MEDICAL PRIVACY: New Rules Proposed to Require Consent

      The Clinton administration said it will "beef up" protections to ensure the privacy of patients' medical records, setting comprehensive federal standards directing physicians, hospitals, pharmacists and insurance companies to limit the disclosure of their medical information, the New York Times reports. As electronic storage and transmission of medical records -- including patients' genetic information -- becomes more common, Americans have become increasingly concerned about their privacy. They worry that results from cancer, HIV and other disease testing could lead to insurance or employment discrimination. The original rules, proposed by the White House on Nov. 3, 1999, would have applied only to electronically transmitted or stored information, but the new rules, set to be issued before the Nov. 7 election, will also apply to paper records, the most common form of medical records. In addition, the new rules are likely to require patient signatures acknowledging the receipt of notices from health care providers and insurers that describe how their records may be used. The rules also will stipulate that doctors should seek patients' consent for the disclosure of their medical information. Administration officials say the new rules will limit medical information disclosure to the "minimum necessary" and grant patients the right to view their records -- preempting any weaker state laws. Anyone found in violation of these rules may be fined $50,000 and imprisoned for one year, and those who disclose information for financial or personal gain may face fines of $250,000 and 10 years in prison.

Going Too Far?
      The new rules are not likely to receive a warm reception from many in the health care industry. Opponents of last year's rules were numerous, as the Health Insurance Association of America and the Blue Cross and Blue Shield Association said the rules "went too far, exceeded the government's legal authority, were unworkable and would impose new costs on patients and employers, who pay for much of the nation's health care." The American Medical Association and the American Civil Liberties Union also opposed the old rules. However, the American Cancer Society praised last year's rules, stating, "We believe that the individual should retain the ultimate right to decide to whom, and under what circumstances, individually identifiable health information will be disclosed, even in cases of treatment, payment or health care operations" (Pear, 8/20).