Confidentiality, Preventive Medicine, Medicare, Safe Harbors, Cookbook Medicine
Many health Web sites offer "health assessment" features that invite users to submit sensitive health data. While patients may assume that the information they provide is protected under federal law, this may not be the case, according to a report by the Health Privacy Project.
The protection afforded by the Health Insurance Portability and Accountability Act of 1996 applies only to entities, such as health plans and providers, that process health claims electronically in a standard format. Since manyif not, mosthealth Web sites aren't operated by "covered entities," they aren't required to comply with the law's privacy regulations. Moreover, researchers note, the law isn't clear about which activities would fall outside the scope of the regulations even at covered sites.
The Centers for Medicare & Medicaid Services (formerly HCFA) plans to establish a centralized "insurance profile" database containing comprehensive personal information on all Medicare beneficiaries and those dually eligible for Medicare and Medicaid. The new records system is intended as support for ongoing program administrationincluding Medicare claims payment, entitlement, Medicaid coverage, Medicare+Choice selection and payments, and coordination of benefits. Moreover, the program will allow viewers (federal and state agencies, CMS contractors, providers, and suppliers) to update beneficiary information.
The first stage of its multiyear implementation will focus on Medicare's managed care program.
The Agency for Healthcare Research and Quality (a division of HHS) has published a step-by-step guide to encourage primary care physicians to deliver preventive services more efficiently. Based on scientific and empirical evidence, the guide provides practical toolsincluding worksheets, health risk profiles, and preventive care flow sheetsthat can be customized for use in various clinical settings. The program provides easy-to-follow, logical steps for establishing preventive care protocols, and delivering and monitoring preventive care.
Copies of "A Step-by-Step Guide to Delivering Clinical Preventive Services: A Systems Approach" are available from the AHRQ Publications Clearinghouse (800-358-9295) or you can view the guide online at www.ahrq.gov/ppip/manual/manual.htm .
Three leading healthcare organizations plan to develop a set of evidence-based measures to improve the quality and consistency of pain management. The two-year project, sponsored by the American Medical Association, Joint Commission on Accreditation of Healthcare Organizations, and National Committee for Quality Assurance, will focus on patients suffering from arthritis, back pain, and cancer.
The groups have been working together on the development of performance measurements since 1998 and, early last year, unveiled a new approach to measuring performance in the delivery of care to diabetes patients.
The inspector general of HHS, Janet Rehnquist, is seeking proposals and recommendations for the development of new safe harbor provisionsor modifications of existing onesunder the anti-kickback statute. The IG describes safe harbors as "relatively innocuous commercial arrangements" that aren't intended to induce referrals or business reimbursable by Medicare and Medicaid.
For comments to be considered, they must be received by 5 pm on Feb. 19. If possible, include a detailed justification or empirical data supporting any suggestion for a safe harbor. Mail your comments to: Office of Inspector General, Department of Health and Human Services, Attention: OIG61N, Room 5246, Cohen Building, 330 Independence Avenue SW, Washington, DC 20201.
Joan Rose. Practice Beat.