Senate draft bill promotes exchange of health information

Draft legislation released by the Senate health committee for public comment would not only reduce healthcare costs but is also meant to improve patient access to data.

Section 501 of the Lower Health Care Costs Act of 2019 includes a requirement to provide patients with health claims, network and cost information to help them make better insurance decisions.

According to the Senate committee, the draft bill “expands on the success of the Center for Medicare and Medicaid Services Blue Button Initiative by requiring commercial health insurers to make information available to patients through application programming interfaces.”

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The east front of the Capitol building stands in Washington, D.C., U.S., on Monday, Jan. 3, 2011. President Barack Obama and Democrats are preparing to confront a strengthened Republican opposition to tax, spending and immigration priorities when the 112th session of Congress convenes this week after Democrats lost control of the House during midterm elections. Photographer: Andrew Harrer/Bloomberg

Also See: Feds want Blue Button 2.0 initiative to spark data sharing in industry

Specifically, the draft legislation calls on payers to provide patients with health insurance claims data, in-network practitioners, as well as expected out-of-pocket costs.

“To help patients pick the best health insurance plan for their family and then navigate that plan when they need care, this ensures that patients have full, electronic access to their own health information and information on what the patient would pay out of pocket for specific care,” according to the committee’s summary of the draft bill.

In addition, the draft legislation “emphasizes that all existing privacy and security protections for patient health data under HIPAA and state laws apply.”

Section 503 of the Lower Health Care Costs Act of 2019 also requests a Government Accountability Office study to “better understand existing gaps in privacy and security protections for health information as patients move their information to third parties, such as mobile applications, that are not covered by the HIPAA privacy and security rules.”

The Health Innovation Alliance (formerly Health IT Now), a coalition of patient groups, provider organizations, employers and payers, applauded the draft bill for seeking to improve patients’ access to their healthcare data, while also proposing a GAO study on HIPAA protections as it relates to third-party applications.

“Chairman Alexander and Ranking Member Murray are absolutely right—it should be as easy to obtain your personal medical records as it is to book a plane ticket. This draft legislation takes meaningful strides to ensure that is the case,” says Joel White, executive director of the Health Innovation Alliance.

Likewise, the American Medical Group Association, praised the draft bill for recognizing the importance of patient access to administrative claims data.

“Moving through the healthcare system can be daunting for patients,” says Jerry Penso, MD, AMGA’s president and CEO. “Our members can guide them, but it’s difficult to do so without a complete understanding of all the care they have received. I’m encouraged this draft legislation offers our members a tool they have been asking for to help provide the best possible care to the communities they serve.”

The committee will accept comments on the draft until 5 p.m. EST on June 5, which can be sent to LowerHealthCareCosts@help.senate.gov.

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