Pharmacy groups appeal to Senate: Apply patient privacy rules with care

ALEXANDRIA, Va. With increasing urgency in the midst of a snowballing movement in Congress to bolster patient-privacy provisions as part of the economic recovery bill, a coalition of pharmacy and retail groups on Wednesday appealed directly to Senate leaders to proceed with caution on the new rules.

The new appeal came even as the Institute of Medicine issued a new report Wednesday calling for tougher privacy standards for health research activities, and asserting that the confidentiality rules established by the Health Insurance Portability & Accoutability Act don’t go far enough to assure patients’ rights to privacy within research projects. That report, sponsored in part by the U.S. Department of Health & Human Services, could bolster efforts by some lawmakers to add new privacy protections in health treatment and prevention – standards that pharmacy and healthcare advocates say will compromise their patient-care efforts and slow the progress of health information technology.

The massive economic stimulus plan passed the House without Republican support, and an even larger version of the bill now is under consideration in the Senate. The bill includes a multibillion-dollar outlay to encourage the rapid adoption of health IT by pharmacists, physicians, insurers, health plans and other healthcare stakeholders, but calls for new, beefed-up privacy standards to accompany the adoption of electronic recordkeeping and other elements of a more automated, data-driven healthcare system.

Some of those new privacy protections are unneeded and actually harmful, pharmacy groups argue. To drive home their point, the National Association of Chain Drug Stores, National Community Pharmacists Association and Food Marketing Institute sent a letter dated Feb. 4 to Senate Majority Leader Harry Reid, D-Nev., and Minority Leader Mitch McConnell, R-Ky., expressing support for important health-related provisions in the “American Recovery and Reinvestment Act of 2009,” but urging the leaders to reconsider so-called “privacy” health IT provisions. Those provisions would inhibit pharmacies from providing patient care, asserted the leaders of the three groups.

“We appreciate that you have included provisions for HIT funding for healthcare providers, including pharmacies and pharmacists,” noted NACDS, NCPA and FMI in the jointly authored letter. “We are concerned, however, that some of the privacy-related provisions in the bill will require pharmacies to devote extensive time and resources toward compliance. With this in mind, we ask you to clarify that the HIT funding for healthcare providers is available to pharmacies for adopting and upgrading HIT systems to ensure their compliance with the privacy-related provisions, particularly the requirement to provide individuals with an accounting of all disclosures of protected health information.”

The pharmacy groups did endorse some elements of the new, stepped-up privacy protections, including an amendment from Iowa Democratic Sen. Tom Harkin that allows such health providers as pharmacies to communicate with their patients about important healthcare items and services. “These communications save money and lives by urging patients to follow their doctors’ prescriptions, such as prescription refill reminders,” noted the authors.

“We believe it is critical to foster HIT adoption without attaching privacy mandates that would actually frustrate the goals of HIT adoption,” added NACDS, NCPA and FMI. “We believe the legislation on the floor this week achieves this goal, and we ask that you pass these privacy provisions without further amendment.”

Also voicing concern over tougher privacy standards was the Washington-based group that lobbies on behalf of insurers, America's Health Insurance Plans. In a conference call with reporters today, AHIP president and CEO Karen Ignagni asserted that proposals within the economic stimulus bill to expand HIPAA privacy rule provisions “would have unintended consequences that could impede progress in using health information technology.”

AHIP supports the overall move to adopt health IT, calling it “a critical down payment on increased quality, transparency and cost efficiencies across the nation.” However, Ignagni noted, “Progress already made to wire up health care would be imperiled if the proposed privacy provisions in the stimulus bill were enacted. This progress has occurred with the current protections outlined under the HIPAA guidelines.”

AHIP's concerns rest with provisions that would further restrict use of patient data for payment, treatment and operational functions. Marketing restrictions that go beyond those already in HIPAA would prevent providers and payers from sending consumers prescription refill reminders and preventive care notices, Ignagni said. The potential in the bill to require patient consent before use of any information would adversely affect disease management programs, result in incomplete medical records and impede emergency care, she added.

NCPA’s newly elected SVP of government affairs, John Coster, agreed with AHIP’s position. “Pharmacies go to great lengths to protect the privacy of patients’ prescription information,” Coster stated Wednesday in response to a query from Drug Store News. “Pharmacists use this information to provide various patient care services that help improve the quality of care and reduce costs. These services include refill reminders, generic substitution notices and medication therapy management services.

“We believe that the current HIPAA regulations strike the right balance in protecting patients’ information, while giving providers the information they need to provide care. However, we recognize policy makers’ concerns that new and innovative medical records technologies are also subject to HIPAA, so we look forward to working with policymakers to assure that any new protections also strike the right balance between patients’ rights and healthcare providers’ responsibilities to their patients,” Coster added.

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