Medical practices with electronic health records would be required to give an on-demand accounting of medical information disclosed to outside parties under a proposed rule printed May 31 in the Federal Register.

The rule, which would amend the Health Insurance Portability and Accountability Act, is required under the Health Information Technology for Economic and Clinical Health Act of 2009. Medical practitioner adoption of EHRs is heavily encouraged by the federal government, with subsidies for adoption possibly adding up to $27.4 billion over a decade combining with a promised drop starting in 2015 to Medicare reimbursements for providers who don't use EHRs in a meaningful way.

HHS says it has paid out $75 million in subsidies to Medicare practices already, as well as $83 million to Medicaid providers.

Under the proposed rule, practices would have to provide a report on medical information disclosure starting on Jan. 1, 2013, although rule applicability would be deferred for a year for practices that installed an EHR before Jan. 1, 2009.

Although covered entities already must track access to electronic protected health information under HIPAA, they are not required to share this information with people, said HHS in a press release about the proposed rule.

Disclosure reports would capture transfers of medical information to entities such as law enforcement, judicial hearing or public health investigations, but would not include any explanation of the purpose of the transaction. Transfers of medical information made via an electronic health information exchange would not be included in a disclosure report under the proposed rule.

"After careful consideration of this option, we concluded that accounting for such disclosures at this time would be overly burdensome when compared to the potential benefit to individuals," the proposed rule states, but adds that HHS could revisit this issue in the future.

HHS is accepting comments on the proposed rule through August 1.

For more:
- go to proposed rule in the Federal Register
- read the HHS press release

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