Congress still wrangles with patient privacy
Deadline passes; delay is widespread
The Aug. 21 deadline for Congress to pass patient privacy legislation came and went without action — but the U.S. Department of Health and Human Services (HHS) has agreed to give Congress a little leeway before implementing its own plan.
The Health Insurance Portability and Accountability Act of 1996 required Congress to pass legislation by August or leave the regulatory job to HHS.
Both the Senate and the House of Represent-atives are working on bipartisan consensus bills in hopes of considering and passing legislation in September or October, according to committee staff members working on the bills.
Bob Stone, executive vice-president of Dia-betes Treatment Centers of America (DTCA) in Nashville, TN, has been carrying on a one-man lobbying effort. Stone’s mission is to persuade Congress that companies like his own, which he claims are legitimately engaged in disease management, should have unhampered access to patient information for the well-being of patients.
"As long as disease management is recognized as a legitimate activity of a health plan and its agents are entitled to access patient specific information for the purposes of disease management, we have no problem," he says.
Stone says there has never been a patient privacy complaint in DTCA’s experience with 130,000 diabetic patients. Yet legislators are concerned that health plans could provide confidential information about patients to the wrong people.
"There’s no question at all that a patient’s identifiable health status should not be released for commercial purposes." Stone says. "That sometimes happens and most inappropriately." He gives the example of a patient to receives a letter from an organization like DTCA inviting a patient for a support group or reminding him of an appointment for foot care or a retinopathy exam. "That’s totally different from a patient receiving a letter from a company that makes monitors soliciting business from a list they bought from a health care provider."
There are two major sticking points to the passage of bipartisan patient privacy legislation in the Senate, says Joe Carpinsky, communications director for the Senate’s Health, Education, and Labor Committee:
• the right of underage children to receive medical treatment without the knowledge of their parents;
• the right of a patient to directly sue a health plan.
While neither issue directly affects Stone’s concerns, Carpinsky says there is a great deal of behind-the-scenes maneuvering to resolve those issues and bring a bill to committee hearings and finally to the Senate floor.
Stone says he is very comfortable with the language in a bill introduced by Health, Education, and Labor Committee Chairman James Jeffords (R-VT). "We’ll definitely go to the August recess without taking this up," Carpinsky told Diabetes Management at press time. "But we’ll come back and address the issue again right after Labor Day."
House Speaker J. Dennis Hastert, (R-IL) has directed legislators to get to work on the issue in the House as well.
Congress is particularly sensitive about patient privacy because a failure to pass legislation would mean Congress would be relinquishing authority on the matter to HHS. Two years ago, HHS began drafting its own regulations. The proposed plan is far less stringent than any legislation that is under consideration in Congress.
HHS spokeswoman Laurie McHugh says the HHS is "not in a big hurry" and is not required to produce its proposed regulations until February. HHS will be involved in producing regulations with the assistance of legislation passed by Congress or not. Then there will be a period of public comment, so any patient privacy regulations probably won’t into effect for at least a year.
"I expect we will get this by October, if it passes at all," says Stone, who concedes it is possible Congress will be unable to come to an agreement on patient privacy.
[Contact Bob Stone at (615) 665-2760.]
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