Privacy

POSTED BY: rue
UPDATED: Thursday, October 4, 2007 21:55
VIEWED: 762
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RUE

Thursday, October 4, 2007 8:40 PM

"Yes, the Notice of Privacy Practices says you can request information not to be released -- but it also says that the health-care provider and related businesses may deny your request for any reason or no reason. You might be thinking, at this point, well I just won't sign that anymore, but alas, it wouldn't matter in the least. Your signature does not mean that you agree to allow the disclosures described in the notice, but only that you have been informed of them."

Privacy Form Delivers Precious Little Protection to Citizens

You know the drill -- you appear for a first visit at a doctor's office or treatment clinic and among the routine papers for your signature is a Notice of Privacy Practices that explains the federal privacy standards set by HIPAA. You sign that too and all is well... or is it? In fact, the paper you have just signed notifies you that your right to privacy concerning even your most personal health issues no longer exists.

A common misperception is that the "P" in HIPAA stands for privacy. Actually, though the "Health Insurance Portability and Accountability Act" was initially intended to help consumers obtain continual health insurance coverage after leaving a job, despite certain preexisting medical conditions, as well as provide standards for electronic transmission of health-care information. Protecting the individual right to privacy in passing those records along was a secondary concern -- though an important one. The regulations to protect patient privacy put a burden on health-care providers and insurance companies -- particularly as the nation moves toward development of a national health information system. Addressing those concerns ("administrative simplification" as it was called by Congress) resulted in a complicated and ultimately ineffectual law that, on the one hand, recognizes and protects an individual's right to privacy with regard to health information -- but, on the other hand, fails to delineate those privacy rights that individuals should have. All this was explained to me by James C. Pyles, a Washington, DC, attorney who specializes in health privacy issues and legal issues associated with HIPAA. "I find this ironic, in that the original intent of HIPAA was to protect consumer rights," he told me.

Obviously doctors and other health-care providers need to be able to disclose information about diagnosis and treatments to insurance companies to the extent it is necessary for reimbursement -- that's not the issue. Rather, the problem is, the way HIPAA now reads makes it acceptable for doctors and insurance companies to use and disclose personal health information in identifiable form for routine purposes defined as treatment, payment or health-care operations -- terms that are so broadly defined, says Pyles, that the "least imaginative insurance company can justify nearly any disclosure in any situation, even if the patient wishes to pay privately." This right to disclose also extends to all business associates of insurance companies and physicians, with no requirement of an audit trail to keep records of these uses and disclosures.

WHY IT DOESN'T WORK TO JUST SAY NO

Yes, the Notice of Privacy Practices says you can request information not to be released -- but it also says that the health-care provider and related businesses may deny your request for any reason or no reason. You might be thinking, at this point, well I just won't sign that anymore, but alas, it wouldn't matter in the least. Your signature does not mean that you agree to allow the disclosures described in the notice, but only that you have been informed of them.

Pyles told me that the principal groups that supported the amended HIPAA Privacy Rule were the insurance companies and the American Hospital Association (AHA), which makes it easier for them to conduct business. In contrast, numerous medical associations, practitioners and consumer groups as well as Attorneys General of New York, California and Vermont protested how wrong it is to eliminate right of consent.

WORKIN

LEADB

Thursday, October 4, 2007 9:08 PM

Yep, when that crossed my plate I made all sorts of modifications to the form I was given, then I signed it. The receptionist looked at me a bit funny, but I did get in that day, and subsequent. However, as the above indicates, the thing is merely telling you 'how it is'; most of my modifications had to do with what I would do if they did what I didn't want them to do, and telling them what I wanted them to do instead. Probably didn't help any, but at least I was on record to objecting.

FLETCH2

Thursday, October 4, 2007 9:55 PM

I actually read one that said that the hospital could use my data in marketing and clinical studies. Don't know if that was standard but like LeadB I explicity edited that out and initialed the changes before submitting it.