PRIVACY AND SECURITY
Breach notification, noncovered entities
Breach notification covered entities
HIPAA privacy modifications
Accounting of disclosure
EHR INCENTIVE PROGRAM
Certification program, temporary
Certification program, permanent
EHR Standards, certification criteria
Meaningful use, stage 1
Meaningful Use, stage 2
Accounting of Disclosures
OCR chose to manage the modifications to the HIPAA accounting of disclosure provisions in a separate rule. In May 2010 OCR
published a request for information on accounting of disclosures. A silence of a year ensued, and then in May 2011 OCR
published a proposed rule.
OCR proposed a new “access report” that it expected would be
easier for covered entities to maintain and more likely to provide
individuals with the information they want. The report would
not distinguish between use and disclosure; instead it would
identify anyone inside or outside the facility who accessed an
The report would be restricted to protected health information contained within the individual’s designated record set and
existing in electronic format.
The access report received mixed reviews. While many industry groups in principle supported the spirit of the report, some
also judged it too burdensome, and others felt it required considerable refinement.
Again, OCR can proceed to an interim final rule that would
take effect but be subject to modification, or it could issue a final
rule. Presumably it will consider revisions to the proposed access report in light of the many comments it received.
Much of the meaningful use regulations appeared in a rush last
summer: final rules on stage 1 of the program, EHR standards
and certification criteria, and a certification program.
Rulemaking on the certification program is complete, with the
Interim final rule
Interim final or final rule
Interim final or final rule
Sunsets with effective date of
Scheduled to begin January 1, 2012
permanent program scheduled to be January 1, 2012.
By far the most widely awaited rule this fall is a proposed rule
on stage 2 of the incentive program. The policy advisory committee to the Office of the National Coordinator released a
glimpse of its work in January 2011, and that preview and the
committee’s subsequent discussions have set the industry’s expectations of what may be coming.
It is expected that all objectives in stage 1 will become mandatory under stage 2, and a limited number of new objectives will
be added. Many of the measures in the committee’s early draft
increased, but not all.
The stage 2 start date is a closely watched item. By the time
the committee submitted its final recommendations, it seemed
likely that stage 2 would be delayed in some manner. There was
prevailing concern that vendor and providers would not have
time to implement the final requirements before the reporting
period began in 2013.
Another item on the watch list is the quality measures to be
reported under stage 2. The committee did not offer a preview
of its recommendations, but it is expected that the number and
the scope will increase.
Once the requirements become final, revised standards and
certification criteria must be published.
The Centers for Medicare and Medicaid Services has indicated
it will release a proposed rule by end of the year, with a final rule
targeted for summer 2012. ¢
Kevin Heubusch ( firstname.lastname@example.org) is editor-in-chief at the
Journal of AHIMA.