Source: DHHS

What is this about?

This edition of Connections provides an advanced copy of the proposed changes to the current rules implementing the privacy and confidentiality provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to be introduced in early 2021.  The document is called “Proposed Modifications to the HIPAA Privacy Rule to Support, and Remove Barriers to, Coordinated Care and Individual Engagement.” HIPAA privacy rules apply to all employers that provide medically-oriented wellness programs to their employees and family members. The detailed rationale for the changes follow the draft “notice of proposed rule-making” section in the downloadable document found below.

The specific proposed changes that are relevant to employer wellness programming include:

• Strengthens the patient’s rights to access their own medical information.
• Shortens to no more than 15 days the permitted response time of covered entities to patient requests.
• Reduces the identity verification requirements for requests.
• Provides for the patient to establish sharing protocols among various covered entities.
• Requiring covered entities to respond to patient requests made through other providers.
• Amending and limiting the charges associated with patient requests for their medical information.
• Clarifying and expanding the permitted sharing procedures for care coordination and case management purposes.
• Clarifying and expanding the range of abilities of covered entities to share Protected Health Information (PHI) with social services agencies, community-based organizations, home and community-based service (HCBS) providers, and other similar third parties.
• Providing for a “good faith” override of regulatory limitations on a case-by-case basis.
• Authorizing disclosure of PHI to “avoid a health or safety threat.”

Why is this important?

This document is important because it describes the areas and situations where HIPAA privacy regulations are being relaxed to expedite coordinated care and improved care management. These changes make it easier for care coordination to take place and for improvements in continuity of care to take place between covered entities. This is particularly relevant in issues that deal with COVID-19 infection and provider care management.

What can you do with this document?

• First, download and skim the main section to get a sense of the scope and purpose of proposed changes.
• Next, identify how and when this information should be presented to senior managers.
• Next, discuss the resulting final rules with your wellness vendors to aid in their program integration efforts.
• Next, determine how this information should be provided to employees and their family members.
• Then, using this information revise Frequently Asked Questions (FAQs) content to reflect the relaxed requirements.
• Then, revisit this information periodically to make sure there are no major impediments to care coordination.

In summary, this proposed set of rules will relax many of the HIPAA requirements and will likely be published in a few months and then will be in effect shortly afterward.  These changes should improve the quality and continuity of care employees and their family members receive and improve employee satisfaction with wellness programming.

(Everyone can now download this document)

Click here to download this document

If you have any problem downloading the document go to our website and submit a comment.

I hope this tool helps you reach your wellness programming goals!  Drop me a note and let me know if you found it to be helpful.