JAMA Editor Discusses Implications of HIPAA Privacy Regulations

In an article in today's issue of the Journal of the American Medical Association, the journal's "Health Law and Ethics" Section Editor Lawrence Gostin analyzes the HIPAA privacy regulations and discusses their implications for the health care industry, as well as notes controversial provisions and potential problems that may arise in application of the rules. Gostin also indicates which provisions may be affected by forthcoming guidelines or revisions expected to be issued by HHS. For example, Gostin briefly explains the meaning of the minimum disclosure standard, which limits health information disclosure to the minimum necessary to achieve the purposes of the use or disclosure. He states that the standard is "justified for many disclosure purposes, such as reimbursement," but that it "could be harmful" if it prevented health care professionals from having all the information required for treatment. Gostin also writes that, "confusingly," the standard applies to "information used for treatment, but not to information disclosed for treatment," and may therefore have the "unintended effect of restricting full communication" among providers in the course of treating patients. Finally, Gostin states, "Future guidance should make clear" that providers "should always have the complete medical record when caring for patients." Gostin concludes that health information privacy will continue to be the subject of "ongoing, and divisive, political debate," but he says that "beyond these legitimate concerns lies the important reality that the United States has adopted the first national health information privacy standard in its history" (Gostin, JAMA, 6/20).