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hhs announces Proposed
changes to hiPaa Privacy rule
under a rule proposed by the U.S. Department
of Health and Human Services
Office for Civil Rights, individuals
would be given the right to get a report on
who has electronically accessed their protected
health information. The proposed
rule is a change to the Privacy Rule under
the Health Insurance Portability and Accountability
Act (HIPAA).
With this change, people could obtain
this information by requesting an electronic
access report that would document
the particular persons who electronically
accessed and viewed their protected health
information. Although covered entities, including
physicians, hospitals, labs, health
plans, and other healthcare organizations,
are currently required by the HIPAA Security
Rule to track access to electronic
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44 CliniCal laboratory news July 2011
p r o f i L e s
p r o f i L e s
protected health information, they are not
required to share this information. The
proposed rule also requires an accounting
of more detailed information for certain
disclosures that are most likely to affect a
person’s rights or interests.
To effect the change, all healthcare organizations
will be required to update their
privacy notices under HIPAA to educate
patients about requesting access reports.
The new rule will take effect January 1,
2013, if adopted.
Comments on the proposed rule will be
accepted through August 1, 2011. To read
the proposed rule or submit a comment, go
to www.regulations.gov.
reform to net $120 billion
in savings for medicare
an analysis issued by the Centers for
Medicare and Medicaid Services (CMS)
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Meet us at AACC, Atlanta, July 26–28, 2011
booth no. 1953
outlines $120 billion in 5-year projected
savings resulting from improvements to the
Medicare program, including implementation
of many provisions in the Affordable
Care Act. The report summed up projected
savings from several sources, including new
tools to combat fraud, waste, and abuse
in the Medicare system, as well as delivery
system reforms, such as those that deter
hospital readmissions.
The report looked at five general areas
of projected savings: reforming provider
payments to reward quality of care, $55
billion; lowering hospital readmission and
hospital-acquired infections, $10 billion;
fraud and abuse prevention, $1.8 billion;
improvements in durable medical equipment
purchasing, $2.9 billion; reducing
payments to insurance companies, $50 billion.
The full report is available from the
CMS website, www.cms.gov/apps/files/
medicare-savings-report.pdf.
sured. Most uninsured people have virtually
no savings, and the median per-family
financial assets for uninsured families are
just $20. Even among higher-income families,
assets are low: half of families with income
at 400% of the Federal Poverty Level,
or $89,400 a year for a family of four in
2011, have financial assets below $4,100.
The report is available from the HHS
website, https://aspe.hhs.gov/health/reports
/2011/ValueofInsurance/rb.shtml.
hhs begins broad
battle over Payment
advisory board continues
The Affordable Care Act established a
15-member Independent Payment Advisory
Board (IPAB) charged with making
cuts to Medicare in years that spending exceeds
a target growth rate. Under the Act,
IPAB recommendations will automatically
become law unless blocked by both Congress
and the President. The Congressional
Budget Office (CBO) recently estimated
that repealing IPAB would inevitably mean
stronger spending growth, adding up to
regulatory review
$2.4 billion between 2018 and 2021.
The U.S. Department of Health and Hu- The CBO report is bad news for House
man Services (HHS) released its pre- Republicans who have targeted IPAB in
liminary plan for retrospective review of their effort to defund or repeal healthcare
existing rules based on a comprehensive reform provisions. This year Representative
inventory of each of its agencies’ existing Phil Roe (R-Tenn.) introduced legislation,
regulations. The plan highlights regulations H.R.452, the “Medicare Decisions Account-
already being modified or streamlined and ability Act,” to abolish IPAB. The projected
identifies additional candidates for further costs of doing away with IPAB means that
review.
the bill would also need to offset these costs
Earlier this year, President Obama out- somewhere else in the budget.
lined his plan for ongoing review of regula- Beginning April 2013, the Affordable
tions in the federal government with the in- Care Act requires the chief actuary of the
tention of culling rules that are out-of-date, Centers for Medicare and Medicaid Servic-
unnecessary, excessively burdensome, or in es to project whether Medicare per capita
conflict with other rules.
spending exceeds the average Consumer
The HHS plan outlined several areas Price Index, based on a 5-year period. If
for improvement, including conflicting so, beginning January 15, 2014, IPAB must
requirements between Medicaid and Medi- submit recommendations to cut Medicare
care; reviewing the criteria used to define spending. The board must also submit rec-
health professional shortages and mediommendations every other year to slow the
cally underserved areas; and using more growth in national private health expendi-
cost-effective technologies like electronic tures while preserving quality of care. The
signatures and document storage.
threshold target will then change begin-
The full regulatory review plan for the ning in 2018, when it becomes Medicare
agency is available on www.whitehouse. per capita spending that exceeds gross do-
gov.
mestic product per capita plus 1%. The law
specifically prohibits IPAB from submitting
proposals that would ration care, increase
report: most uninsured
revenues, or change benefits, eligibility, or
can’t Pay bills
Medicare beneficiary cost sharing.
new report released by the U.S. De- More information is available from the
a partment of Health and Human Ser- CBO website, www.cbo.gov.
vices (HHS) shows that few families without
health insurance have the financial
assets to pay potential hospital bills. On
average, uninsured families can only afford
to pay in full for approximately 12% next in CLN
of hospital stays they may experience, and
even higher-income uninsured families are
unable to pay for most potential hospitalizations,
the report found.
Hospital stays for which the uninsured
cannot pay in full account for 95% of the
total amount hospitals bill the uninsured.
Platelet
function
Testing
The idea that people without heath insurance
can get care with little or no problem
is an enduring myth, said HHS Secretary
Kathleen Sebelius.
According to the new report, approximately
50 million Americans are unin-
30 years of
hiv Testing