Bush allows new medical-privacy regulations to go into effect

Friday, April 13, 2001

The Bush administration stunned the health care industry and some press advocates with an announcement yesterday that it would immediately implement sweeping new rules that would give patients the right to guard the privacy of their medical records.

Health Secretary Tommy Thompson had put the rules on hold last February sparking hope among journalists and some health care groups that they might have another chance to persuade federal officials to revise the regulations. Journalists contend the rules would restrict their access to vital records, such as patient condition and various emergency logs, that they use for reporting daily events.

“We think hospitals are going to read the rules as (meaning) you shouldn’t give any of the records to anyone under any circumstances,” said Ian Marquand, who follows freedom-of-information issues for the Society of Professional Journalists.

Some health care groups also believe the rules may harm their operations. Medical researchers say the regulations may make it harder for them to use patient information in studies, the Associated Press reported. Insurers also say they need access to patient records in deciding coverage.

But privacy advocates, such as the American Civil Liberties Union and Health Privacy Project, cheered the surprise announcement, saying it puts in place the first federal rules to allow patients to protect some of their most personal information.

The guidelines take effect tomorrow, but the health care industry has two years to comply with the rules, the AP reported.

The U.S. Department of Health and Human Services unveiled the final version of the Health Insurance Portability and Accountability Act in December. The rules were designed to protect patients’ privacy by improving patients’ access to their medical records; narrowing instances where such information may be released to other physicians, health care providers or researchers; and requiring written authorization for use and disclosure of health information for other purposes.

But the Clinton administration apparently failed to formally submit the new regulations to Congress as required by law when they were finalized Dec. 28. As a result, the regulations, which originally were to go into effect on Feb. 26, were delayed.

Thompson opted to reopen the rule-making process, allowing public comment to continue through March 30. Yesterday, he announced that the administration would implement the rules and make revisions over the next year.

“We have laws in this country to protect the personal information contained in bank, credit card and other financial records,” Thompson said in a statement. “Our citizens must not wait any longer for protection of the most personal of all information — their health records.”

The final regulation provides privacy protection for all personal medical information, whether collected in oral, paper or electronic form. They also require patients’ consent for release of any of their medical records, even those for routine purposes.

Penalties for the unauthorized release of such information can reach as high as $250,000 and 10 years in jail for each violation. The rules offer some waivers for law enforcement officials conducting investigations.

But the rules don’t offer any concessions to journalists who worry that routine medical sources might dry up. They say such rules might also hinder medical reporters who routinely visit hospitals and clinics to follow doctors and nurses on their rounds or who use health records to reveal the workings of the medical profession.

Marquand of SPJ says journalists don’t oppose most of the news rules and understand the need to protect personal medical privacy. But he says he fears that hospitals won’t give reporters access to vital information during emergencies or when public officials check into a hospital.

“It’s possible it may not be played out as we expect,” he said. “But our experience shows that whenever a department or organization might be punished for releasing some records, they won’t release anything.”

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