September 11, 2013

HHS Sends Plan To Amend HIPAA To Bolster Gun Database to OMB

From: iHealthBeat

HHS’ Office for Civil Rights has sent a proposed rule to the Office of Management and Budget that would ease legal barriers under HIPAA that prevent some states from reporting certain medical data to a federal gun-purchase background check database, Health Data Management reports.

OMB review is one of the last steps before a rule is published in the Federal Register (Goedert, Health Data Management, 9/9).

Background on Database

The National Instant Criminal Background Check System, or NICS, is used by gun dealers to ensure they are not selling weapons to individuals who are prohibited from owning firearms, such as people with substance use disorders and those with severe mental health issues.

Many states have declined to release certain information to the NICS, citing prohibitions under HIPAA.

Although HIPAA states that hospitals and agencies are allowed to disclose data when it is required by law, a 2012 Government Accountability Office report found that some states did not have explicit laws requiring state agencies to share patients’ mental health data.

Further, the report showed 17 states had submitted fewer than 10 records of individuals barred from owning firearms for mental health reasons.

In April, HHS published a notice of proposed rulemaking seeking public comment on how HIPAA is preventing states from sharing patient mental health information with the database.

The notice followed through on one of 23 executive actions President Obama announced in January in the wake of the mass shooting in Newtown, Conn.

Opposition to HIPAA Amendment

Medical groups have criticized the proposed HIPAA amendment, arguing that it is unnecessary and potentially could interfere with the patient-physician relationship.

In June, the National Association of State Mental Health Programs in a letter to HHS said that the amendment would “exacerbate the stigma faced by people with mental illnesses and could potentially have a significant chilling effect” on their desire to seek mental health services.

The American Psychiatric Association, the American Medical Association and the American Psychological Association also have criticized the proposed amendment.

In response, HHS spokesperson Rachel Seeger said that the department “do[es] not expect that providers are reporting on their patients directly to NICS,” noting that some doctors might need an exemption from HIPAA to report involuntary commitments to state mental health agencies, which could then submit the information to NICS (iHealthBeat, 6/13).


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