Bush Administration Decides Not to Require Written Patient Consent for Sharing Medical Records

ap ^ | August 9, 2002 | Janelle Carter

[TomGuy]

Bush Administration Decides Not to Require Written Patient Consent for Sharing Medical Records

By Janelle Carter Associated Press Writer

Published: Aug 9, 2002

WASHINGTON (AP) - Hospitals and physicians can share private information about a patient's health with HMOs and insurance companies without the patient's permission, the Bush administration said Friday in a decision denounced by privacy advocates.

Finalizing rules on the handling of medical records, the Department of Health and Human Services set aside a Clinton administration proposal that would have required a patient's written consent before that information could be released.

However, doctors and other health care providers will have to notify patients of privacy policies and make a "good faith effort" to get written acknowledgment under the new policy. Health care providers had complained that requiring written permission could stall needed treatments.

The Clinton version "would have forced sick or injured patients to run all around town getting signatures before they could get care or medicine," said Health and Human Services Secretary Tommy Thompson.

He said the Bush administration's approach "strikes a common-sense balance by providing consumers with personal privacy protections and access to high quality care."

"Patients now will have a strong foundation of federal protections for the personal medical information that they share with their doctors, hospitals and others who provide their care and help pay for it," Thompson said.

The regulations take effect April 14, 2003.

The Clinton version of the proposal, which was never put into effect, would have required signed consent forms from patients even for routine matters such as billing statements to insurance providers. The Bush administration announced in March that it planned to strip the written consent requirement from the medical privacy regulations.

Sen. Edward Kennedy, D-Mass., chairman of the Senate Health, Education, Labor and Pensions Committee, promised to introduce legislation to reinstate the mandatory consent forms.

"These regulations are a serious setback for medical privacy," Kennedy said Friday. "Insurance companies and HMOs are given broad access to highly sensitive personal medical information. Action by Congress is clearly needed to guarantee all Americans that the privacy of their medical records will not be abused."

The regulations clarify that personal information cannot be sold or given to drug companies or others that want to market a product or service without patient permission. The final version includes more explicit language to ensure that companies don't use business associate agreements to circumvent marketing rules.

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On the Net:

Health and Human Services regulations: http://www.hhs.gov/ocr/hipaa

AP-ES-08-09-02 1759EDT

[11th Earl of Mar]

I suggest you visit a site called hippainfo.net. It may give you some answers.

I tried the website but it did not work. Is this the correct url?

[olliemb]

The patient has full control over who gets what information now. However, b/c there is a third party paying for the bills incurred by the patient, the third party needs information to pay. To have patients conveniently sign forms and have them faxed is done now. But when the patient is needed for more information that the insurance company needs, and if the patient does not respond, then we can't give the info to the third party.

You need however free ability to care for a patient when they are sick. I am sure that when the patient comes in to one hospital in a coma and we know that a MRI was done in another hospital that it would be quite silly not to be able to get the MRI results b/c the patient could not sign. In the medical care of the patient, there are appropriate times when sharing of medical information is imperative.

In my opinion, I don't see what the problem was that needed fixing. The government presently if they refuse to pay for a hospital visit, will ask of the physician to submit the office notes or the hospital visit notes. The government right now goes thru the hospital records to determine if payment is due or not. There are presently lots of people that can read your chart. But again, if you want a third party to pay for the bills, you got to give them that authority to tap into your charts.

And now the patient has the right to look at their charts, has the right to tell the doctor what he/she can release, and the patient has the right to tell you not to put the info in the chart.

So again, what was the problem that Clinton thought needed fixing? And why are some people angry at Bush for easing some of the tough Clintonian rules that would make the art of practicing medicine cumbersome.

In the medical world, medicare sets the precedent. If medicare does it then so do the private insurances.

[grania]

The majority of the healthcare dollars spent today are by EMPLOYERS

Yes, but they're part of salary packages. And most don't have the option of taking the money and using it to provide for ones own health care.

[bimbo]

The insurers have driven up the cost of health care to such an extent …

The insurers had help driving up those costs – help from the physicians and HMOs, certainly. But don’t forget those malpractice lawyers, too, and their friends in the legislatures. And lastly, they had help from the patients … those who didn’t bother to scrutinize the bills and didn’t question those increases because “someone else was paying.”

[Freedom'sWorthIt]

Thank you for making sense of a nother SLAM at President Bush. (Attempted).

If anybody thinks Ted Kennedy is the friend of conservatives or of any Americans for that matter - they are living in a dreamworld.

[bimbo]

If you can't trust your health professional with your records, can you really trust him with your life?

I trust my physician with my health records … I do NOT trust those who could acquire those records without needing them– any HMO, NIH, CDC, Credit Agencies, Insurance Companies, Social Security Agency, Dept of Justice, Grad Student Writing a Thesis, etc. Once the records are beyond the physician-patient relationship, there is no privacy!

[WilliamWallace1999]

Thank the unions for that one. Remember, if the employers just gave you the money; uncle Sam gets his cut first. We need tax advantaged medical savings accounts NOW. If people took back control, good doctors AND patients would win. THAT'S why the Dems and unions are fighting MSA's tooth and nail.

[A. Pole]

Better be real careful about what you tell your doctor.

True. Doctors are becoming the eyes and ears of the state. (Presumably to fight the terrorism, domestic violence, drugs, smoking, drinking, tax evasion, fat food, listening to the Rush, gun ownership, homophobia etc ...).

[Dave S]

Example, I find out my new insurance provider (United Health Care) is selling every detail of my medical history to credit agencies. To maintain my privacy I withhold my SSN. Result: I lose all coverage

This ruling doesnt allow your HMO to sell to outside entitities. It only allows doctors and hospitals to share medical information with other medical personal and with the HMO's and insurance companies that pay for the care. Your records are better protected today from outside sources than they were 10 years ago.

[Dave S]

Some of you ought to do a little research before you go ballistic. I pulled the following from the Health & Human Services website. I pulled the following from a press release yesterday that the AP guy wrote from. Note this is not a sell out to any one and that the rulings do protect our rights.

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Under the privacy rule:


Patients must give specific authorization before entities covered by this regulation could use or disclose protected information in most non-routine circumstances - such as releasing information to an employer or for use in marketing activities. Doctors, health plans and other covered entities would be required to follow the rule's standards for the use and disclosure of personal health information.

Covered entities generally will need to provide patients with written notice of their privacy practices and patients' privacy rights. The notice will contain information that could be useful to patients choosing a health plan, doctor or other provider. Patients would generally be asked to sign or otherwise acknowledge receipt of the privacy notice from direct treatment providers.

Pharmacies, health plans and other covered entities must first obtain an individual's specific authorization before sending them marketing materials. At the same time, the rule permits doctors and other covered entities to communicate freely with patients about treatment options and other health-related information, including disease-management programs.

Specifically, improvements to the final rule strengthen the marketing language to make clear that covered entities cannot use business associate agreements to circumvent the rule's marketing prohibition. The improvement explicitly prohibits pharmacies or other covered entities from selling personal medical information to a business that wants to market its products or services under a business associate agreement.

Patients generally will be able to access their personal medical records and request changes to correct any errors. In addition, patients generally could request an accounting of non-routine uses and disclosures of their health information.

[codercpc]

You have every right in the world to keep your information private, but then you cannot ask your insurance company to pay for your care.

When you sign the contract with the physician asking them to submit your claim to your insurance company, you are signing the right to give the insurance company that information.

Do you really believe that when you see your doctor today that the billing staff just sends your insurance company a note that says "Adam saw Dr. X today, please pay Dr. X $50.00"?

If you are a private pay patient(no insurance), you have privacy.

The privacy regs as written by Clinton, would have tied the hands of your physician to get payment, and you would have been legally responsible if you refused to sign away your confidentiallity for each and every visit you had.

If you are being treated for a STD, or something else that you don't want reported, You have every right in the world to tell the Doctor not to submit that bill to your insurance company for that visit only. Pay cash at the time of the visit, and you have are free.

An insurance company only has the right to your records for the claims they are being asked to pay for. You are still in control.

[Dave S]

I've been without coverage for a year now because of my refusal to submit my SSN. As an avid motorcyclist and rock climber, this is very disconcerting. Do you know of *any* insurance companies that aren't pre-occupied with hawking my personal information.

Well in 2003 when these new regs become law, you will be free to use any insurance company and they will not be able to hawk your personal information to outside companies without your express written permission.

In the meantime get your ass covered before you cant get coverage at any price. Then worry about whether some marketing company is sending you literature on Depends.

[Dave S]

Please tell us how our medical care is going to be better once the federal government puts out these regulations REGARDLESS of what they say or who puts them out.

UNTIL these new regs go into effect in 2003, the insurance companies and HMO's ARE free to sell your private medical information to outsiders for marketing use (ie. trying to sell you Depends, ads for various prescriptions, etc. They are already doing it. UNTIL THESE REGS GO INTO EFFECT YOU HAVE LITTLE PRIVACY. Does that help put this in perspective?

[Dave S]

Under his watch, the growth of government spending has been cut by more than half; the number of employable adults on welfare has been reduced by 60 percent; and Tennessee became the first state in the nation to connect every public school and library to the Internet and to offer universal health care coverage to all children

And you dont think that the Gov of Tenn was given the right to pick "his accomplishments" for this news release about his support for Bush for President. This is real politics, bud. Has nothing to do with what Bush believes or doesnt believe. What world do you live in? It's certainly not the real one.

[Afronaut]

If you are not sick then you have nothing to be afraid of.

[Dave S]

Why is this any business of the federal government at all?

Duh, because some in the medical establishment were selling your information to outside marketing firms without your knowledge. Increasing computerization of records was only going to make more abuses possible. There were no federal laws protecting your right to medical privacy until HIPAA was passed in the late ninties. Everyone has been bellyaching about the regulations being written by Health & Human Services since.

Of course someone could sue and probably win without this law but once that happens then you are not goign to see one doctor being willing to share information with another doctor for fear of being sued. HIPAA establishes for all what is and is not allowed and what safeguards need to be in effect. Most of us think this is pretty good idea. But i guess for you folks who think the only functions of government are to protect the borders and ensure your right to buy and sell drugs, its probably a bummer.

[TomGuy]

To: TomGuy

Some of you ought to do a little research before you go ballistic.

I was just the messenger. I posted the AP and I didn't even comment on it. Ouch! Don't kill the messenger! Ouch, quit hitting! Help!!! I'm being brutalized. Much more of this and I'll declare victim status ... I smell lawsuit.

LOL

[GWfan]

the site should have been hipaainfo.net

[Dave S]

Okay, guys, which is it? These rules have been in effect for 20 years or these are rules to be implemented?

Guess you cant read. Being in the works doesnt mean they are law, it means that they have been discussed and everyone knew that at some point there would be regulations. HIPAA was passed by Republican congress in the late 90's. The clinton administration tried to write rules to implement these laws but screwed them up so bad they had to put them on hold. Bush came in to office and has rewritten the rules to make them reasonable. They are not Bush's doing. He's merely making the best of what was passed by congress. The purpose is to protect our medical privacy which today can be sold to outside marketing firms by the insurance companies or can be used by sister companies of the Insurance firms that do marketing.

[Dave S]

Why am I not surprised?

Because your ignorant.