Legislation Proposed to Improve the Accuracy of Patient Matching
New legislation has been introduced that seeks to establish standards and protocols to improve the matching of patients with their medical records and promote interoperability without increasing the burdens on providers and health systems.
Adding patient data to the medical records of incorrect recipients can have serious consequences and it has been a problem that has plagued the healthcare industry for years. There have been many cases where incorrect matching has resulted in denied claims, medical errors, and even patient deaths. Patients with mismatched records often have to undergo unnecessary repeated medical tests, the cost of which can be considerable. Each instance of mismatched records costs an average of $1,950 per patient inpatient stay, and more than $1,700 per emergency department visit, and 35% of all denied claims are due to inaccurate patient identification.
The HIPAA Journal was recently contacted by one patient who has been plagued by mismatching problems with her healthcare provider due to her having the same name and date of birth as another patient. The other patient’s medications have been added to her medical records, some of which she is highly allergic to. Records of COVID-19 vaccinations have been added to one record which prevents the other patient from getting the vaccine. Further, when requesting records, there have been impermissible disclosures of each patient’s records to the other patient. She lives in fear that she will be given medications that have been prescribed to her namesake and that she will die as a result of the error.
The Patient Matching and Transparency in Certified Health IT (MATCH IT) Act of 2024 was proposed by Rep. Mike Kelly (R-PA) and Rep. Bill Foster (D-IL) and calls for the establishment of a uniform definition and standards for accurate and precise patient matching, which will allow patient match rates to be tracked and for improvements in patient matching to be documented over time. Rep. Kelly explained that the cost of inaccurate patient identification for an average hospital is $2.5 million per year and the cost to the US health system is more than $6.7 billion annually.
In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was signed into law and included a requirement for the Department of Health and Human Services (HHS) to develop a national patient identifier that would ensure that patients could be accurately matched with their medical records. A national patient identifier would solve the problem of mismatching health records, but in 1999, Congress enacted a budget provision that banned the HHS from developing or promulgating a unique national patient identifier system due to privacy concerns. That ban has been renewed annually ever since.
There have been several attempts at introducing legislation to address the problem and prevent the thousands of unnecessary deaths each year that are caused by matching errors. Reps Kelly and Forster have previously introduced legislation that sought to remove the ban on the HHS funding a national patient identification system, and while the legislation was passed by the House it failed to get passed by the Senate.
With no sign of movement on a national patient identifier, the MATCH IT Act could be the answer and there is considerable excitement about the legislation. “The American Health Information Management Association (AHIMA) commends Representatives Mike Kelly and Bill Foster for prioritizing patient safety and for continuing to champion the issue of patient matching,” said AHIMA President and Board Chair, Mona Calhoun, Ph.D., MS, Med, RHIA, FAHIMA. “The MATCH IT Act would help decrease rates of misidentification, improve patient privacy and patient care through a standardization of patient information, and allow records to be matched more accurately. AHIMA looks forward to the passage of this critical legislation,”
“On behalf of our members, which include chief information officers and other digital health leaders from hospitals and healthcare providers across the globe, we appreciate the leadership of Representatives Mike Kelly and Bill Foster in introducing the MATCH IT Act,” said Cassie Ballard, Director of Congressional Affairs, CHIME. “This bill will make a meaningful impact on patient misidentification through the standardization of patient information and builds off important work by CHIME and the other organizations in the Patient ID Now coalition to improve patient matching.” What is needed is more co-sponsors and Senators to provide their support to get the legislation passed to improve patient safety.
