When HIPAA was enacted in 1996, the law called for development of a unique patient identifier (sometimes referred to as a “national patient identifier”). In 1999, Congress passed legislation prohibiting the Department of Health and Human Services from funding, implementing, or developing a unique patient identifier system. This ban has been in place since then. Recent legislative activity in the US Senate seeks to preserve this status quo. Specifically, Senator Rand Paul of Kentucky has introduced the National Patient Identifier Repeal Act to remove the language in HIPAA about development of a unique patient identifier.
What Action has the U.S. Senate Taken with Respect to Unique Patient Identifiers?
Recently, the House of Representatives added an amendment to its Departments of Labor, Health, Human Services, Education, and Related Agencies Act of 2020, which removed the ban. Removal of the ban would allow the HHS to follow through on this HIPAA requirement to develop a unique patient identifier.
However, a Senate Appropriations Subcommittee’s draft 2020 fiscal budget bill, released in September of 2019, has retained the text that bans HHS from developing a unique patient identifier. In simpler terms: the ban will most likely remain for at least another year.
In addition, Senator Rand Paul of Kentucky has introduced the National Patient Identifier Repeal Act. The purpose of the National Patient Identifier Repeal Act is to eliminate the language in HIPAA about development of a unique patient identifier altogether.
What is a Unique Patient Identifier?
HIPAA, upon its passage, called for the development of a unique patient identifier for individuals. The purpose of a unique patient identifier is to allow for patients to be efficiently matched with their health codes. Under a unique patient identifier system, individuals would be assigned a unique national patient identifier code, to which their health data would be tied. This system, its advocates claim, would help to ensure patient data could flow freely between healthcare organizations. A number of covered entities have advocated for a unique patient identifier system, claiming the system is necessary for full healthcare interoperability.
Healthcare industry experts believe that the ban is unlikely to be lifted as long as privacy concerns remain. One particular sticking point for privacy advocates is that, under the unique patient identifier system, a single identifier would tie an individual to medical records from the time the individual is born until the individual dies. The fear is that such a system could allow for tracking of Americans on a scale never before seen, through Americans’ healthcare records. Privacy advocates also worry that a unique patient identifier system could facilitate the use and disclosure of protected health information (PHI) without patient authorization.
What is the National Patient Identifier Repeal Act?
The National Patient Identifier Repeal Act attempts to have the “development of a national patient identifier of HIPAA” removed – permanently. Senator Paul, himself an ophthalmologist, has expressed concerns that implementation of a national patient identifier system would pose significant privacy concerns.
In introducing the legislation, Senator Paul noted how the physician-patient relationship relies upon privacy and trust, and how the doctor-patient relationship would, in his view, be thrown into jeopardy by a national patient ID.
