Monday, March 25, 2002

State of Hawaii

State to review
HMSA’s policy on
medical records

Doctors and the AMA say the
provision violates privacy rights

Star-Bulletin staff

The state Insurance Division will hear oral arguments April 16 on a petition asking it to declare that the Hawaii Medical Service Association lacks authority to look at physicians' personal health records.

Dr. Arleen Jouxson-Meyers, pediatrician and lawyer who heads the Hawaii Coalition for Health, and two other doctors filed the petition.

The conflict between HMSA and participating doctors received national attention when it was reported in the latest edition of the American Medical Association's newspaper, the American Medical News.

The AMA said in the article that it "opposes any contract to provide care that requires access to a physician's own medical records. The request is in direct violation of AMA policy regarding the privacy of a physician's personal records."

The policy states, "Our AMA opposes any attempt by hospitals, health maintenance organizations, managed care companies and other entities that contract with physicians to provide patient care, to require access to a physician's personal medical records as a criterion for participation."

The controversy between HMSA, the state's largest medical provider, and its contracted doctors ignited last fall when a re-accreditation form included a provision giving HMSA access to the doctors' personal medical records.

After an outcry by doctors, HMSA revised the form last month to provide for a two-step process.

To be re-accredited as a participating physician with the carrier, they must sign the first form, which authorizes HMSA to ask to look at their medical records if it feels it is necessary.

Doctors who refuse to sign the form will not have their credentials renewed to participate with HMSA. If they sign it, then refuse to let HMSA look at their medical records if asked, they lose their credentials.

HMSA officials told the Star-Bulletin last month that they would have to ask permission twice before they could gain access to a doctor's personal records, and they would only do it if information was uncovered about a physical or mental condition that might affect patient care.

In such cases a committee of physicians would decide if it was necessary to review the doctor's health records, HMSA said.

Meyers and other doctors said the disputed provision violates patients' rights and that there are regulatory agencies to handle complaints about inappropriate behavior by doctors.

The Coalition for Health advocates for patients in health-care matters and is trying to return health-care decision-making from insurance companies to medical professionals and consumers.

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