Senate Stalls on Lifting of Ban on Funding National Patient Identifier System

The Health Insurance Portability and Accountability Act of 1996 called for the Department of Health and Human Services (HHS) to develop and implement a national patient identifier system. That system would see all Americans issued with an ID number which would be used throughout the healthcare system and would tie an individual to their medical records.

23 years on and the national patient identifier has failed to materialize, because in 1999 a ban was introduced which prevented the HHS from using any of its budget to fund the development of such a system. The ban was introduced out of privacy concerns about such a system. Little has happened in the intervening years to allay those concerns and the ban has been included in every congressional budget ever since.

The problem is that without such a system, it is difficult to match medical records with patients. Healthcare providers use internal patient identifiers, but patients receive treatment from multiple providers who have their own ways of identifying patients. In order to achieve full interoperability, patient records must be able to be easily matched with a patient, regardless of where those records are created.

Industry associations have long been calling for the ban to be lifted and momentum has been building in recent years. This year, the College of Healthcare Information Management Executives (CHIME) and 55 other industry associations came together to urge Congress to lift the ban on funding the national patient identifier and significant progress has been made. This year, the House of Representatives passed an amendment to the Departments of Labor, Health, and Human Services, and Education, and Related Agencies Act of 2020 lifting the ban. That amendment received strong bipartisan support.

There is hope that the Senate will follow the lead of the House of Representatives and will finally lift the ban on funding the national patient identifier system, but it would appear that the Senate will pass on the opportunity for another year. On Wednesday September 19, 2019, the Senate Appropriations Subcommittee’s draft 2020 fiscal budget bill was released and included the same language as previous years.

“None of the funds made available in this act may be used to promulgate or adopt any final standard under section 1173(b) of the Social Security Act providing for, or providing for the assignment of, a unique health identifier for an individual (except in an individual’s capacity as an employer or a health care provider), until legislation is enacted specifically approving the 13 standard.”

This does not mean that the ban will not be lifted this year, as there is still time for the Senate to amend its budget bill but as it stands, it appears that the Senate will take much more convincing that the benefits of a national patient identifier outweigh any privacy risks.