, they won't provide
access to them to a new healthcare provider... AND if the process to
transfer the patients isn't completed until after the specified
notifications period is over, the records will have been destroyed.
Now keep in mind, most of this is discussing transfer of physical records
(paper-based information, films, etc.) but the Act does speak about
electronic medical information as well [351(3)(1)(b)]. But with all of the
pressure to go to "national electronic patient records", what happens to
records in the servers and/or on computers of the bankrupt practice that
were sold as assets in the bankruptcy process? Or worse yet, those being
stored by 3rd parties whose contracts for maintenance of the data went
unpaid?
I'd REALLY be interested in hearing from those of you who work with medical
records, or have been involved with a medical practice that went bankrupt,
or that might be thinking:
"Hmmmm.... what if these were MY records, or the records of an aging parent
or a dependent of mine?"
Larry
--
Larry Medina
Danville, CA
RIM Professional since 1972
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