Posted on 08/09/2002 3:28:25 PM PDT by 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
HUH? All that happened here is that Bush got rid of and EO that Clinton signed and that never went into effect. Even if you make a lot of money you will still have to have one doctor knowing what the other doctor is doing or you will not be treated. That is a medical necessity. They can not treat you when they do not know what has already been found out. Or you can just pay them more money to start the process over and find out, but if they need any external lab or external x-rays etc. you are back to square one with giving out your medical records. Do you think doctors are psychic or something? They have a variety of fields because no one of them can do everything themselves. Even hospitals have specialties because the field of medicine is so large.
Also regarding insurance companies. Do you think they should just get a bill for some amount and pay it without knowing that it is their responsibility? Without knowing what they are paying for? Without knowing if someone else already paid the bill? They also have some needs to know and that requires sharing of medical records also.
I like the way you posted this and then sited current regulations and used how appropriate the current regulations are as a way to bash Bush for not caring about the individuals. The Clinton version would no longer allow a patient to wave their signature, and would outlawed faxing or mailing copies. Bush took those ridiculous items out. If they would have stayed in, then yes you would have to drive to your doctor's office each time he/she sent you for lab or x-ray or even each time you were referred to the physical therapist etc.
No. You are the guy who is going to allow insurance companies and HMOs to look at your medical records. They will not pay the bills without your medical records. That is how the system already is and nothing on that level has changed. The only thing that nearly changed was the Clinton plan that would have required you to sign for each and every bill or referral to another doctor, hospital, lab, etc and sign again to get the records back to your regular physician.
That is already illegal. Prosecute them. Quit implying something that is now illegal is Bush's fault because you do not try to get the current laws enforced. This situation that you give as an example would not be changed.
If it falls under their coverage as items covered yes I do when they say we cover such and such service it should be their responsibility to do so. Not many persons can afford two insurance companies and they dearly love to play the good old the other company is responsible game and place doctor and patient in the middle.
All they need to know is a very basic numerical diagnostic code. They do not need to be making medical decessions on your behalf or rather theirs. The answer is simple. A basic binding agreement of services covered and services not. Insurance companies do not belong in any doctors exam room. The HMO Industry is book cookings just waiting to be discovered. There is no concievable way they can cover their so called plans simply by the way they are set up.
BTW my former employer was my health insurance source. We were self insured. My employer didn't have to know my diagnoses or prognoses all they saw was a simple services code and re-embursed me those expenses with zero hassles along with my medications again all that was required was a print out of prescription drugs total cost to me with just a print out from my drug store. Again they didn't have to know each and every medication I took just my cost.
This was a nursing home BTW that did this. The Administrator and Board of Directors were tired of Insurance Companies ripping them and us off and their never ending demands and denials of services. It can be made simple but the insurance industry by it's very nature and with help from lawmakers is allowed to continue abuses not afforded other businesses or industries.
While much of the time your simple scene is correct, there is one item you do not address in this scene. Why would your doctor have you go take an x-ray unless there was something he could learn from it? He could not learn from it unless the x-ray (medical records) was shared with him as well as the interpretation (another medical record).
Yes and the vast majority of this communication regarding patients is done between the healthcare workers. If the Clinton plan would have gone into effect, the healthcare workers could not communicate hardly at all without getting a signature from you every time. The government could get just about any access and records they want whether they need it or not.
Why is this a federal issue? I don't know. Probably some liberal judge made a decision that made it a federal case because of medicare/medicaid and determined that insurance and HMOs had to follow the same rules as medicare/medicaid, but I don't really know the answer to that question.
Rule 1 of Liberalism:
Consistency and logic are not required.
Those simple service codes are standard throughout the industry. You dont think anyone with half a brain wouldnt be able to determine what the likely diagnosis was by the tests that were done. You get a VDRL and they will know VD. You get a code for seeing a psychiatrist, they will know you are not there to clean your teeth.
And that simple code alone is all the justification for payment they need. If you have a code for GI bleeding then necessary testing to determine cause should be done. This however is not the case. They want to go ten steps further. The HEY MOE wants to decide over your doctors best judgement which testing procedure is used. That is what this is actually about despite the political spin being given it. It is giving the HMO's yet more info to play Ghost Doctor. Bush & company just wants to make it easier. Now if Bush and company had addressed the other legitimate concerns mentioned I might think different.
Go back to what I said. Insurance Companies & HMO's should in simple terms list coverages and non coverages in simple exact terms. They have no right or no business beyond that point making medical judgements concerning a patients health. Requiring prior approvals by any health care insurance company should be prohibited. This alone would eliminate 90% of the required paper work to get something done as well as this so called needed exchange of information.
My falling out with POTUS & Congress over this is the fact this issue will never be addressed except in favor of the insurance and HMO interest. It doesn't matter what party is in power on this matter they both are slaves to the insurance industry special interest money.
Get the insurance company out of the exam room they do not belong there. In many cases they prejudice advice for prudent medical care enforced by gag orders they place on doctors. The insurance industry is always looking to congress and the oval office to increase it's profit margin and be granted waivers of privlidge. This needs to be stopped. Call for an imediate recinding of the HMO act President Bush then I will take you serious on health care issues but not until that time.
All they need to know is a very basic numerical diagnostic code.
Those codes that you speak of as if they are the be all and end all are, in actuality, nothing more than a very general idea of where to account for the payouts of the insurance company. They are anything but definitive. You think that the insurance does not need to know the diagnosis to pay prescriptions, just try to file a prescription that does not match any known diagnosis. It will be denied.
You tell me that the insurance company has to pay according to the contract, but then you also tell me that they do not need to be able to verify that what they pay is in accordance with the contract. That makes no sense. Do you pay bills because they are sent to you? or if they do not make sense do you start asking questions and refuse to pay until you have answers?
Now, back to the coding. When I first worked in insurance in the early 80s I got an unusual claim. It was from a surgeon, there was not prior history (some think that does not matter), there was no diagnosis, there was a code for surgery. The bill was $1000. My guidelines said that the prevailing charge for that kind of surgery in my area would allow me to pay $25. Was this mis-coded? No. Was this fraud? NO. I requested more information, that lead to my requesting more information. After receiving this information I realized that the code that was given was for a large laceration, but not so large as to be defined as "other". While the laceration was not huge, it was deep. It was also a laceration to the skull. It seems that this insured was heading to college on his motorcycle and was not wearing a helmet. He was in an accident and cut his skull very deep. The coding was not designed to tell how deep a laceration was, and certainly did not account for a skull injury. After the details came in there was certainly justification to pay for the surgery. Also after I paid the surgery and anesthesia bills and a couple others that had come in the meantime, another bill came in. Because of the work I did to get details early on the person who got the surgery bill didn't do much other than blink when she got a hospital bill for $200,000. She ask the supervisor, then paid the bill. Information is needed, especially in a complicated field such as medicine, and having the information may seem a pain and time consuming, but it can also make a difference.
That is the whole point. Clinton's guidelines would have made it necessary to get a release for the x-rays from the x-ray specialist to give the x-ray to the doctor and possibly another release for the interpretation. Bush just overruled that and got rid of that rule. He also made sure that that little slip that your doctor gives you is not considered medical records that you have to sign an ok to release for before he/she (your doctor) would give it to you to have the x-ray taken. There are also many times that medical professionals call and consult with each other. Would you like to have to drive to both doctor's offices to sign releases before they could call each other and talk? Under Clinton's rules (thankfully they have not gone into effect and because of Bush they will not) you would have to sign each of these times.
The HIPPA regs that Bush is trying to set aside was a major grab of your health info by the government and privacy was just a cover story to get wackos like you to go for it. Do a little research on the actual law and then come back rather than attack GW and reveal yourself to be the dork you are.
Actually, I have not only researched the Health Insurance Portability and Accountability Act at length, but I have written about it many times, both here on FreeRepublic and on Action America (see Tick-Tick-Tick - The Economy Bomb, among others). Here's a question for you. Who was it who sponsored HIPPA. Does the name Bill Archer ring a bell? We aren't talking about some fringe Republican here. And, what party were the cosponsors of that hideous legislation from? Here's a hint. The party name begins with the letter "R". And, which party overwhelmingly supported inclusion of Title V, Subtitle B of HIPPA (now 26 USC 877(a)(1)), that granted the US government the unprecedented right to tax FORMER CITIZENS for 10 YEARS after they have renounced their citizenship and taken citizenship in another country, but only if that ex-citizen was rich?
Dubya is not trying to repeal ALL of HIPPA. Check the facts. His only interest in HIPPA is in repealing certain parts of Title II of HIPPA. Not only has Dubya given no sign that he would like to repeal any part of Title V, his other actions and statements on capital flight issues places him firmly on the side of liberalism, by attempting to punish those who leave, rather than on the side of conservatism, by rewarding those who stay.
Adopting a purely liberal tone, Dubya said, "I think we ought to look at people who are trying to avoid US taxes as a problem" (GWB, AP 8/1/02), rather than acting conservatively and properly identifying punitive and intrusive US laws as the problem. He chose to abrogate his constitutional responsibility as the people's ELECTED representative, when he signed Campaign Finance Reform, leaving the fate of blocking that law to the least representative branch of government, the courts. He not only signed, but supported the USA (UN-)Patriot Act, which virtually gutted the 4th Amendment.
I applaud Dubya's token move to repeal a small portion of HIPPA. But, compared to the damage that he has done, it is just that - an insubstantial token to give his supporters something to point to and say, "See! See! I told you he was conservative! I told you!" He knows that as long as he throws a conservative bone to his supporters every few months, they will stay loyal to him, despite his significantly liberal actions.
Just a thought here. Instead of calling names, maybe you are the one who should be doing the research.
Total sellout....I can't believe I voted for this TURD!
Congratulations. Like the alcohol, smoking and drug withdrawal programs all say, the first step to recovery, is admitting that you have a problem. Well, we have two problems. The primary problem is Dubya and the solution is to replace him with a true conservative in the next primary. But, we can't solve that problem, until we solve the second problem - educating all of the conservatives who are addicted to the Dubya propaganda.
WilliamWallace1999, you made a little Haiku with your attacks on Action-America that you apparently think are necessary in order to make your point:
Thanks for chiming in. Your detailed post made some excellent points. As a follow-up, you might also want to check out my response to WW1999, at post 157. Note that the version of HIPPA that passed, was the brainchild of, and largely supported by, Republicans.
You expect liberals to post things without checking the facts, but it is very disappointing to see that occurring more and more often with supposed conservatives.
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