Advocates laud medical Hawaii health insurers, advocates and others concerned with protecting patients' medical information generally are pleased with the latest revisions to federal medical privacy regulations.
privacy law revisions
Federal law eliminates the need
for written consent for treatmentBy Helen Altonn
haltonn@starbulletin.comThe most significant change would be elimination of the need for written patient consent to allow use of protected health information for treatment, payment and health operations.
With the new features, the federal privacy regulations mirror the Hawaii medical privacy law that was repealed last year by the Legislature, said Richard S. Miller, University of Hawaii professor of law emeritus and Hawaii Coalition for Health consultant.
He believes parts of Hawaii's law were incorporated into the federal regulations, issued under the Health Insurance Portability and Accountability Act of 1996.
In drafting the state law, Miller had argued that it was "a shibai" to require patient consent for treatment, payment by a health insurer or health-care operations required by managed-care plans.
"I said we should put a big box around those things and say specific consent by a patient should not be required. On the other hand, information should be very carefully controlled."
Dr. Philip Hellreich, HMA legislative liaison and past president, said changes to the federal regulations eliminate most "Draconian features" that interfered with good practice of medicine.
But now there is a question whether the regulations are too lax about protecting patient confidentiality, he said, noting the American Medical Association is working with federal officials to tighten the law.
HMA had protested penalties in the state law for violating the privacy requirements, which Hellreich said "put physicians at risk."
The federal law also imposes penalties for violations, but "it's appropriate" with the changes, Hellreich said. "If you make an honest mistake, you're not going to be thrown in jail and pay $100,000."
The proposed changes were published March 21, and the U.S. Department of Health and Human Services is accepting comments for 30 days. The privacy regulations will take effect next April.
Moya T. Davenport Gray, Office of Information Practices director, said the federal regulations "still are fairly protective of privacy while ultimately reducing the cost of privacy, which is a real critical element."
She said removal from the federal regulations of the consent requirement, which Hawaii's law did not have, "allows for almost seamless medical treatment because one doctor doesn't have to make sure he or she has appropriate consents in writing before speaking to another doctor about treating the patient."
Although initial costs of implementation may be high, she said use of electronic technology ultimately will reduce personnel costs and issues. "There is a slow tsunami effect in business when you begin to convert from paper to electronic information."
Fred Fortin, Hawaii Medical Service Association vice president for policy and planning, said the new federal rules are much more detailed than the initial regulations and do not leave as many unanswered questions.
Kaiser Permanente still is analyzing the proposals, recognizing they may be changed again, said Phyllis Dendle, government relations director. But she said, "So far, we're happy with what we see."