Proposed HIPAA Disclosure Rule, Explained
DRS definition: According to the HIPAA Privacy Rule, a DRS is a group of records maintained by or for a CE which:
- Consists of medical records and billing records about individuals maintained by or for a CE
- Contains enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan; or
- Is used, in whole or in part, by or for the CE to make decisions about individuals
Comment period: Comments on this proposed rule must be submitted on or before August 1, 2011.
New rule a burden for providers and BAs? Yes, according to HHS itself in the proposed rule. Adam H. Greene, JD, MPH, of Davis Wright Tremaine LLP, based in Seattle, adds that healthcare providers who do not maintain comprehensive audit logs will be required to do so and the proposed rule may represent a significant burden. "For health plans, this proposed rule most likely represents an unwelcome surprise since it encompasses their systems, rather than only 'electronic health records,' " said Greene, a 12-year health law veteran and key regulator for HHS who left the government agency last month, but not before helping author this proposed rule published this week.
Is this accounting completely new? No. The HIPAA Security Rule already requires audit tracking: Rule 45 CFR 164.312, technical safeguards, requires CEs (and now BAs, per HITECH) to "implement hardware, software, and/or procedural mechanisms that record and examine activity in information systems that contain or use ePHI."
Chris Apgar, CISSP, president, Apgar & Associates, LLC, in Portland, OR, points out that 45 CFR 164.308 includes two periodic audits (user login monitoring and information systems activity review) that rely or should rely on generated audit logs. Rebecca Herold, CISSP, CIPP, CISM, CISA, FLMI, of Rebecca Herold & Associates, LLC, in Des Moines, IA, says she doubts if more than 40% of CEs and BAs combined actually have such logging in place.
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