HIAA s comments, summarized below, are intended to strengthen the regulation to meet these goals. These include critical management functions that support the treatment of patients and the payment of claims. The list of allowable activities in the proposed regulation excludes certain administrative functions, as well as such essential services as disease management programs, programs to identify high-risk workers, and education targeted at particular populations. Disease management programs, for example, can be critical to the well being of patients, and are required to meet nationally recognized accreditation standards, as well as by Medicare. Patients with such diseases as diabetes, asthma, or congestive heart failure may be offered potentially life-saving materials that familiarize them with their disease, including signs, symptoms, causes, and triggers.
Medical errors are all too prevalent in the health care system.
This narrow standard would have a chilling effect on detecting and reporting error. It would reduce the ability of physicians, nurses, non-physician providers, and administrators to review and share information, thereby preventing health plans and insurers from quickly pinpointing medical errors. For example, if a patient receives an incorrect mix of medications, all personnel involved must be free to share information so as to avoid repeating the incident with that patient or another. In addition, the minimum necessary standard will not only impede the reporting of medical errors but could even preclude structural changes that might help reduce them in the future. This invites claimants under investigation to interfere with records, which would undermine private sector efforts to combat waste, fraud, and abuse.