Life Style & Wellness

Epic files to dismiss antitrust suit



Epic Systems asked the court Thursday evening to support its request to dismiss Particle Health’s complaint that the company violated federal antitrust law.

In addition to explaining why the plaintiff failed to claim “tortious interference” with potential business relationships and contracts, Epic said in the filing that the case was in retaliation for its revelation that Particle enabled some of its customers to obtain confidential patient medical records under false pretenses. On the Carequality health information exchange network.

To help providers deliver on their privacy promises to patients and comply with HIPAA and state disclosure laws — while expanding the scope of automatic exchange of patient data — an Epic representative said the company believes screening and onboarding participants is necessary to uphold its data privacy promises to patients.

Why does it matter?

In September, Particle Health filed a lawsuit against Epic in the Southern District of New York. in Particle Health Inc. v. Epic Systems Corporationthe data exchange and analytics company claimed that the electronic health records (EHR) giant was trying to use its size and market share to crush competition in the payer interoperability market.

“Particle claims there is a rigged market that is artificially limited to one group of customers — payers — while wishing to eliminate all competing products that perform the same functionality as the Particle product,” Epic said in its memo declining to participate with Healthcare IT News.

Epic said the company failed to “reasonably allege anti-competitive conduct.”

Epic said Healthcare IT News They validate endpoints as a qualified health information network under the Trusted Exchange Framework and Common Agreement, an implementer on the Carequality Network and in providing interoperability support and directory services to EHR customers.

It does so because participants in networks that falsely emphasize treatment purposes could theoretically take large amounts of patients’ medical records, without real-time manual review. Therefore, providers do not have the opportunity to review whether data requests meet the terms of use and cannot guarantee that HIPAA protections are maintained, the company said.

While many interoperability networks help providers facilitate the exchange of patient information and there are rules to set up participants seeking to automatically receive patient data for treatment purposes, there may be liability for HIPAA-covered entities that send patient data to questionable endpoints.

Such HIPAA gaps in data-sharing networks — what Epic calls the crisis of trust in health data-sharing — allow limited recourse under the law for some endpoints that request and exchange data but are not HIPAA-covered entities.

The question is whether gaps in trust-based networks and interoperability frameworks might prompt some health systems to consider abandoning participation in TEFCA. Interoperability works when everyone follows the same rules of sharing, and the more guardrails there are, the faster data can flow.

The biggest trend

In a letter last October asking Judge Naomi Rees Buchwald to dismiss Particle Health’s lawsuit, a legal representative for Epic called the suit a baseless attempt to “distract attention from the public reckoning caused by Particle customers violating patient privacy by improperly accessing patient records.” Patients for purposes other than treatment.”

There is a dispute over Carequality, initially filed by Epic last year, that has led to a public debate over data transparency and connecting new customers to interoperability networks.

Epic previously said it opened the dispute when it learned that a non-HIPAA-regulated entity had requested to become an endpoint under a different name through the Carequality Network and, in doing so, received patient records under the guise of treatment but for a limited period. Different purpose.

During Carequality’s dispute resolution process, the network said Particle confirmed that the covered entity’s use of the network was for treatment.

“The third customer in question may participate in the exchange through Carequality for treatment purposes. This customer acts as a business partner for healthcare providers,” the network said in a statement, describing the matter as resolved.

“Particle Health has agreed to secure additional written documentation from its client to ensure that its client has documentation of the relationships related to the health care providers to whom it provides services.”

Epic said the company in question, which received hundreds of thousands of patient data records via the Particle portal, has since been unable to confirm that its purposes for requesting patient data were related to treatment and has indicated that it will delete the records. It may still be active on the Carequality network, although Epic customers have disconnected from it due to the conflict.

“Particle Health has provided Carequality and Epic with the necessary certifications for all three involved clients, including certification of BAAs for payer-provider relationships,” a Particle Health spokesperson said in an email response to this story on Friday. “The information was accepted by Carequality within the required time frame, as set out in the decision. Epic’s statement is a misrepresentation,” they said. Healthcare IT News.

Under HIPAA, taxpayers must obtain only the minimum amount of data necessary for payment purposes to avoid discriminatory reimbursement and enforce medical decisions.

When payer screening endpoints become cloudy, so-called care coordination services are initiated by the payer on behalf of providers and may request full access to medical records. Such agreements must be documented by the payer through business partnership agreements, according to Epic.

Although TEFCA has taken steps to increase governance, interoperability frameworks—network networks—are not required under current federal laws and policies to comprehensively vet endpoints.

It is not known whether Carequality will reopen the dispute to pursue corrective action, however Healthcare IT News He has reached out to us for comment and will update this story if there is one.

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“Particle’s fabricated claims are supported only by conclusive allegations and conjecture, and should be rejected in their entirety with prejudice,” Epic said in its court filing.

“We are pleased that Epic has agreed to an expedited timeline for filing its motion to dismiss, and we are confident that our claims will survive the motion,” a Particle Health spokesperson said. Healthcare IT News Via email on Wednesday.

This article was updated on December 20, 2024, with an additional response from Particle Health.

Andrea Fox is a senior editor at Healthcare IT News.
Email: afox@himss.org

Healthcare IT News is a HIMSS media publication.

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