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  • From: Kate Johnson <johnk AT ils.unc.edu>
  • To: internetworkers AT franklin.metalab.unc.edu, spam AT lambada.oit.unc.edu
  • Subject: Changes in Healthcare Data Privacy Rules
  • Date: Thu, 28 Mar 2002 17:40:54 -0500 (EST)



Dear all:
Recent proposed changes, to the HIPAA medical privacy regulations,
eliminate the requirement that patients consent to the disclosure of their
private health information. In addition, activities that many would
consider marketing would be allowed by health plans, providers, drug
stores, and others.

NY Times article on this below.

Comments to the Department of Health and Human Services can be made
via
this URL: http://www.hhs.gov/ocr/hipaa/



Bush Acts to Drop Core Privacy Rule on Medical Data



March 22, 2002



By ROBERT PEAR


WASHINGTON, March 21 - The Bush administration today

proposed dropping a requirement at the heart of federal

rules that protect the privacy of medical records. It said

doctors and hospitals should not have to obtain consent

from patients before using or disclosing medical

information for the purpose of treatment or reimbursement.



The proposal, favored by the health care industry, was

announced by Tommy G. Thompson, the secretary of health and

human services, who said the process of obtaining consent

could have "serious unintended consequences" and could

impair access to quality health care.



The sweeping privacy rules were issued by President Bill

Clinton in December 2000. When Mr. Bush allowed them to

take effect last April, consumer advocates cheered, while

much of the health care industry expressed dismay.



Today's proposal would repeal a provision widely viewed as

the core of the Clinton rules: a requirement that doctors,

hospitals and other health care providers obtain written

consent from patients before using or disclosing medical

information for treatment, the payment of claims or any of

a long list of "health care operations," like setting

insurance premiums and measuring the competence of doctors.





The proposal is to be published in the Federal Register

next week, with 30 days for public comment. The government

will consider the comments and then issue a final rule,

with the force of law.

Secretary Thompson said he wanted to remove the consent

requirements because he believed they could delay care.



Pharmacists and hospitals had expressed the same concern.

Drugstores said they could not fill prescriptions phoned in

by a doctor for pick-up by a patient's relative or

neighbor. Hospitals said they could not schedule medical

procedures until the patient had read a privacy notice and

signed a consent form.



Hospitals and insurance companies praised today's proposal

as a victory for common sense, but consumer advocates and

Democratic members of Congress denounced it as a threat to

privacy.



"In general, this is great for the health care industry,"

said Elisabeth Belmont, corporate counsel for Maine Health,

which operates seven hospitals, a nursing home and a home

health agency in Maine. Mary R. Grealy, president of the

Health Care Leadership Council, which represents drug

makers, drugstores, insurers and hospitals, said: "The new

proposal strikes an appropriate balance. It's a workable

compromise."



But Janlori Goldman, coordinator of the Consumer Coalition

for Health Privacy, an alliance of more than 100 groups

favoring patients' rights, said the administration was

proposing "a destructive change."



Representative Edward J. Markey, Democrat of Massachusetts,

said: "By stripping the consent requirement from the health

privacy rule, the Bush administration strips patients of

the fundamental right to give their consent before their

health information is used or disclosed. The

administration's proposal throws the baby away with the

bath water."

Senator Edward M. Kennedy, Democrat of Massachusetts, said

he was "very concerned" because he believed that "an

individual should have to give permission before medical

information is disclosed."



The Bush administration denied that it was eviscerating

privacy protections. "The president believes strongly in

the need for federal protections to ensure patient privacy,

and the changes we are proposing today will allow us to

deliver strong protections for personal medical information

while improving access to care," Mr. Thompson said.



Under the rules, doctors and other health care providers

would still have to notify patients of their rights and the

providers' disclosure policies. Patients would be asked to

acknowledge in writing that they had received such notice,

but could receive care without the acknowledgment.



Ms. Goldman, director of the Health Privacy Project at

Georgetown University, said: "It's absurd to suggest that a

notice serves the same purpose as consent. Signing the

consent makes it more likely that people will understand

their rights."



Some parts of the Clinton rules would survive the changes

proposed by the Bush administration. Patients would, for

example, have a federal right to inspect and copy their

records and could propose corrections.



Congress could try to set privacy standards by law,

overriding decisions by the Bush administration. But that

appears unlikely. Under a 1996 law, Congress instructed the

secretary of health and human services to issue rules on

medical privacy in the absence of action by Congress, and

lawmakers have never been able to agree on standards.

In its proposal today, the Bush administration tries to

ensure that parents have "appropriate access" to medical

records of their children, including information about

mental health, abortion and treatment for drug and alcohol

abuse. The Clinton rules "may have unintentionally limited

parents' access to their child's medical records," the Bush

administration said. The proposal makes clear that state

law governs disclosures to parents.



The Bush proposal would also relax some consent

requirements that medical researchers saw as particularly

onerous.



The rules, the first comprehensive federal standards for

medical privacy, affect virtually every doctor, patient,

hospital, pharmacy and health plan in the United States.



Health care providers and insurers must comply by April 14,

2003. Anyone who violates the rules after that date will be

subject to civil and criminal penalties, including a

$250,000 fine and 10 years in prison for the most serious

violations.



When Mr. Clinton issued the rules in December 2000, he

described them as "the most sweeping privacy protections

ever written." Mr. Bush took political credit for accepting

those rules last April. White House officials said Mr. Bush

would back a wide range of privacy protections for

consumers, even if he had to defy his usual business

allies.



The White House wanted to avoid the political embarrassment

Mr. Bush suffered when he altered Clinton policies on

arsenic levels in drinking water, global warming, ergonomic

rules and the contamination of school lunch meat with

salmonella. But after studying the medical privacy rules

and listening to the concerns of companies in the health

care industry, the administration concluded that major

provisions of the Clinton rules were unworkable.










  • Changes in Healthcare Data Privacy Rules, Kate Johnson, 03/28/2002

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