NYS to Seek Public Comment about Sharing of Protected Healthcare Information in the VBP Environment

NYS to Seek Public Comment about Sharing Protected Healthcare Information in the VBP Environment

CMS, the federal Medicaid and Medicare agency, recently approved NY’s Value Based Payment Roadmap update. The Roadmap referenced that patient confidentiality issues would be subsequently considered by a VBP Patient Confidentiality Work Group that subsequently met during the past winter and that included groups like NYAPRS.

Central to our discussions were how best to share protected healthcare information (PHI) to help inform provider, care management, health home and PPS coordination and response, especially in a value based payment environment.

Current rules governing PHI sharing within both Medicaid and commercial insurance programs require an affirmative patient consent process, e.g. requiring signed releases of information.

To make it easier to coordinate care, the Work Group recommended a move to the automatic sharing of PHI sharing across all healthcare information networks, including the state’s Regional Healthcare Information Organizations (RHIOs), UNLESS beneficiaries Opted Out of such a practice.

Such an approach could require a change in state law to eliminate current prohibitions against the sharing of mental health treatment records without individual signed releases.

The NYAPRS Board and a number of consumer rights groups opposed the automatic sharing with an Opt-Out approach, advocating for a robust education process that informed patients that they could Opt In, e.g. permit the broad sharing of their PHI across all provider networks by signing a single consent form covering all treatment needs and participation.

See attached NYAPRS position paper demonstrating that 95% of patients consent to the broad sharing of their PHI via an informed Opt In process.

In response, “the Department of Health and the VBP Workgroup mutually decided that more discussion via a public stakeholder process was needed “before any action can be taken to carry out the (Opt Out) recommendation.”

Look for details about this process in the coming weeks.