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The Department of Health and Human Services (HHS) is prohibited from using any of its budget to fund the development and implementation of a national patient identifier, but there was hope that the ban would finally be lifted this year.
The House of Representatives added an amendment to its Departments of Labor, Health, and Human Services, and Education, and Related Agencies Act of 2020 which removed the ban, which would allow the HHS to follow through on this requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
It now looks likely that the ban will remain in place for at least another year as the Senate Appropriations Subcommittee’s draft 2020 fiscal budget bill, released last Wednesday, has retained the text banning the HHS from acting on this HIPAA requirement.
The ban has been in place since 1999 and was introduced because of concerns over patient privacy. The ban has been written into the Congressional budget every year since and the proposed 2020 fiscal budget bill is no different.
The proposed fiscal budget bill includes the text, “None of the funds made available in this act may be used to promulgate or adopt any final standard under section 1173(b) of the Social Security Act providing for, or providing for the assignment of, a unique health identifier for an individual (except in an individual’s capacity as an employer or a health care provider), until legislation is enacted specifically approving the 13 standard.”
The purpose of the national patient identifier is to make it easier for patients to be efficiently matched with their health records. Regardless of where a patient receives treatment, their health data will be tied to them through their unique national patient identifier code. The new identifier would help to ensure that patient information could flow freely between different healthcare organizations and it is seen by many healthcare industry stakeholders to be essential for full interoperability. A national patient identifier could help to improve patient privacy, patient safety, and eliminate considerable waste and misspending in healthcare.
For several years, industry associations such as the College of Healthcare Information Management Executives (CHIME), the American Health Information Management Association (AHMIA), and the Health Innovation Alliance (HIA) have been calling for the ban to be lifted.
HIA Executive Director Joel White has called the ban ‘antiquated’ and said studies have suggested that patients are matched with their records as little as 50% of the time. A national patient identifier would instantly solve that problem.
Efforts to have the ban removed have stepped up in recent years, and this year 56 healthcare stakeholder groups urged the Senate to remove the ban. Significant progress was made this year when the amendment receives strong bipartisan support in the House of Representatives.
Convincing the Senate to lift the ban is proving more difficult. As long as privacy concerns remain, the ban is unlikely to be lifted. One of the main issues is a single identifier would be used to tie medical records to an individual from birth until death, and that could allow unprecedented tracking of Americans through their health records. It could also potentially facilitate the sharing, use, and analysis of patient data without patient consent.
While the draft fiscal budget bill has not had the ban removed, it is possible that an amendment could be made at a later date. AHMIA and CHIME leaders remain hopeful that the Senate will follow the House’s lead and have the ban lifted this year.