April 2002 Bulletin

In the News

HHS begins process to amend HIPAA privacy regulations

Health and Human Services (HHS) Secretary Tommy G. Thompson issued a Notice of Proposed Rule Making (NPRM) March 21, 2002 through which his agency begins the rule-making process to amend the Health Insurance Portability and Accountability Act (HIPAA) privacy regulations issued December 2000. Perhaps the most notable of the proposed amendments is the removal of the HIPAA consent requirement. The proposed changes would continue to cover oral communications and maintain the "minimum necessary" requirement, but would make clear that doctors could discuss a patient’s treatment with other doctors and professionals involved in their care without fear that their conversations could lead to a violation. Other changes assure appropriate parental access to their children’s records and prohibit use of records for marketing. The proposals would eliminate the need for researchers to use multiple consent forms–one for informed consent to the research and one or more related to information privacy rights. Researchers could use a single combined form to accomplish both purposes. In March 2001, after Thompson requested additional input on the rule changes, HHS received more than 11,000 comments. Those comments and other public input were used to develop the proposed changes, which were published in the March 27, 2002 issue of the Federal Register, with a 30-day comment period.

CDC issues report on allograft-associated infections

The Centers for Disease Control (CDC) has issued an updated report on infections in allograft surgery, "Update: Allograft-Associated Bacterial Infections–United States, 2002." In the report the CDC says, "After the reported death of a recipient of an allograft contaminated with Clostridium sordellii (an anaerobic spore and toxin-forming organism), the agency investigated this case and solicited additional reports of allograft-associated infections." Twenty-six cases have been identified as of March 11. The patient who died underwent reconstructive knee surgery in Minnesota last November. The report in the March 15, 2002 issue of MMWR summarizes the investigation of these cases and describes additional steps given to a tissue processor to enhance tissue transplant safety. The AAOS has referred the matter to the Patient Safety Committee and its subcommittee, the Tissue Banking Workgroup, for study. The AAOS is monitoring the situation and will inform members about any pertinent new developments in the case. The report can be viewed on the CDC web site

Pennsylvania governor signs malpractice reform legislation

Pennsylvania Governor Mark Schweiker signed legislation March 20 to reform the state’s medical malpractice insurance system. State officials said the reforms will save doctors as much as 20% on insurance premiums and provide strong new patient safety measures. The legislation took effect immediately. Highlights of the bill include: Providing immediate relief to physicians by giving them a Pennsylvania Medical Catastrophe Fund (CAT Fund) discount in 2002, 2003 and 2004; privatizing the claims handling of the CAT Fund beginning this fall, and phasing it out entirely beginning in 2006; allowing malpractice judgments for future medical costs to be spread out over time; requiring claims to be filed within seven years from the date of injury; and eliminating the duplication of recovery for past medical expenses. The law also allows doctors and hospitals to have verdicts lowered by a judge if it would force a doctor out of practice or force a hospital to cut services, thereby damaging the community. Other provisions are: Requiring hospitals to report medical errors to a newly formed Patient Safety Authority and the State Department of Health in an effort to identify preventable trends and problems; and strengthening the state Medical Board’s power by granting it enforcement authority to investigate physicians. For more on this legislation, see page 30.

Free wrong-site surgery prevention tool available

The North American Spine Society (NASS) has introduced the Sign, Mark & X-ray (SMaX) program, a new patient safety tool. Designed to help prevent wrong-site spinal surgery, the SMaX is available free of charge to any spine care provider. It includes:

NASS encourages providers to share the SMaX protocols with their colleagues and operating room staff. Copies may be obtained from the NASS Web site at www.spine.org or by contacting Dana Rennie, Member Services Manager at (708) 588-8088.

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