HIPAA Privacy Rules Protect Patients but Raise Confusion
Rosenblatt, Robert A., Aging Today
The United States is in the first stages of a privacy revolution in the field of healthcare. Patients are starting to learn about new rights they gained on April 14, when a long-awaited set of federal regulations aimed at securing their privacy became the rule.
Every person who goes to a doctor's office, visits a pharmacy or is admitted to a hospital is now being given new weapons to help protect personal information from flowing without control into distant computers. The new rules provide patients with the unquestioned right to see their complete medical records, and the regulations limit the ability of healthcare providers-doctors, hospitals, pharmacists-to disburse that information. The notices of privacy standards will be handed to every patient and will be posted in all doctors' offices and hospitals.
Residents of 20 states already enjoyed strong protections under state privacy codes, but those in 30 states did not. The new rules, the "Standards for Privacy of Individually Identifiable Health Information" were implemented as part of the 1996 Health Insurance Portability and Accountability Act (HIPAA), and the rights that they safeguard now apply universally to all in the United States.
The standards set by the government carry tough penalties for violation, including fines up to $250,000 and 10 years in prison for profit from disclosing this information. The Office for Civil Rights at the U.S. Department of Health and Human Services (HHS) is charged with investigating complaints. The rules on privacy were first prepared by HHS under the Clinton Administration, then revised by the current Bush Administration.
Some of the major changes in the regulations are:
* Patients can get their complete medical records on request, with a maximum copying fee of 50 cents a page. They can no longer be charged the clerical cost of searching for and extracting information from medical files. For the first time, patients can make additions or amendments to the contents of their records. "If you think something is inaccurate, you can have it corrected," said Thomas Wilder, counsel for the American Association of Health Plans, which represents the HMO industry. If the doctor or hospital disagrees and refuses to make the change, patients can insist on having their statement added to the file.
* Sign-in sheets at doctors' offices will no longer have a space where the individual indicates the purpose of the visit. This is aimed at preventing inadvertent disclosure of information to other patients.
* Patients can ask for a full accounting of how their records were distributed by doctors, hospitals, health plans or pharmacists for the past six years. Who was given the information and for what purpose? Was information about their deseases given to midical researcher? If a patient is obese, was his name sold to companies offering weight-loss classes, or, perhaps, medications? Did a health plan inform a company that certain employees had amassed medical bills exceeding $10,000 in a given year? Which public health agencies were notified that a has a sexually transmitted disease?
With HIPAA in effect, it becomes much harder for the news to find out what is happening with hospital patients. Previously, reporters could call say, "I heard there was an accident at 5th and Main, and four people were rushed by ambulance to the hospital. Who are they, and what is the condition?" The hospital can no longer release the names of the patients and the general nature of their injuries. The Society for Professional Journalists argued unsuccessfully for exceptions that would recognize the media's role in informing communities under certain circumstances. With the new rules, patients or family members speaking on their behalf can opt out of the hospital directory and ask that no information be disclosed. Even if the patient agrees to be listed, the hospital will issue only a one-word statement of condition, such as undetermined, critical, serious, fair, good or deceased. …