Regulatory_and_Legislative_Issues_Paper

Many issues in the health care arena are influenced by orders from regulatory agencies, called regulations. For instance, state boards of nursing develop regulatory rules to enforce standards of practice for nurses. These regulations dictate how nurses are to practice and are enforced by the law. A topic within the past few years that has raised questions pertains to the requirement of healthcare facilities to implement an electronic health record within one’s system. Privacy is important to both patients and their healthcare provider; thus the importance of the protection of records. Consequently, the Health and Human Services Department created The Health Information Technology for Economic and Clinical Health Act (HITECH), a component of the American Recovery and Reinvestment Act of 2009. This new act consists of incentives for health care information technology designed to accelerate the adoption of electronic health record (EHR) systems among providers in protecting patients’ privacy ("HIPAA," 2009). The HITECH Act was developed to enhance the scope of privacy and security protections available under HIPAA as well as to increase legal liability for non-compliance and to provide increased enforcement. In terms of quality, the new HITECH Act will greatly prevail over the older privacy protection HIPAA law. Unfortunately, in the past HIPAA was not highly monitored or enforced, hence the development of this new act. HITECH’s design and strict rules will ensure a higher degree of privacy and improve patient care for all patients nationwide. The EHR promises an array of potential benefits for patients and the United States health care system through improving clinical care and reducing costs. Under HITECH guidelines, providers will be cited for willful neglect on a case-by-case basis if he or she does not comply. When a provider displays cavalier behavior toward complying with the rules, these providers are likely to be charged with willful neglect. To demonstrate the seriousness of this act, the penalties for noncompliance consist of up to $250,000 fine with repeat violations extending up to $1.5 million (HIPAA, 2009). Additionally, the Health and Human Services Department (HHS) is required to conduct periodic audits on providers and their business associates. Breach of secure data from unauthorized users requires notification to HHS. If the breach affects more than 500 patients, this will require the posting of the facility’s name on HHS’ website. Also depending on the degree of the offense, the offender’s name may be given to the local media. Once the media is notified, this facility is likely to undergo negative publicity to the area, affecting the amount of business received. This notification process shall help patients decide which facility he or she is most comfortable in receiving his or her healthcare needs. Another enhancement for patients pertaining to this act applies to circumstances that arise in which a provider has implemented an EHR, the patient has access to an electronic copy of his or her health record for a small fee. To qualify for the HITECH incentives, providers must advance their system to have these capabilities for patients to receive the records him or her desire. Although not a direct cost to the American people, the HITECH Act demands more transparency and accountability to the providers because of the significant taxpayer dollars providing the incentive funding to these providers. If a provider desires to receive the benefits of an EHR incentive, he or she must comply with the guidelines set forth in the provisions of this new act. For eligible professionals, the Medicare EHR incentive is $44,000 distributed over five years if they participate by 2012. If professionals choose to participate in the Medicaid incentive program, the providers must implement their EHR program by 2012 and will receive $63,750 throughout six years of participation (Centers for Medicaid and Medicare Services [CMS], 2010). A goal of HITECH is to lower health care costs for everyone by mainstreaming and protecting health records. The groups in favor of the HITECH Act include the Office for Civil Rights, Health and Human Services, Federal and state agencies. These groups’ focus is to enhance patient privacy, improve accuracy of patient records, lower health care costs, and provide health care information to any individual who desire a copy. Based on a survey of Americans, despite his or her concern for privacy, the majority are eager to benefit from the use of EHR by improving his or her quality of care by reducing the number of redundant or unnecessary tests and procedures in addition to reducing medical errors and healthcare costs (Thede, 2010). This survey also revealed the people believed that exchanging health information can result in improvement of care. Another benefit of EHR is to help those patients who have a difficult time remembering his or her health history by maintaining a more accurate health record. One additional appealing element of the EHR is that one’s health records will be inclusive and contained within one system, making it easier for patients to track his or her medical records. Drug companies and lab testing agencies are often opposed to HITECH and EHRs because of the potential for decreased lab tests and the uncovering of side effects of drugs based on the increased accuracy of patients’ records, therefore decreasing these company’s profit margins. A portion of the population may be opposed to EHR’s and have a difficult time accepting them because of his or her fear of unauthorized personnel accessing his or her records. A risk facing these patients who lack the trust in electronic exchange of health information because of perceived risks to individually identifiable health information or the accuracy and completeness of this information may not willingly disclose necessary information increasing his or her life-threatening consequences. Attention at the Federal and sate level is necessary to develop and implement appropriate privacy and security policies along with enhancing the level of trust among patients. The Chief Privacy Officer, Joy Pritts, of the Office of the National Coordinator for Health Information Technology (ONC) is working with HHS to develop and coordinate privacy policies that will encourage patient trust and participation in adopting electronic health record and health information exchange (2010). The formation and enforcement of the HITECH Act is projected to enhance the privacy of Americans health care records. Given adequate time, the implementation of electronic health records will improve quality of health care, access to records and lower costs to all patients nationwide. This federal law will ensure providers’ accountability to the HHS department and to individuals for properly protecting his or her private information.