Washington

On March 27, the Bush Administration proposed pivotal changes to a controversial medical privacy law.

While consumer advocates and Congressional Democrats say the changes would gut the 1996 Health Insurance Portability & Accountability Act, many in the health care industry are applauding the changes, saying that the revised law strikes a good balance between patients' privacy and patients' access to effective health care.

Written in response to more than 11,000 comments from health care industry stakeholders, the proposed changes attempt to apply “common sense revisions” to rules that forbid providers from releasing patients' medical information, according to Tommy Thompson, secretary of the U.S. Health and Human Services Department.

“For example, sick patients will not be forced to visit the pharmacy themselves to pick up prescriptions — and could send a family member or friend instead,” Thompson explained. And, “doctors will be able to consult with nurses and others involved in a patient's care to ensure that they get the best care.”

Specifically, the administration's proposed changes would:

• Remove a rule that requires providers to obtain a patient's consent before using or releasing a patient's medical information for any reason;
• Allow treatment-related conversations between doctors and other professionals involved in a patient's care, while limiting oral communications to the “minimum necessary” for treatment;
• Defer to state laws on issues involving parents' access to their children's medical records;
• Permit providers to communicate freely with patients about treatment options, while at the same time requiring providers to obtain a patient's consent before sending the patient any marketing materials;
• Reduce the number of consent forms necessary to comply with HIPAA; and
• Give providers a “sample” business associate contract, to make it easier and less costly for providers to implement required privacy agreements with business associates.

The first of these proposed changes is causing uproar among consumer health advocates, such as Janlori Goldman, director of the Health Privacy Project at Georgetown University in Washington.

“The most devastating blow to patient privacy is the proposal to eliminate the existing requirement that patients give their consent before health care providers use or disclose a patient's health care information,” she said. “A prior consent requirement is the best way to ensure that patients know how their health care information will be used or disclosed and know what their privacy rights are.”

Despite these concerns, many in the health care industry are encouraged by the proposed changes. The new privacy rule, “is a positive step toward eliminating regulatory burdens that impede effective and efficient patient care,” said Asela Cuervo, vice president of government relations for the Alexandria, Va.-based American Association for Homecare.

Still, some in the health care industry say the proposed changes do not go far enough to ensure that providers can give adequate care without fearing a lawsuit.

“While these modifications will substantially improve the overall rule on medical privacy, several concerns remain,” the Washington-based American Association of Health Plans said. “First, we urge the Administration to continue to work toward establishing uniformity so that confusion and inconsistency between the federal rule and the individual laws of 50 states do not complicate the ability to provide quality health care.”

Second, AAHP asked the president to lessen the financial and administrative burdens of HIPAA's April 14, 2003, deadline by implementing a transition schedule.

After publishing the proposed changes in the Federal Register on March 27, HHS for 30 days will accept public comments on the proposed changes.

To learn more about the privacy rule, go to www.hhs.gov/ocr/hipaa.

For breaking news, go to www.homecaremonday.com, the electronic news service of the home medical equipment industry.