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
There are too many otherwise intelligent people who will believe anything, no matter how preposterous that supports their flawed hero while ignoring anything, no matter how credible and provable that doesn't. You're expecting miracles if you think a Bushbot can be saved from himself.
As a psychotherapist, I never put anything in the chart that would cause my patient pain if known by another, e.g., Mrs. X tells me she is having an affair with Pastor Y or her neighbor, Mr. M was not put in the chart. The court could subpoena my chart, but not what was in my head or heart. By law, I was required, and did, document and report information concerning child abuse and other felony crimes, but that happened very rarely during my years of practice.
All the insurance companies required of me was to document sufficient symptoms to validate the diagnosis, make a note each session to confirm I saw the patient on that date, and was property treating said diagnosis. I could touch the required diagnositic bases of depression, for example, by saying Mrs. X was anhedonic, sleeping poorly, had poor appetite, felt worthless, etc., giving details of the symptoms without having to metion her affair. (To an insurance company Mrs. X was merely a diagnosis to be treated, not a person.)
I well knew that any time I submitted records to an insurance company or to another clinic the record then could easily become public information.
It's becoming more difficult every day to tell who the real enemy is. We are our own worse nightmare.
Let me put it this way, if your plan doesn't pay for certain care (ie smoking cessation), how do they know that what you are seen for is a covered service unless the doctor tells them what you were seen for.
No insurance that I know covers everything. They all have their provisions, so it is up to the doctors billing department to tell them what you were seen for.
As I said, you can opt out by paying cash. Or by asking your doctor to let you submit the claim on your own, and then only submitting the ones that you think ok for them to see.
This is my job to submit these claims, so I am up to date on all of the HIPPA rules and regulations, and I will tell you that this particular rule we are talking about would have made it extremely difficult for your physician to get payment for your treatment, and I could have forseen many, many more physicians refusing to submit to any insurance and telling the patient that would be their responsibility.
After all I am a certified coder, and I kind of like having a job.LOL
When Bill Clinton unveilled his list of regs, doctors around the country were up in arms, because most of them were unworkable. There were things written in their that would have, for instance, made it illegal for you to go to the pharmacy and pick up you wifes prescription. Or made it illegal for your doctor to call a specialist on your behalf and set up an appointment for you without you first signing a consent form, having it sent to the specialist, and having them keeping it on file, before they could even get your name to set up the appointment. Once you saw the specialist, you would then need to sign another consent form and have it sent back to your original physician, before the specialist could even call your physician and tell him what he thought of your condition.
Just imagine what these regs would mean to your care, if you were being treated in an Emergancy Room, and having to sign all these forms every time you saw another provider.
When President Bush came into office, he put a hold on all of these regulations, and opened a comment period in which physicians and other Healthcare workers could comment on what changes they wanted. And these are regs that you are seeing now.
So after all of that said, that is why it was put in the executive offices hands. (you can thank congress for that)
Per my hypothetical patient above, if Mrs. X winds up with a STD, that information is in her medical chart. Down the road she or a member of her family applies for a loan, job, scholarship, security clearance, etc., etc., etc. Anyone along the way can access the record and add it to other data bases.
Thus, my friends know to never send me an email that includes the addresses of others, i.e., if they just must send the latest corny joke, they know to send it to Bcc "Undisclosed-Recipient" or suffer my wrath. There are those who work for spammers who have software that most easily harvests email addresses from those passed around the world urban legends, jokes, etc.
I thought you all(especially Libertarians) were against Bush implementing the original Clinton EO.
Now that he has discarded it, you all are still up in arms
I think the government should butt-the hell-out of our lives, and our medical records.
Duh, could it be because its federal law and the executive branch is responsible for carrying out the law of the land. The regulations are written by HHS in order to implement laws passed by Congress. Deciding not to write regulations, doesnt eliminate his responsibility to carry out the law. Presumably in your questioning mode you want to know why he doesnt just get congress to rescind the act. Fat chance of that happening. Apparently you want him to attack "windmills" because it supports your ideology, not because its going to make any difference in the real world.
Insurers waste the time of the physician and add huge staffing issues to the physician and hospital by "requiring" more information before paying. These requests for "more info" are now infringing on patient privacy, the autonomy of physician decision making, and the health of our nation.
I am also "up to date" on all of the HIPAA rules. As a matter of fact, I WAS INVOLVED WITH THE PROCESS TO WRITE THE CODE. The current code is NOT what was intended by physicians who wanted gov't to PROTECT the American people's interests BEFORE the interests of insurers.
Having patients submit claims would at least bring the insurer into a mode where they need to respond to the people. Right now, the insurers are not responsible to anyone.
I dont disagree with you at all. I was just trying to explain how the executive branch got involved in the first place.
As a certified coder, I need to keep up to date with all new rules and regulations. That doesn't necessarily mean I agree with them.
I think what shot the cost of health care through the roof in the first place was Medicare and other Government interference. People don't realize that the cost of a doctors visit today would be about $10.00 if the physicians could do their jobs and treat people without worring about all on the govermental redtape.If they don't believe Big Brother is watching them, they are delusional.
This is all because somebody thought it would be a good idea years ago to have a third party pay for their healthcare.
What I would really like to know is how expensive an oil change would be today if people demanded that their car insurance paid for that?
Insurance should be just that, insurance against catastrophic finacial loss. Not for the common cold.
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