WASHINGTON (Reuters Health) Mar 21 - Healthcare providers and insurers would not have to receive written consent about privacy policies before providing or paying for care under proposed changes to medical records confidentiality rules unveiled Thursday.
US Health and Human Services Secretary Tommy Thompson said that the changes, which will be subject to a 30-day public comment period "will allow us to deliver strong protections for personal medical information while improving access to care."
Healthcare provider groups had complained that the rules, initially proposed by the Clinton administration in December 2000, included provisions, particularly the consent requirement, that were unworkable. Thompson allowed the rules to take effect as scheduled last April, but said at the time that the department would be proposing changes. Most entities do not have to be in full compliance with the rules until April 2003.
The consent provision was by far the most contentious. Physician, hospital, and insurance groups complained that the need to obtain advance consent could make it impossible for patients to send family members to pick up prescriptions at a pharmacy, or for physicians to consult with specialists.
The change, which still requires that patients be informed of their privacy rights, "have really made it much more workable and will help avoid disruptions in patient care," said Mary Grealy, President of the Healthcare Leadership Council.
But privacy advocates, who strongly backed the prior consent requirement, are outraged that the Bush administration wants to drop it. "Proposing to eliminate it is a radical change and will undermine the entire purpose of the act," said Janlori Goldman of the Georgetown University Health Privacy Project. If patients do not know what their privacy rights are, Goldman said, "how can they exercise them?"
Goldman, however, praised another proposed change that Grealy said her group is concerned about. The proposal would tighten the rules governing the use of medical information for marketing, by requiring specific permission before sending marketing materials. Grealy said that she wanted to review the specific language to ensure that change does not threaten the operation of "disease management" programs.
Other proposed changes would make it easier for parents to access their children's medical records, streamline requirements for researchers to obtain permission to use individuals' medical information, and provide a standardized form for hospitals and health plans to use to ensure their "business associates" comply with confidentiality requirements.
The changes are scheduled to be published in next Wednesday's Federal
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