MEDICAL RECORDS PRIVACY: Is Senate Bill ‘Doomed?’
Amid contentious debate over medical records privacy, the bill currently before the Senate Health, Education, Labor and Pensions Committee "has evolved into a measure that would allow insurers and employers continued access to sensitive medical information," and poses difficult questions regarding access to medical records -- including whether or not the bill would provide adequate protections for patients, and pre-empt state laws, the Los Angeles Times reports (Rubin, 6/20). With so many competing interests closing in on the legislation -- including insurance companies, health care businesses, law-enforcement officials and consumer advocates -- the measure proposed by Sen. Jim Jeffords (R-VT) is "dying under pressure" and "appears to be doomed," the New York Times reports. Although the bill stipulates that individuals must authorize disclosures of medical records, it also says that anyone with health insurance must "as a condition of enrollment in the health plan," authorize the disclosure of personal health information for "the vaguely defined purpose of 'health care operations.'" Opponents of the legislation, which has been yanked from committee four times just as it comes up for amendment or a vote, charge that the bill would strong-arm patients by threatening them with losing their health insurance. "The bill tends to erode confidentiality more than it guarantees confidentiality," said George Annas of the Boston University School of Public Health. "More people would be authorized to have access to your medical records than have access under current law," he said (New York Times, 6/21). Denise Nagel, executive director of the National Coalition for Patient Rights, said, "I had high hopes for this legislation. ... So I was really surprised that they came out pre-empting [future] state law" (Los Angeles Times, 6/20).
Under the bill, a health insurance company could craft one authorization form for patients to sign that would clear access to medical records for "treatment, payment and health care operations." The last "broadly defined" term could apply to "almost everything for which a health plan might want to use a patient's medical records," including tracking the behaviors of doctors, auditing claims and setting insurance rates. In trying to push the bill, Congress has run headlong into several questions, the Times reports:
- Should states be permitted to take the government's standards one step further and pass even stronger medical privacy legislation?
- Should the legislation provide greater protection for HIV, AIDS and genetic test results?
- Should parents have access to the medical records of their children? As it stands, the bill would allow the "rights of minor children [to be] exercised by a parent or by a child, as provided under state law. Abortion opponents back the provision; advocates of abortion rights take issue with the clause.
- Should patients be able to sue based on improperly disclosed medical records? Although the bill would establish a right to sue for "certain intentional violations of a patient's privacy rights, ... neither consumer advocates nor insurance companies like the proposed compromise" (New York Times, 6/21).