House Committee Revises Privacy Protection Language In Electronic Health Record Legislation

Main Category: IT / Internet / E-mail
Also Included In: Public Health
Article Date: 24 Jul 2008 - 10:00 PDT

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House Energy and Commerce Committee Chair John Dingell (D-Mich.) and ranking member Joe Barton (R-Texas) on Tuesday released a revised version of a bill (HR 6357) that aims to promote nationwide adoption of an electronic health record system, CongressDaily reports. According to CongressDaily, the lawmakers "substantially changed the information-sharing and privacy provisions of their proposal" following "concerns from stakeholders in the health care, high-tech and consumer advocacy arenas." The bill is scheduled for a full committee mark up on Wednesday (Noyes, CongressDaily, 7/22).

Under the revised bill, patients would give their consent only once to health care companies that want to access health care records without identifying information for HHS-approved purposes, such as hospital audits or fraud and abuse allegations. The bill previously would have required patient consent each time the records were accessed (Young, The Hill, 7/22). According to the revised bill, the patient consent provision would be implemented two years after the bill is enacted, and HHS would be required to develop "reasonable and workable" rules to implement the provision.

The original version of the bill also would have required health care providers to notify patients of any unauthorized acquisition, access or disclosure of their health care information. The revised version states that a "good faith" disclosure, such as a mislabeled letter with a wrong address, would not be considered a breach.

Other revised provisions in the bill would:

• Prohibit the sale of patients' records without consent unless it is necessary for treatment or to receive payment for treatment;
  
  
• Change existing federal privacy laws to allow for the provision of a no-cost digital copy of an individual's medical record;
  
  
• Strengthen language to ban direct and indirect payments to providers who advertise health care products to patients without permission; and
  
  
• Require the HHS Office of Civil Rights to launch a formal investigation of complaints and allow the office to impose fines for violations deemed "willful neglect" (Noyes, CongressDaily, 7/22).

Comments
House Energy and Commerce Subcommittee on Health ranking member Nathan Deal (R-Ga.) said the bill could advance on Wednesday. Deal said, "I think we worked out most of the big issues, barring amendments that come in and change that balance," adding, "Assuming the mark up goes fairly smoothly this week ... we probably would see it maybe even in the form of a suspension on the floor" (Armstrong, CQ Today, 7/22).

Mary Grealy, president of the Healthcare Leadership Council -- who on Monday sent a letter to Dingell and Barton stating her concerns about the proposed bill's effect on the Confidentiality Coalition -- said, "They did make improvements in those provisions we had some concerns about, so I do feel like we're making progress." However, she added, "Do I think they have completely addressed all the issues? No" (The Hill, 7/22).

A spokesperson for America's Health Insurance Plans said the provision that would allow patients to access their medical records and require them to provide consent for third-party access could restrict health care providers from developing wellness, disease management, quality assurance and other essential programs (CongressDaily, 7/22). A spokesperson for Patient Privacy Rights said the revised bill is being reviewed and declined comment (The Hill, 7/22).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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