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

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 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.

I do not understand. Why is this a proper function of the federal governement?

Actually, it's a bit late to be asking the question. HIPAA passed Congress in 1996. It mandated that Congress come up with federal privacy standards by 2000, and if Congress failed to do so, the responsibility to come up with a federal privacy standard would fall to Health and Human Services. So, HHS followed the mandate of the HIPAA law. One might argue that we don't need a federal standard, but Congress, in it's infinite wisdom, deemed one necessary in 1996.

You are incorrect in your interpretation of HIPAA. The original concern posted was correct and is indeed what is occuring.

You've lost me. What, exactly, was I incorrect about? Have you read the HIPAA Privacy Rule? With the background information, it's over 1500 pages long (in Word format). Have you read it? I have. I've attended three workshops giving an overview and the details of HIPAA; I've read the HHS guidance on the original rule; I've read the Workgroup for Electronic Data Interchange white paper on implementing the Privacy Rule in a small practice office; I've put together a training on HIPAA for health care professionals. If my interpretation is wrong, I'd sincerely like to know what, and how.

In terms of "what is occurring," the Privacy Rule hasn't taken effect yet. The compliance date is April 14, 2003.

That is insulting and wrong. We have tried to keep as much control of our profession as possible despite being under constant assault by the trial lawyers, insurance companies, government agencies and a public that thinks they know everything after watching a segment on "Sixty Minutes".

I don't watch tee vee, it rots the mind and spirit. Selling my personal info to credit agencies is wrong as is my doctor's willingness to tolerate such practices without speaking out. It is at the very least a violation of his oath. I call people who break oaths, liars. Or is the oath also a "living document" that needs to roll with the times. .

Comments like your's above is just another part. I just got home from the ER after admitting a patient. This completed a day that started at 0800 and, since I'm on call, may continue. The first thing I see when I turn on my computer is I'm called a liar. You have issues dude.

Damn straight I have issues. Why are doctors more pre-occupied with a serial number from Bismarkian Ponzi scheme than they are with my health. Why can I get a tetanus shot in Moscow but not in the States? Hell you can buy tetanus shots for pigs in this country but not for people. Why do I have to prostrate myself before an agent of the State every time I need a scrip. Half the time I can figure out the problem with a PDR and a Merck Manual. And finally there are friggin *tons* of weapons class smallpox and anthrax stockpiled in Russia guarded by lice ridden Russian teenagers who haven't started shaving due to malnutrition. Any ideas on when we might start a voluntary vaccination program or allow stockpiling of basic anti-B's. I suppose this would set a dangerous precedent of self-ownership and we can't have that cutting into a government controlled monopoly.

People get what they ask for and my fellow doctors are leaving in droves and med schools applications were down 6% this year. Many residencies are filling up with as many as 50% foreign med grads.

Yes this is typical of Socialist enterprises.

Look, I'm sure you are a very dedicated professional who cares about people. But the gripes above have snowballed with being ill and being refused treatment to make me rather cynical.

I agree with your last posting. With respect to the issue of the cost of a patient visit, the cost of employing billers and staff to phone insurers more than doubles the cost of the primary care office. So, we would have 40-50% less payroll if we had more effective methods of addressing the most common ailments.

For this reason, I see the tremendous overhead in medical documentation and billing as the most obvious area for improved efficiency. Insurers disable growing medical offices and good doctors by simply denying payments. That is blatantly unfair, and it borders on fraud!

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