Physicians will have 2 years to develop the consent forms and
compliance programs dictated by the medical records confidentiality rule
published by the Clinton administration on December 28. Some provider groups,
particularly in the health insurance industry, want the Bush administration to
review and change elements of the final rule, but that is very unlikely to
happen. Not only will oncologists have to get a consent form signed before the
patient can be seen for the first time, but they will also have to give the
patient a form that includes a "detailed discussion of the provider’s
health information practices." That form must tell the patient that he or
she has the right to ask the doctor to request certain restrictions as to how
information about the patient will be used or disclosed. Moreover, oncologists
will have to develop a compliance program to make sure that they don’t send a
patient’s protected information to someone who is not cleared to receive it.
Christian Downs, director of provider economics and public
policy for the Association of Community Cancer Centers, said the requirements
will "demand a lot" from office-based (as opposed to hospital-based)
oncologists. "Much of what is required is outside the expertise of the
office manager, and what needs to be done will not be compensated for,"
said Mr. Downs. The Department of Health and Human Services estimates that
first-year costs for office-based physicians will be $3,700, with succeeding
year costs at $2,000.