Important change for requested health records
Beginning Oct. 6, behavioral health providers will need to provide additional types of electronic health records, including medical and billing information, to their patients and to other providers upon request, or risk noncompliance.
Under the 21st Century Cures Act, providers are already required to provide certain types of health records to patients or other providers or face penalties for intentionally withholding that information.
But the Act mandated access for only certain types of electronic health information (EHI). For example, clinical notes are required to be accessible through an application of the patient’s choosing, or Electronic Health Record (EHR) portal.
A new, broader EHI definition
On Oct. 6, a new and broader definition of EHI becomes effective under a U.S. Department of Health and Human Services rule that implements the Cures Act and expands the types of data providers must make available.
In addition to other information already required to be made accessible, EHI will now include:
- Medical records and billing records about individuals maintained by, or for, a covered healthcare provider;
- Enrollment, payment, claims adjudication, and case or medical management record systems; or
- Other records used in whole or in part by, or for, the covered entity to make decisions about individuals.
Examples of medical records which must be provided include discharge summary notes; the patient’s history and physical, imaging narratives; laboratory report narratives; pathology report narratives; procedure notes; progress notes; and other information.
Aligning with HIPAA
The new definition for EHI aligns with all Protected Health Information (PHI) that a patient would have the right to request under the HIPAA Privacy Rule. The HIPAA Rule gives patients the right to access all individually identifiable health information about them that is in the medical record or is possibly stored in other records.
Specific limitations or exceptions will apply to information sharing, such as when the patient is an adolescent or when the PHI was prepared in relation to litigation.
Certain psychological and neuropsychological testing data and reports may be exempt. Advocacy organizations are challenging the legalities now, but most psychological records do fit the broader definition of EHI, including much of the data a psychologist might keep in an EHR. The patient assessment and treatment plan, clinical notes, progress notes, and health concerns would meet the new EHI definition.
If the patient wants paper…
The change taking effect Oct. 6 applies only to electronic information and will not cover paper records. However, HIPAA considers paper, electronic and verbal data to be PHI, and patients have the right to access that information.
This means that if a behavioral health patient requests a paper copy of PHI maintained by the practice, it is still expected that the practice will provide the individual the paper copy requested.
Even patients who have not paid outstanding balances are entitled to receive requested data under this important change.
Providers are prevented from charging exorbitant fees that make the exchange of data cost prohibitive.
INFINITY can help
At INFINITY, we understand that ongoing regulatory changes and increasing payment obstacles make it difficult for behavioral health providers to fully focus on caring for patients.
We’re here to help on all counts.
Our knowledgeable team delivers top-notch revenue cycle outsourcing services for timely and optimal reimbursement. We drive your cash flow and optimize profitability, getting you paid faster and more reliably.
We also work hand in hand with the industry’s leading network of healthcare compliance experts. If you have compliance questions about sharing information with individuals outside of your practice or other regulatory questions, our strategic compliance partners can provide the guidance you need.
Use the form below to begin the conversation about how we can strengthen your business and help you focus on caring for your patients.