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White Paper: HIPAA's Impact on Banks - An
Emerging Policy Debate
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Table of
Contents
- The Opportunity
- Sensitive Policy Issues - Will We Derail
Progress?
- The Market Speaks
- Macro Policy Concerns
- A Sustainable Business Model
- Conclusion
- Exhibits
Background
In 2001, the nation’s first HIPAA readiness survey for
banks, administered by the Medical Banking Project,
heralded an emerging story widely covered in the media.
In a nutshell, banks often have access to personal health
information but many were unsure of HIPAA’s impact
on their operations. Under HIPAA, these banks are
considered “business associates” and so must
implement procedures to protect sensitive health
information. Further, some banks may be directly
regulated under HIPAA, because they perform HIPAA-defined
clearinghouse functions. While these issues
became increasingly clear to industry experts and HHS
regulators after the survey was broadcast, banking
associations and regulators aren't so sure.
These groups are seeking to make a case for 100%
exempt from HIPAA based on Section 1179 of the
statute. Yet the framers of the statute argue that this
exemption was exclusively granted to permit consumer-conducted
financial transactions, (i.e., credit cards,
personal checks, etc), allowing the consumer to decide when to use a card
or check that could link them with sensitive treatment information (i.e.,
AIDs clinic, rehab
center, etc). These experts indicate that the exemption
does not cover individually identifiable health data (i.e.,
remittance information) that accompanies health insurer
payments through our banking system.
Privacy groups, banks, clearinghouses and regulators
are lining up on this issue. Privacy groups demand tight
control of PHI that flows through banks. Large banks,
noting that HIPAA is a catalyst for electronic payments,
see a multi-billion dollar industry in the making for
reducing the “paper payment chase” to a streamlined,
digital system. Community banks, that can’t afford to
offer digital payment systems, are finding ways to align
with those that can to protect market share.
In the meantime, AFEHCT, a national clearinghouse
association, drafted a letter to HHS Secretary Thompson
objecting to special treatment for banks under HIPAA,
and heightening the debate among regulators. Finally,
the National Committee on Vital and Health Statistics
held hearings in February 2004 related to the issues.
These dynamics suggest that the once obscure notion of "medical banking"
has arrived into the mainline of healthcare policy formation and product
development.
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