Governance & Risk Management , HIPAA/HITECH , Privacy

Senate Budget Bill Would Keep Patient ID Ban Intact

After House Votes to Allow HHS Funding for Patient IDs, Senate Bill Calls for Renewing Ban
Senate Budget Bill Would Keep Patient ID Ban Intact
Lights out for Congress lifting the longstanding ban on funding unique patient IDs? Not necessarily, some proponents say.

The movement to lift the longstanding Congressional ban on federal regulators funding the development or adoption of a national unique patient identifier appears to have hit a roadblock.

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A Senate appropriations subcommittee’s proposed fiscal 2020 budget bill released on Wednesday would retain the long-running ban on Department of Health and Human Services funding to “promulgate or adopt any final standard for … the assignment of a unique health identifier for an individual.”

Proponents of lifting the ban – including the College of Healthcare Information Management Executives and the American Health Information Management Executives Association – had intensifyied their lobbying of the Senate after the House of Representatives in June approved a budget measure that included a provision lifting the ban (see National ID Debate Intensifies).

Supporters of lifting the ban argue that a unique patient ID could improve the accuracy, interoperability and security of health information exchange and enhance patient safety. Since 1998, Congress has banned such funding, citing privacy concerns. HIPAA, enacted in 1996, called for creation of such an identifier.

Not Dead Yet?

But some proponents of lifting the ban say the Senate budget proposal won’t necessarily derail the effort.

”This is the same situation we had when the House considered its Labor-HHS appropriations bill earlier this summer - the underlying bill had the same rider that’s been included for the past 20 years,” says Bill Foster, D-Ill., who led the House effort to lift the ban.

"While a national patient identifier would significantly help patient matching, potentially improving the quality of patient care, as long as some privacy concerns remain, it will be difficult to change the status quo."
—Adam Greene, Davis Wright Tremaine

”That’s why I worked to amend the underlying legislation to strike it,” Foster says in a statement provided to Information Security Media Group. “The Senate is just beginning the mark-up process for their version, and I hope for a similar process to amend the underlying text. I was proud to have my amendment pass the House with strong bipartisan support, and it is great that over 50 patient and healthcare groups have sent a letter urging the Senate to do the same.

”It is rare that Congress gets an opportunity to save thousands of lives and billions of dollars by improving our medical system, and we expect the Senate and the Administration to join the House in this bipartisan effort.”

Proponents Keep Pushing

AHIMA and CHIME leaders also say they remain hopeful the Senate will follow the House’s lead in approving an end to the ban.

”We believe there is still a possibility that the ban can be lifted,” says attorney Lauren Riplinger, vice president of policy and government affairs at AHIMA. “We will continue to work with a diverse group of stakeholders that have urged Congress to reject this archaic ban.”

Leslie Krigstein, vice president of congressional affairs at CHIME, offers a similar assessment.

”While we are disappointed the Senate maintained the funding prohibition on a unique patient identifier, it doesn’t come as a surprise. We’ve had a tremendous victory in the House, and we’ve seen the industry mobilize is recognition of this as a critical patient care issue. So I remain optimistic about our possibilities for removing the ban once and for all,” she says.

As part of the ongoing effort to rally support for lifting the ban, CHIME, AHIMA and other industry groups will host a “Patient ID Day” on Sept. 24 in Washington.

Prominent Supporter of Ban

Former Rep. Ron Paul, R-Texas, was a sponsor of the original provision banning the development of a national patient identifier, and his son, Rep. Rand Paul, R-Kentucky, is said to be one of the staunchest supporters for keeping the ban.

Rand Paul’s office did not immediately respond to an ISMG request for comment. However, the senior Paul – who runs the Ron Paul Institute of Peace and Prosperity – is still a staunch opponent of a unique patient IDs.

Privacy Worries

Some privacy advocates also strongly support keeping the ban.

”I do think that there continues to be pockets of concern that introduction of a new national identifier will lead to privacy problems, similar to how the use of Social Security numbers expanded beyond the original intent of the number, leading to the numbers becoming tools of identity theft,” notes privacy attorney Adam Greene of the law firm Davis Wright Tremaine.

”While a national patient identifier would significantly help patient matching, potentially improving the quality of patient care, as long as some privacy concerns remain, it will be difficult to change the status quo.”

Twila Brase, president of privacy advocacy group Citizens’ Council for Health Freedom, is among the strongest opponents of the development and adoption of a national unique patient ID.

”This is a hot button issue,” she tells ISMG. “The idea that Congress would issue every American a single number under which their data could be shared, linked and tracked would likely become a political nightmare. This identification number would authorize unprecedented linking, tracking and analysis of patients and their data without patient consent, leading to comprehensive computerized dossiers on the American people.”

A national patient identifier, Brase says, “would create a national data system that links a patient’s medical records from birth to death and empowers the tracking and analysis of all Americans through their medical records. It would also empower control of treatment decisions by outsiders that have been given access to these comprehensive records.”

Riplinger of AHIMA, a proponent of lifting the ban, contends some of the privacy concerns date back to “a pre-HIPAA, paper-based world.”

Prior to enactment of HIPAA, no national standards existed for the protection of health information within the healthcare industry, she says. “The HIPAA privacy and security rules not only protect the privacy of individually identifiable information but set forth administrative, technical and physical safeguards for covered entities to ensure the confidentiality, integrity and availability of electronic personal health information.”

About the Author

Marianne Kolbasuk McGee

Marianne Kolbasuk McGee

Executive Editor, HealthcareInfoSecurity, ISMG

McGee is executive editor of Information Security Media Group's media site. She has about 30 years of IT journalism experience, with a focus on healthcare information technology issues for more than 15 years. Before joining ISMG in 2012, she was a reporter at InformationWeek magazine and news site and played a lead role in the launch of InformationWeek's healthcare IT media site.

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