Epic Systems requested on Thursday night to back up its lawsuit that Particle Health claimed the business had broken a federal antitrust law. Epic claimed in the filing that the case was retribution for revealing that Particle had allowed some of its users to obtain personal patient health records under false notions on the Carequality health information exchange system in addition to describing why the claimant failed to allege” tortious intervention” with prospective business ties and deals. An Epic representative said the company believes vetting and onboarding participants is crucial to upholding data privacy promises made to patients in order to help providers keep their privacy promises to patients and comply with HIPAA and state disclosure laws. WHAT IS IT MATTERSParticle Health sued Epic in the Southern District of New York in September. The data exchange and analytics firm Particle Health Inc. v. Epic Systems Corporation made the claim that the electronic health record ( EHR ) giant was attempting to use its size and market share to stifle competition in the payer interoperability market. In a memo to dismiss shared with Healthcare IT News, Epic claimed that” Particle alleges a gerrymandered market artificially restricted to a single set of customers – payers” while wishing away all the competing products that perform the same functions as Particle’s product. The company fails to “plausibly allege anticompetitive conduct”, Epic said. Epic provided its EHR customers with interoperability support and directory services as well as the verification of endpoints as a Qualified Health Information Network under the Trusted Exchange Framework and Common Agreement and the Trusted Exchange Network Implementer. This is done because networks that falsely claim treatment purposes can theoretically take large volumes of patients ‘ medical records, without real-time manual review, do this. Therefore, providers do not have the ability to check whether the data requests adhered to the terms of use and cannot guarantee that HIPAA protections are upheld, according to the company. There may be a liability for HIPAA-covered entities that send patient data to dubious endpoints despite the fact that many interoperability networks help providers facilitate the exchange of patient information and there are regulations for onboarding participants seeking to automatically receive patient data for treatment purposes. Epic calls a crisis of trust in the exchange of health data, and such HIPAA gaps in data exchange networks limit the legal recourse available to specific endpoints who request and exchange data but are not HIPAA-covered entities. The question is whether gaps in trust-based interoperability frameworks might cause some health systems to consider rescinding their TEFCA participation. Interoperability occurs when everyone adheres to the same code of conduct, and the flow of data is faster the more guardrails there are. A legal representative of Particle called the lawsuit a “baseless attempt to distract from the public reckoning stemming from Particle’s customers violating patient privacy by improperly accessing patient records for non-treatment purposes” in a letter this past October asking Judge Naomi Reice Buchwald to toss out the Particle Health lawsuit. The issue is a Carequality dispute that was initially brought up by Epic last year and has caused the public to debate data transparency and the availability of interoperability networks. Epic previously stated that the dispute began when it learned a non-HIPAA-regulated entity had requested to use a different name to become an endpoint through the Carequality network and had received patient records for a different reason using a different name. During Carequality’s dispute resolution process, the network said Particle confirmed that the covered entity’s use of the network is specific to treatment. The third customer in question might be negotiating through Carequality for treatment purposes. This customer serves as a Business Associate of healthcare providers”, the network said in a statement, calling the matter resolved. The company in question that received hundreds of thousands of records of patient data through Particle’s gateway has since been unable to confirm that its requests were related to treatment and has indicated it will delete the records, according to Epic. Even though Epic’s customers have been disconnected from it as a result of the dispute, it may still be active on the Carequality network. A Particle Health spokesperson said in an email response to this story on Friday that” Particle Health provided Carequality and Epic with the attestations needed for all three customers in question, including an attestation of the BAAs for the payer-provider relationships.” ” The information was accepted by Carequality within the required timeframe, as outlined in the resolution. Epic’s statement is a misrepresentation”, they told Healthcare IT News. To avoid discriminatory reimbursement and impose on medical decisions under HIPAA, payers should only obtain the bare minimum of the necessary information for payment purposes. What are labelled as payer-initiated care coordination services on behalf of providers and where vetting payer endpoints becomes problematic is when they are asked to have complete access to medical records. According to Epic, these agreements must be documented by the payer through business associate agreements. Although TEFCA has taken steps to improve governance, networks of networks ( networks ) are not required by current federal laws and regulations to thoroughly evaluate endpoints. Healthcare IT News reached out for comment and will update this story if there is one. However, it is unknown whether Carequality will reopen the dispute to follow up on corrective actions. ON THE RECORD” Particle’s invented claims are supported only by conclusory allegations and conjecture, and should be dismissed in their entirety with prejudice”, Epic said in its court filing. We are pleased that Epic complied with a timely deadline for briefing its motion to dismiss, and we are confident that our claims will be resolved,” a Particle Health spokesman wrote in an email on Wednesday. This article was updated on December 20, 2024, and Particle Health provided an additional response. Andrea Fox is the publisher of Healthcare IT News.
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