Transcription trade groups offer ethics guide

By Joseph Conn

The medical transcription industry, represented by its two trade groups, is preparing for what it sees as the possibility of heightened privacy, security and fraud enforcement by coming up with its own guidebook of ethics and best practices.

The Association for Healthcare Documentation Integrity, an association of medical transcription practitioners, formerly known as the American Association for Medical Transcription, and the Medical Transcription Industry Association, the trade group for transcription service providers, have released their “Manual of Ethical Best Practices for the Healthcare Documentation Sector.”

The release of the full guideline is timed to coincide with the MTIA’s annual conference April 28th-May 1st in Daytona Beach, Fla., according to Peter Preziosi, CEO of the two organizations, which formed what they describe as “a strategic legal partnership” in 2007.

Scott Edelstein, a Washington, D.C., lawyer in the healthcare law practice at Squire, Sanders & Dempsey, was the lead author of the manual for the MTIA and AHDI. Edelstein said that more stringent privacy and security protections in the American Recovery and Reinvestment Act of 2009—which include new breach notification provisions and empower state attorneys general to enforce HIPAA privacy laws—as well as the increased fraud-fighting sections of the recently enacted Patient Protection and Affordable Care Act, will likely yield more government enforcement activities going forward, Edelstein said.

And that prompted the two trade groups to take a pro-active approach in producing the manual. “I think just generally, the tone for this administration is going to be increased in enforcement, because there is increased sensitivity for privacy of information,” Edelstein said.

“Most of the companies in the medical transcription industry tend to be small mom-and-pop operations, but they’re handling such sensitive information,” he said. “The concern is that some of these companies may not have taken all the measures needed under HIPAA and fraud and compliance laws, and this manual was to provide guidance for them.”

Data on the medical transcription industry is somewhat sketchy. The federal Bureau of Labor Statistics places the number of medical transcriptionists in the U.S. workforce at around 100,000, but the BLS figures don’t capture independent contractors, according to Preziosi, “and I’d say a good 50% are independent contractors.”

Add in small physician offices where the office manager might double for an MT and, all told, there may be as many as 250,000 to 300,000 medical transcriptions working full or part-time for 1,500 to 1,700 companies, mostly sole proprietorships, though there also are a handful of “giants,” he said.

The manual offers a best practices check list, copies of the codes of ethics of both organizations, guides on billing practices and the rules on hiring employees vs. independent contractors, roughly 170 pages devoted to compliance with Health Insurance Portability and Accountability Act privacy and security rules, a how-to section on establishing a HIPAA-compliant home-based office, and a “50-state data privacy survey,” according to a listing of the manual’s contents on the AHDI website.

Such guidance doesn’t come cheap. Copies of the manual cost $4,000 for non members of the two associations, with prices ranging between free to $750 for MTIA members and $750 or $950 for AHDI members.

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