Secretary Sebelius spotlights new efforts to empower patients
to increase secure access to their health information
New Office of Civil Rights Director joins HHS from Department of Justice

On September 12, 2011,  HHS Secretary Kathleen Sebelius proposed new rules that 
would expand the rights of patients to access their health information through 
the use of health information technology (IT). Specifically, the new rules 
would empower patients and allow them to gain access to test results reports 
directly from labs. They would ensure that labs covered by the Health Insurance 
Portability and Accountability Act of 1996 (HIPAA) provide such information, 
upon request, directly to patients or their personal representatives.  The 
announcement came at the kick-off of the first-ever HHS Consumer Health IT 
Summit, which brought consumers, providers, and the public and private sectors 
together to discuss how best to empower consumers to be partners in their 
health and care through health IT.

“When it comes to health care, information is power.  When patients have their 
lab results, they are more likely to ask the right questions, make better 
decisions and receive better care,” said Secretary Sebelius. “This Summit 
offers a unique opportunity for the public and private sectors alike to share 
strategies to improve consumer access to their health information, while 
safeguarding the privacy and security of their data.”

The Notice of Proposed Rulemaking (NPRM), jointly drafted by the Centers for 
Medicare & Medicaid Services, the HHS Office for Civil Rights (OCR), and the 
Centers for Disease Control and Prevention, proposes to amends the Clinical 
Laboratory Improvement Amendments of 1988 (CLIA) regulations and HIPAA privacy 
regulations to strengthen patients’ rights to access their own laboratory test 
result reports.

Secretary Sebelius also announced the appointment of Leon Rodriguez as the new 
Director of the Office for Civil Rights. Rodriguez brings his Department of 
Justice experience to HHS and will be dedicated to ensuring consumers’ health 
information is kept private and secure.

“Consumers need to know that private and secure access to their health 
information is a given,” stated OCR Director Rodriguez. “The privacy and 
security of health data will be a top priority for OCR during my tenure.”

Secretary Sebelius also unveiled today an innovative voluntary Personal Health 
Record (PHR) Model Privacy Notice<http://healthit.hhs.gov/phr_privacy>, which 
creates an easy-to-read, standardized template allowing consumers to compare 
and make informed decisions based on their privacy and security policies and 
data practices about  PHR products. The new template is similar to the 
Nutrition Facts Labels in that it presents certain complex information in a 
simple way to improve transparency and consumer understanding about data 
practices.  By making this Model Privacy Notice available, PHR companies can 
help build greater trust in PHRs.

Today’s Summit included more than 25 health care stakeholder organizations, 
representing consumers, large and small practice providers as well as insurers 
and health IT industry leaders, that have pledged to empower consumers by 
making it easier for them to get secure access to their health information to 
engage more fully in their health.

“As technology improves more aspects of our daily lives, it makes sense to 
marry cutting-edge technology with our medical and personal health records so 
that we can improve both the quality and efficiency of the care that people 
receive,” said  National
Coordinator for Health Information Technology, Farzad Mostashari, M.D., Sc.M. 
“We are encouraging everyone to visit our website at 
www.HealthIT.gov<http://www.healthit.gov/> to read our newly released Strategic 
Plan that sets forth our comprehensive plans for consumer empowerment for the 
next five years.“

The Summit highlighted vital benefits of electronic health records and health 
IT, including:


 *   Health IT empowers patients.  For example, people at risk for heart 
attacks may use mobile health applications to manage their weight, diet, and 
medication adherence.
 *   Health IT can facilitate lasting quality improvements, which can lead to 
greater efficiency and cost savings in the long-term.
 *   Health IT is driving innovation in all parts of consumers’ lives – from 
new interactive applications to devices like digital pedometers and other 
devices that capture important health information from everyday experiences.
 *   Health IT helps coordinate better care, and can be a powerful tool if you 
or a loved one is managing a serious medical condition.
 *   Health IT has robust security and all users, from patients to caregivers 
to doctors, can easily and safely access and share health information 
electronically.
 *   Health IT may help diagnose health problems sooner, avoid medical errors 
and provide safer care which can result in lower costs.

“We are at a critical moment in time when we can either choose to innovate, or 
lag behind in care,” said Dr. Mostashari. “A commitment by health care 
stakeholders to support health IT and provide greater consumer access to their 
health information is the first step toward a healthier future.”

In the coming year, ONC will work with health care stakeholders to further 
consumer access to information and empower consumers to become active 
participants in their health. The new website, 
www.HealthIT.gov<http://www.healthit.gov/> creates dedicated consumer-oriented 
information that describes the benefits of health IT, provides consumer health 
education materials and will be a valuable resource for learning about new 
advances in health IT.

For more information about the proposed amendments to the CLIA and HIPAA 
Privacy regulations, please visit 
https://www.cms.gov/apps/media/fact_sheets.asp.


###



HHS proposes broad patient rights to access clinical laboratory test result 
reports


Overview:  As part of an ongoing effort across the Department of Health and 
Human Services (HHS) to empower patients to be informed partners with their 
health care providers in making health care decisions, HHS today proposed  
rules that would give patients (and their authorized representatives) direct 
access to their own laboratory test result reports.

The proposed rule is being jointly issued by three agencies within HHS ‑ the 
Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease 
Control and Prevention (CDC), which are responsible for laboratory regulation 
under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), and the 
Office for Civil Rights (OCR), which is responsible for administering the 
Privacy Rule that was issued under the Health Insurance Portability and 
Accountability Act of 1986 (HIPAA).  The proposed rules are also consistent 
with a proposed regulation under the HITECH Act that would bolster patients’ 
rights to access their information stored in electronic health records and that 
would help ease the transition to nationwide adoption of electronic health 
records.


Background:  The proposed rules address the interplay between the CLIA rules, 
state laws governing direct disclosure to patients of their laboratory test 
results, and the Federal Privacy Rule, which currently defers to CLIA’s 
disclosure provisions and which preempts contrary State laws on privacy and 
disclosure of personal health information.  Under existing CLIA regulations, a 
laboratory may release patient test results directly to the patient only if (1) 
the ordering provider expressly authorizes the laboratory to do so at the time 
the test is ordered, or (2) state law expressly allows for it.

The current Privacy Rule generally requires certain health care providers such 
as most clinical laboratories to give individuals access to their health 
information on request.  However, the Privacy Rule’s access requirements, 
deferring to the CLIA rules, include an exception for direct access by patients 
to their laboratory test result reports.  Thus in 26 states without laws 
authorizing direct disclosure of test results to patients and 13 states that 
expressly prohibit it, patients do not have access to their complete medical 
information.


Provisions of the Proposed Rule:  The proposed rule would amend the CLIA 
regulations to allow laboratories to give a patient his/her individual test 
result reports on request.  At the same time, the proposed rule would eliminate 
the Privacy Rule’s exception for an individual’s access to laboratory test 
result reports.   The amended Privacy Rule would, in turn, preempt contrary 
state laws governing a patient’s direct access to lab result reports.


The proposed rule can be downloaded from the Federal Register Inspection Desk 
at www.ofr.gov/inspection.aspx<http://www.ofr.gov/inspection.aspx>.  Comments 
will be accepted for 60 days, and a final rule, responding to comments will be 
published later this year.

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Vaccinate Early to Protect Against the Flu. The Centers for Disease Control and 
Prevention (CDC) recommends a yearly flu vaccination as the first and most 
important step in protecting against flu viruses. Remind your patients that 
annual vaccination is recommended for optimal protection. Medicare pays for the 
flu vaccine and its administration for seniors and other Medicare beneficiaries 
with no co-pay or deductible. Take advantage of each office visit and start 
protecting your patients as soon as your 2011-2012 seasonal flu vaccine 
arrives. And, don’t forget to immunize yourself and your staff. Get the Flu 
Vaccination -- Not the Flu.



Remember – Influenza vaccine plus its administration are covered Part B 
benefits. Note that influenza vaccine is NOT a Part D covered drug. For 
information about Medicare’s coverage of the influenza vaccine and its 
administration, as well as related educational resources for health care 
professionals and their staff, please visit 
http://www.cms.gov/MLNProducts/35_PreventiveServices.asp.

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