IP: Bush drops protection on medical files

[Dave Farber <dave () farber net>]

------ Forwarded Message
From: "Alan J. Cook" <alanjcook () earthlink net>
Reply-To: <alanjcook () earthlink net>
Date: Sat, 10 Aug 2002 06:19:49 -0500
To: <farber () cis upenn edu>
Subject: for ip - Bush drops protection on medical files

Dave, this surprised me. [ why? Djf]   What do IP readers think?

http://www.chicagotribune.com/news/nationworld/chi-0208100181aug10.story?col
l=chi%2Dnews%2Dhed

Bush drops protection on medical files

Plan lets doctors share patients' records without written consent

By Bob Kemper
Washington Bureau
Published August 10, 2002

WASHINGTON -- The Bush administration on Friday officially eliminated many
protections for the privacy of medical records by issuing final rules that
allow doctors and hospitals to distribute patients' health information
without the patients' written approval.

The new rules, the first comprehensive federal standards for medical
privacy, would affect virtually all patients, hospitals, drug stores, health
insurance companies and medical researchers in the country.










The rules would establish a series of new safeguards for medical records.
Doctors would be specifically prohibited from sharing medical information
with a patient's employer without written approval.

Patients would be allowed to inspect their records and correct mistakes.
They also would be able to find out who has looked at their records and seek
punishment of those who misuse the information.

But in a reversal of regulations proposed by former President Bill Clinton,
Bush would allow doctors and hospitals to share patients' medical
information with insurance companies, health maintenance organizations and,
in some circumstances, marketing companies, without patients' prior
approval.

The Bush plan does retain a Clinton-era change that would allow
law-enforcement agencies access to patients' records without patients'
permission. Civil liberties groups have sharply criticized the provision.

In unveiling the final rules, Health and Human Services Secretary Tommy
Thompson called them a "common-sense balance" between patients' desire for
privacy and the need for doctors, insurance companies and other health-care
professionals to share information necessary for treatment and payment.

The Clinton-era regulations would have increased paperwork, slowed treatment
and "forced sick or injured patients to run all around town getting
signatures before they could get care or medicine," Thompson said.

For instance, the Clinton rules, which Bush effectively blocked from taking
effect, would have required patients to keep a signature card on file at
their pharmacy to have prescriptions filled.

Under the new regulations, doctors and other health-care providers would
have to notify patients of their privacy policies, but they would not be
required to secure the patients' signature acknowledging awareness of the
policy.

Privacy advocates and congressional Democrats denounced the administration's
rule changes as an invasion of patient privacy. Activists said a legal
challenge could be mounted to block the rules from taking effect in the
spring.

"This is very bad news," said Richard Sobel, a senior research associate at
Harvard Medical School. "It's very short-sighted."

Sobel and others charged that the administration was caving in to political
pressure from the medical and insurance lobbies that had tried without
success to eliminate the privacy provision during the Clinton
administration.

"This is yet another example of the Bush administration favoring the
interests of powerful corporations over those of ordinary Americans," said
Sen. Edward Kennedy (D-Mass.), chairman of the Senate Health, Education,
Labor and Pensions Committee.

`A serious setback'

"These regulations are a serious setback for medical privacy," Kennedy said.
"Action by Congress is clearly needed to guarantee all Americans that the
privacy of their medical records will not be abused."

The rule changes do not require congressional approval, but Kennedy could
try to restrict the provisions through separate legislation.

Groups representing the medical and insurance industries hailed the rule
changes as a victory for patients, saying they would help reduce the costs
of health care by eliminating excessive paperwork while speeding up
treatment.

"We think they have really removed a barrier to getting health care," said
Mary Grealy, president of the Healthcare Leadership Council, a consortium of
hospitals, drug companies and HMOs.

"For the health-care industry, they've made the rule much more manageable
than it was before," she said.

The American Association of Health Plans said in a statement that the more
restrictive Clinton-era rules would have undercut patient care by "unduly
restricting the flow of vital health information between physicians,
hospitals and health plans."

The group, the nation's largest association of HMOs and other health-care
organizations, called the Bush plan "a balanced, workable approach that
protects the privacy of patients without undermining their health care."

The Bush administration first announced its intention to change the rules in
March. It collected 11,000 public comments on the rules, though critics
charge that the administration cut the comment period short and virtually
ignored any criticisms of the changes.

The final rules the administration unveiled Friday appeared virtually
unchanged from what it proposed in March, according to advocates on both
sides of the issue who were scrambling late Friday to interpret the
regulations.

The rules state that a doctor or hospital must get written permission before
releasing "protected information" for "marketing activities." But it makes
an exception if the marketing company only wishes to provide a patient with
"a promotional gift of nominal value," such as unsolicited pamphlets about
treatments or samples of drugs related to whatever illness the patient
suffers.

Critics charge that allowing marketers such access could stigmatize patients
by revealing their sensitive medical conditions to neighbors, co-workers or
other outsiders. A 59-year-old Florida woman with a history of depression
recently initiated a class-action lawsuit against drugmaker Eli Lilly and
three doctors after she received in the mail a free one-month sample of the
anti-depression medication Prozac and a note congratulating her on being on
her way to "full recovery."

Effective dates

The rule changes take effect Aug. 14, 2003, for patients covered by large
health plans. Smaller health plans would have until Aug. 14, 2004, to meet
the new regulations.

The debate over privacy regulations dates back to 1996 when Congress
proposed making them part of the Health Insurance Portability and
Accountability Act. Congress set a three-year deadline to enact the
provisions, but failed to meet it. The job was then given to Clinton's
Department of Health and Human Services, which released its rules in
December 2000, Clinton's last month in office.

Those rules would have taken effect last spring, but the Bush White House
put them on hold for a year until it could consider the changes it wanted to
make.


Copyright C 2002, Chicago Tribune


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