The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced the first enforcement action and settlement in its Right of Access Initiative. This program aims to “vigorously enforce” the rights of patients to receive copies of their medical records promptly and without being overcharged.
Since 2014, an HHS rule also has required clinical laboratories to provide results directly to patients who request them within 30 days of a request. Before the 2014 rule, CLIA regulations that did not specifically provide for sharing results with patients meant that laboratories in many states only would send results to the ordering clinicians. HHS’ 2014 final rule made changes to both CLIA and the Health Insurance Portability and Accountability Act (HIPAA) that had exempted labs from the requirement to share records.
In the recent OCR settlement, Bayfront Health St. Petersburg paid an $85,000 fine and adopted a corrective action plan to settle a potential violation of the right of access provision of the HIPAA rules. According to OCR, the health system failed to provide a mother timely access to prenatal records for her child.
OCR began investigating based on a complaint from the mother. It took the hospital 9 months to provide the requested records, according to the settlement.
“Providing patients with their health information not only lowers costs and leads to better health outcomes, it’s the law,” said OCR Director Roger Severino. “We aim to hold the healthcare industry accountable for ignoring peoples’ rights to access their medical records and those of their kids.”
Medicare Notches Savings as Costs Surge for Private Health Plans
With several leading candidates for the Democratic Party’s nomination for president supporting a “Medicare for All” plan to tackle the growing burden of healthcare costs, the Centers for Medicare and Medicaid Services (CMS) administrator Seema Verma is defending the administration’s empha-sis on competition and a move away from central planning after recent news of Medicare program cost savings.
In a speech to members of the American Hospital Association, Verma cited her agency’s success in driving down Medicare Advantage premiums—which are expected to decline 14% in 2020—as proof that her focus on deregulation and increasing the transparency around price and quality is working.
“Over several decades, government has concocted a complex system of rules—a time-sucking mo-rass that has contributed to obscene administrative costs and stifled innovation and competition,” Verma said. “One of the hallmarks of bureaucracy is a regulatory hodgepodge, requiring armies of expensive experts to untangle. Central planning can never match the free market’s efficiency, so bu-reaucrats continuously tinker, trying to attain regulatory perfection. It never works.”
Verma also outlined the programs that CMS will tackle next in its deregulation push. These include a continued drive to publish more hospital pricing information, revamping the hospital comparison tool that tracks quality ratings, and updating Medicare’s information technology platform that allows beneficiaries to electronically receive, store, and share healthcare information.
Meanwhile, a report from the Kaiser Family Foundation (KFF) found that annual family premiums for employer-sponsored health insurance rose 5% to average $20,576 in 2019. During this time wages rose 3.4% and inflation grew at 2%. The report found that workers contribute $6,015 on aver-age toward the cost of family coverage, with employers paying the remainder. This marks a 54% in-crease for family premiums since 2009.
“The single biggest issue in healthcare for most Americans is that their health costs are growing much faster than their wages are,” KFF President and CEO Drew Altman said in a statement about the report’s findings. “Costs are prohibitive when workers making $25,000 a year have to shell out $7,000 a year just for their share of family premiums.”
The KFF report also found growing deductibles for insurance that mean greater out-of-pocket spending for patients. Now 82% of workers have a deductible in their health plan—up from 63% a decade ago. More than a quarter, including 45% of those at small employers with fewer than 200 employees, are now in plans with a deductible of at least $2,000. That is almost four times the share who faced a high deductible in 2009.