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Sen. Rand Paul, M.D., (R-Kentucky) has introduced a new bill that attempts to have the national patient identifier provision of HIPAA permanently removed due to privacy concerns over the implementation of such a system.
Today, HIPAA is best known for its healthcare data privacy and security regulations, but the national patient identifier system was proposed in the original HIPAA legislation of 1996 as a measure to facilitate data sharing and help reduce wastage in healthcare.
The provision called for the HHS to “adopt standards providing for a standard unique health identifier for each individual, employer, health plan, and healthcare provider for use in the health care system.” However, in 1998, former Congressman Ron Paul (R-Texas), Sen. Rand Paul’s father, introduced a proposal which called for a ban on funding the development and implementation of such a system. The ban was introduced into the Congressional budget for 1999 and has been written into all Congressional budgets ever since.
This year there was hope that the ban would finally be removed following a June amendment to the House of Representative’s appropriation bill for fiscal year 2020. The amendment received strong bipartisan support and it was hoped that the Senate would follow the House’s lead and have the ban finally lifted. However, on September 18, 2019, the Senate appropriations subcommittee’s proposed budget bill for fiscal year 2020 included the same language as previous years and, as it stands, the ban looks set to remain in place for at least another year.
Sen. Rand Paul’s National Patient Identifier Repeal Act seeks to repeal the HIPAA provision, which Sen Paul believes will place the privacy of Americans at risk. He considers the provision to be dangerous, as it would allow a government-issued ID number to be linked with the private medical histories of every man, woman, and child in America.
It is for the very same reason that dozens of healthcare industry stakeholder groups want the national patient identifier introduced, as without such an identifier, it is difficult to accurately match medical records with the correct patient. Those seeking to have the ban lifted believe it will improve the accuracy of health information exchange and improve security and patient safety.
Sen. Paul disagrees, as he believes the potential privacy risks are too great. “As a physician, I know firsthand how the doctor-patient relationship relies on trust and privacy, which will be thrown into jeopardy by a national patient ID,” explained Sen. Paul. “Considering how unfortunately familiar our world has become with devastating security breaches and the dangers of the growing surveillance state, it is simply unacceptable for government to centralize some of Americans’ most personal information.”
Industry associations such as the College of Healthcare Information Management Executives (CHIME) have stepped up efforts to have the ban lifted due to the difficulties matching medical records with patients.
CHIME CEO, Russ Branzell explained that Congress has already approved a healthcare identifier for Medicare beneficiaries, but a national identifier is also required. “The patient identification conversation is one about saving lives and unlocking the potential for technology to revolutionize healthcare while cutting costs.” He has called Sen. Paul’s views on the national patient identifier “antiquated and from some bygone era.”
While many industry associations share Branzell’s view, Sen. Paul’s bill has received support from certain privacy advocacy groups, including the Citizen’s Council for Health Freedom. Advocates of the removal of the HIPAA provision believes the centralization of patient information would greatly increase the risk of security breaches and could allow hackers to steal individuals’ lifelong healthcare records and such a system would allow unprecedented tracking of Americans through their healthcare records.