In an abrupt turnabout that goes to the heart of medical privacy in the U.S., the Bush Administration has proposed significant changes to the Health Insurance Portability and Accountability Act's privacy rule, issued in December 2000 by the Clinton Administration.
The changes announced Thursday by Health and Human Services Secretary Tommy Thompson would eliminate the requirement that healthcare providers obtain patient consent before disclosing medical information for the purpose of treatment, reimbursement, or healthcare operations.
Thompson said the proposals would ensure adequate patient privacy protections while eliminating potential pitfalls in the HIPAA privacy rule that could make it difficult for patients to obtain care quickly and easily.
In brief, the proposed changes would:
- Strengthen notice provisions and remove consent requirements hindering access to care. Rather than having to sign a consent form to disclose medical information prior to receiving care, patients would be asked to sign a disclosure acknowledging that personal healthcare information would be released in order to provide care. The patient's signature would not be required prior to treatment. Similarly, the proposal would ensure that prescriptions could be called in or picked up by a friend or relative of the patient without prior patient authorization.
- Maintain the "minimum necessary" rule while allowing treatment-related conversations. While healthcare providers would still be required to disclose the minimum amount of healthcare information needed to provide care, providers would be able to discuss a patient's care freely without fear of violation, HHS said.
- Ensure parental access to their children's records. Potentially the most controversial measure, this proposal clarifies that state law governs parental access to medical records. Civil libertarians have argued that parental disclosure laws in some states could, for example, prevent teens from obtaining safe abortions.
- Ease patient-marketing prohibitions to enable physicians to communicate freely with patients. While patient marketing efforts would still require patient consent, healthcare providers would be free to discuss disease management programs, for example.
- Simplify HIPAA's paperwork requirements in order to avoid impeding medical research, provide more time for covered entities to revise business contracts, and simplify the authorization process to permit the use of a single patient form.
The new rules represent a sea change from the strict privacy standards shaped by the Clinton Administration. The proposals will be published in the Federal Register on March 27, with a 30-day comment period. More information is available at the HHS Web site.
By AuntMinnie.com staff writersMarch 22, 2002
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