Magazine article Clinical Psychiatry News

Final Federal Privacy Rule Disappoints APA. (May Discourage Care-Seeking)

Magazine article Clinical Psychiatry News

Final Federal Privacy Rule Disappoints APA. (May Discourage Care-Seeking)

Article excerpt

WASHINGTON -- The Department of Health and Human Services has released a final rule regarding the privacy of medical records, minus what psychiatrists say was its heart: a requirement for written patient consent for treatment and claims payment.

"Abolishing the prior-consent requirement regrettably will ensure that patients no longer have control over who has access to their medical records," American Psychiatric Association President Paul S. Appelbaum said in a statement. "Patients may be discouraged from revealing information to their physicians that is necessary for treatment."

The medical privacy rule is the culmination of many years' work by the Clinton and Bush administrations to implement patient protections stipulated in the Health Insurance Portability and Accountability Act of 1996. Physicians and other "covered entities," such as health plans, drugstores, and hospitals, must comply with the new rule when it goes into effect on April 14, 2003. The final rule was published in the Aug. 14, 2002, Federal Register. It is available online at

The rule has been through a number of revisions. The last one occurred in March, when HHS proposed removing the written patient consent requirement for treatment and payment. At the time, HHS cast its decision as an effort to increase patients' access to medical services.

Consumer rights groups joined psychiatrists in opposing the final rule. "Today's changes will undermine patient control over private medical information and further erode patient trust in the health care system," said a statement from the Washington, D.C.-based Consumer Coalition for Health Privacy.

Instead of seeking written patient consent for treatment, the final rule requires covered entities to provide patients with a notice of their rights and the privacy practices of the covered entity. That's inadequate, the consumer coalition said: "Notice alone does not provide a comparable opportunity for dialogue or understanding. …

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