Bush Administration Medical Privacy Rules Lack ‘Safeguards,’ Commentator Says
Recent Bush administration medical privacy rules have created a "deeply disturbing contradiction" that "clamped down" on how doctors practice but allowed "a tremendous loophole" that gives drug companies access to patient information for marketing purposes, according to a commentary by Dr. Marc Siegel, an associate professor of medicine at New York University that aired Friday on PBS' "NOW with Bill Moyers" (Siegel, "NOW with Bill Moyers," PBS, 12/20). In August, the Bush administration issued a final medical privacy rule, which applies to electronic but not paper medical records, that allows providers to share the records for the purposes of treatment and other "health care operations." Under the regulation, providers must obtain consent from patients before they can disclose medical records in "nonroutine" cases. However, providers do not have to obtain written consent before they disclose medical records, a provision included in an earlier version of the rule issued by the Clinton administration. Providers only have to inform patients of their new rights and make a "good faith effort" to obtain written acknowledgment from patients that they have received the information. In October, Reps. Howard Berman (D-Calif.), Michael Capuano (D-Mass.), John Dingell (D-Mich.), Ed Markey (D-Mass.) and Henry Waxman (D-Calif.) introduced a bill (HR 5646) that would restore the patient consent provisions. The legislation would require providers to inform patients when they receive payments from pharmaceutical companies to send unsolicited promotional materials and would place restrictions on the use and disclosure of medical records by companies regulated by the FDA (California Healthline, 8/23). According to Siegel, allowing pharmacies to sell patient prescription information to drug companies for advertising and marketing purposes constitutes an "invasion of patient privacy" and a "breakdown" that "violates the whole system." Siegel concludes that a "consistent" privacy policy that applies "across the board" to "all aspects" of the health care system is needed ("NOW with Bill Moyers," PBS, 12/20). A transcript of the commentary is available online. Video of the commentary is available online in RealPlayer. The program's Web site also includes a compilation of resources on HIPAA and HR 5646.
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