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Protecting Americans' Medical Privacy:
Why Congress Must Act or Be Acted Upon

Did you know that if Congress does not pass a medical privacy law by next year, the Secretary of Health and Human Services (HHS) will establish regulations governing your medical records within the following six months?

This deadline was imposed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), also known as the Kennedy-Kassebaum health insurance reform. The law puts pressure on Congress to act, or be acted upon, to protect the confidentiality of Americans' medical records. Specifically, if Congress does not act by August 21, 1999, HIPAA requires the HHS Secretary to issue regulations, which must be finalized by February 21, 2000.

Who's Reading Your Medical Records?

Hundreds of individuals and organizations have access to your medical records now, whether you know it or not. The Congressional Research Service reports that according to one 1996 estimate, during the course of a hospital stay, as many as 400 people may see at least part of a patient's medical record. Records are accessed every day to help researchers examine the outcomes of medical procedures, assist actuaries in determining the price of health insurance, and provide lawyers with information for medical malpractice cases.

Medical information is also commonly bought and sold. The National Research Council (NRC) estimates that the health care industry spent between $10 billion to $15 billion on health care information technology in 1996. The NRC reports that people and entities likely to gain access to medical records include:

  • health insurance companies
  • life insurance companies
  • self-insured employers
  • employers' clinics and wellness programs
  • state bureaus of vital statistics
  • the Medical Information Bureau
  • lawyers in malpractice cases
  • consulting physicians
  • managed care organizations
  • clinical laboratories
  • pharmacies and their benefits managers
  • hospital-accrediting organizations
  • health care researchers
  • law enforcement agencies

Should Congress Override State Privacy Laws?

Today a patchwork of state laws protects patients' medical records. A 1997 survey prepared by Lawrence Gostin, professor of law at Georgetown University, and his colleagues [http://www.epic.org/privacy/medical/cdc_survey.html] found that:
  • 37 states require physicians to maintain the confidentiality of medical records;
  • 26 states extend this duty to other health care providers;
  • 33 states and territories require health care institutions to maintain the confidentiality of medical records they hold; and
  • 4 states have specific legislation requiring insurers to maintain the confidentiality of medical records

However, if recent activity is any indication, Congress is likely to try to override these laws. The Republican's Patient Protection Act (H.R. 4250), which passed the House but was never enacted into law, would have done just that. The act would have permitted the collection, exchange, and distribution of personal medical information. True, its use would have been limited to health care providers and administrators engaged in "health care operations," but that vague term includes everything from monitoring people's health to auditing health insurance records.

Whether or not Congress will act, or be acted upon, to protect your medical privacy remains uncertain. But one thing is certain: Your medical records are currently available to many individuals and organizations. These private and government entities have strong financial interests in maintaining access to your medical records.

If you care about your medical privacy, be sure to voice your opinion well before August 21, 1999. Watch your medical privacy, or the federal government will do it for you!

This article was originally published in the November/December 1998 issue of Health Freedom Watch.

 
Hundreds of individuals and organizations have access to your medical records now, whether you know it or not. The Congressional Research Service reports that according to one 1996 estimate, during the course of a hospital stay, as many as 400 people may see at least part of a patient's medical record.