April, 1999
NASW is in coalition with several provider and consumer groups advocating for strong medical privacy protection in the managed care industry. We are committed to the development and enactment of public policies and private standards that guarantee the confidentiality of personal health information and promote both access to high quality care and the continued viability of medical research. We believe that a federal medical privacy law must set a uniform floor rather than a ceiling that would maintain the right of states to enact stronger medical privacy protections to address the needs of their residents once a federal law is passed.
Privacy protections of medical records must apply to those collecting, transmitting and analyzing health data including payers, providers, health plans, researchers, administrators, benefit consultants, drugstore chains, pharmacy benefit managers, marketing companies, vendors, and employers especially those self-insured employers who actually own the right to their employees complete medical record.
The Supreme Court’s 1996 Jaffee v. Redmond, 116 S.Ct. 1923, decision recognized the importance of "the atmosphere of confidence and trust" between health care providers and patients. The Court ruled that "the mere possibility of disclosures of confidential communications may impede the development of the relationship necessary for successful treatment." We want to insure that any new legislation recognizes the privilege granted to psychotherapy records as a result of Jaffee v. Redmond.
Congress recognized the need to act on protecting identifiable health information, when they included in the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L. 104-191) provisions requiring the Department of Health and Human Services (HHS) to submit recommendations on privacy standards by August 1997. HIPAA also stated that if Congress failed to act pass legislation protecting identifiable health information within 36 months from the date of enactment of HIPAA, that HHS would be required to promulgate final regulations. Congress has until August 21, 1999 to pass a health data confidentiality law. If it misses this deadline, HHS Secretary Shalala is required to issue health privacy regulations by January 2000. Those rules will apply to all entities that transfer data electronically.
Rep. Michael Bilirakis (R – FL). 19 cosponsors.
To provide new patient protections under group health plans. House Leadership Bill would repeal important medical records privacy provisions of current State law. This bill would preempt existing State laws. Currently thirty-two States have passed medical records privacy laws. Health plans and providers of health services could disclose medical records for very broadly defined "health care operations" purposes to any other plan or provider, including those who are not treating the particular patient. This bill does not set limitations on subsequent redisclosures. i.e. to mortgage bankers, newspapers, etc. and provides no safeguards for disclosure to employers and pharmacies.
Sen. James M. Jeffords (R-VT) and Sen. Christopher Dodd (D-CT).
Requires patient consent prior to disclosure of any medical information that identifies an individual. Employers, health plans, physicians and others having personal health information are required to safeguard the information. It would impose stiff criminal and civil penalties for unauthorized disclosure. Limits use of disclosed information to the purpose, for which it was disclosed, prohibits passing it on to others. Exceptions for disclosure to patient consent requirements for emergency circumstances when disclosure would protect the patient from harm or when information is needed for an investigation of health care fraud. Allows grandfathering of existing state laws pertaining to medical-records-privacy as long as the state’s law was at least as stringent as the federal law. Imposes an 18-month deadline from the date of the bill’s enactment for states to adopt stronger laws. After the 18-month period, the floor sunsets and federal preemptive ceiling comes into effect. Would allow patients to self-pay following denial of coverage. Privately funded research conducted outside the auspices of the FDA would not be subject to internal review board (IRB) approval.
Sen. Patrick J.Leahy (D-VT) and Sen. Edward M. Kennedy (D-MA), Sen. Thomas A. Daschle (D-SD), Sen. Byron L. Dorgon (D-ND).
Provides individuals with access to health information of which they are a subject, ensures personal privacy with respect to health-care-related information, imposes criminal and civil penalties for unauthorized use of protected health information. Provides for the strong enforcement of these rights. Protects States’ rights. Limits use of disclosed information to the purpose, for which it was disclosed, prohibits passing it on to others. Sets a permanent floor. Allows grandfathering of existing state laws pertaining to medical-records-privacy as long as the state’s law was at least as stringent as the federal law. Would extent current regulations to privately funded research. Therefore, all research would be subject to IRB approval.
We support this bill because it offers the best protections for health and mental health practitioners and consumers.
Rep. Edward J. Markey (D-MA) 21
co-sponsors
Companion bill to S.573
We support this bill because it offers the best protections for health and mental health practitioners and consumers.
Staff Contact: Pat Gorman, Government Relations Associate, Division of Professional Development and Advocacy, 202-336-8336.