Fw: Bush Accepts Rules to Guard Privacy of Medical Records

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From: " ilena rose " <ilena@...>

Sent: Friday, April 13, 2001 8:08 PM

Subject: Bush Accepts Rules to Guard Privacy of Medical Records

The New York Times

http://www.nytimes.com/2001/04/13/politics/13PRIV.html

April 13, 2001

Bush Accepts Rules to Guard Privacy of Medical Records

By ROBERT PEAR

WASHINGTON, April 12 ó President Bush announced today that sweeping

rules to protect the privacy of medical records would take effect on

Saturday.

But he said the rules, issued by President Bill Clinton, could later be

revised or clarified

to address " legitimate concerns " of the health care industry.

The rules establish the first comprehensive federal standards for medical

privacy. They

will affect virtually every doctor, patient, hospital, pharmacy and health

insurance plan

in the United States.

The Bush administration had considered delaying the rules to consider

objections from

the health care industry, which said the standards would impose costly

administrative

burdens. Instead, Mr. Bush decided that the rules would take effect on

schedule, but

he asked the secretary of health and human services, Tommy G. , to

suggest

" appropriate modifications " to ensure, for example, that parents can see

their children's

records.

Under the rules, Mr. Bush said, " patients will have full access to their

medical records

and more control over how their personal information will be used and

disclosed. "

The rules require doctors, hospitals and other health care providers to

obtain written

consent from patients before using or disclosing medical information for

even routine

purposes like treatment or the payment of claims. Patients would have a

federal right

to inspect and copy their records and could propose corrections. The rules

cover not

only paper records, but also computer files and even oral communications.

Consumer groups see the rules as a landmark in the history of American

medicine.

Many insurers, they say, have disclosed personal health information to

lenders,

employers or marketers without the patients' permission. As a result, they

say, people

have lost jobs and suffered other forms of discrimination, and some

patients are so

worried that they shun care or provide inaccurate information to doctors.

By allowing the rules to take effect, despite the administration's view

that some

provisions are unworkable, Mr. Bush avoided the criticism that surrounded

the

rollback of other Clinton administration policies. Those policies dealt

with arsenic in

drinking water, global warming and preventing repetitive- stress injuries

in the

workplace, among other issues.

In reversing such policies, Mr. Bush has run the political risk of

cementing an image of

his administration as one that favors business at the expense of consumers.

Last week, the administration hastily reversed course on a plan to end the

testing of

school lunch meat for the bacteria salmonella. Rather than suffer another

such incident,

Mr. Bush took a more nuanced approach today, embracing the popular cause of

medical privacy while opening the door to changes sought by the regulated

industry.

Mr. Bush's decision guarantees a new struggle over the details of the rules

and their

interpretation.

Today's decision was a victory for consumer groups and privacy advocates,

without

being an utter defeat for the health care industry and insurance companies,

which

strenuously opposed the rules.

Democrats, consumer groups and privacy advocates praised the Bush

administration.

Hospital executives and other health care providers said they were

profoundly

disappointed.

P. Swire, chief counselor for privacy in the Clinton White House,

said: " Today's

decision by President Bush sends a clear signal to industry that it's time

to stop the

delay and get to work protecting privacy. But there's a risk that possible

future

modification of the rules could turn into very large exceptions. "

Representative J. Markey, Democrat of Massachusetts, said the rules

represented " a huge step forward for the medical privacy rights of all

Americans. " His

tone echoed that of Mr. , who said, " The president considers this a

tremendous victory for American consumers. "

But P. Serota, president of the Blue Cross and Blue Shield

Association, said the

rules would create " an operational nightmare. "

Health care providers and insurers have two years to come into compliance.

After

April 14, 2003, a person who violates the rules will be subject to civil

and criminal

penalties, including a $250,000 fine and 10 years in prison for the most

egregious

violations.

One provision of the rules, the consent requirement, was particularly

troublesome for

pharmacists. They said it would be difficult to obtain written consent from

a patient

whose doctor phoned in a prescription that was picked up by a neighbor or a

relative.

Secretary said the government would make clear, through guidelines

or

changes in the rules, that pharmacists can " fill prescriptions over the

phone and serve

their customers in a timely manner. "

In addition, Mr. said, the government will make clear that parents

have

" access to information about the health and well-being of their children,

including

information about mental health, substance abuse or abortion. "

The American Civil Liberties Union welcomed today's " surprise decision, "

but said it

saw " ominous signs " that the administration might weaken the rules.

Weiss,

director of the union's reproductive freedom project, said, " The law has

long allowed

minors to obtain confidential health care services in such areas as mental

health,

substance abuse or abortion. " Without such protections, she said, minors

will not

receive the care they need.

In the last month, Mr. expressed concern that the rules could

impose a

" tremendous burden " and cost on health care providers. At a news conference

just

three days ago, he said the effective date of the rules would probably be

delayed.

In an interview today, Mr. said: " I have not changed my opinion

with

regard to the need for changes. There has to be some fix-up of the rules to

inject a

greater degree of common sense. "

The A.C.L.U. and the American Psychoanalytic Association had threatened to

sue the

government if it delayed the rules.

C. Pyles, a health care lawyer who had already drafted the complaint

for such a

lawsuit, said: " The Bush administration was vulnerable legally and

politically if it

blocked the privacy rules. The rules were mandated by statute, and the

administration

could not ignore an unequivocal directive from Congress, which said the

rules should

have been issued by Feb. 21, 2000. "

Under the rules, hospitals and other health care providers can disclose no

more than

the minimum amount of information necessary to accomplish a specific

purpose.

Hospital executives said a strict reading of this standard could harm

patients by limiting

the free flow of information among people who care for patients.

Mr. said the government would address this concern. " Doctors and

hospitals will have access to necessary medical information about a patient

they are

treating, and they will be able to consult with other physicians and

specialists regarding

a patient's care, " he said.

Related Sites:

April 8, 2001

White House Plans to Revise New Medical Privacy Rules

http://www.nytimes.com/2001/04/08/politics/08PRIV.html

November 5, 2000

Clinton Vetoes a Bill on Protecting Secrets

http://www.nytimes.com/2000/11/05/politics/05PRIV.html

White House Politics

http://www.nytimes.com/library/politics/whouse/index-whouse.html

Copyright 2001 New York Times