HIE Implementation with Conflicting Federal and State Laws
University of Maryland University College
Professor Arthur Reynolds
HCAD 650
February 24, 2013

HIE Implementation with Conflicting Federal and State Laws Health Information Exchange (HIE) is a primary determinant of Stage 2 Meaningful Use in order for health care organizations to qualify for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program (Healthcare Information and Management Systems Society (HIMSS), 2012). This emphasis on EHRs and HIE come from Congress’ passage of the Health Information Technology for Economic and Clinical Health Act (HITECH Act), which was part of the American Recovery and Reinvestment Act of 2009. The issue for facilities in meeting the Meaningful Use requirements is the conflicting federal and state laws that govern consent required to share patient information. At the federal level, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 established the baseline consent standard “as ‘No Consent’ required for treatment, payment and health care operations disclosures, and includes specific Opt-In or Opt-Out processes for sensitive health information” (Christiansen, Apgar, & Melamed, 2011, p. 2). The “No Consent” default established by HIPAA pertains to the disclosure of Protected Health Information (PHI) where the purpose is for the treatment, payment, and health care operation (TPO) to remove previous obstacles in the care delivery process by various providers. HIPAA gives individuals greater disclosure control beyond TPO and for specific programs, like those for drug and alcohol treatment (Christiansen, Apgar, & Melamed, 2011). In these instances, patient’s must Opt-In, by way of written authorization, before their information may be shared. HIPAA’s concern is primarily with privacy as it was originally designed