Are Your Health Records an Open Book?
The right to privacy is a bedrock of the
American value system. Unfortunately when it comes to one's medical records,
there are many concerns and questions about how far that privacy really
extends. Ask yourself the following questions: Who has access to my medical
records? Does the information stay in my doctor's office? Does my information
stay in my insurance company's files? Do insurance companies share health
information with each other? Do you know the answers? Here are some things you
should know:
- Patients share sensitive information
with their medical providers such as: family history, physical conditions,
personal habits, mental state, and the types of medications they are
taking.
- Currently, the health information you
provide your doctor doesn't necessarily stay in the office. It may be shared
for many reasons (for treatment purposes, to process claims, or measure
outcomes and fight disease) and with many people (other doctors and hospitals,
pharmacies, insurance companies, schools, employers, data clearinghouses,
pharmaceutical companies, and even marketers).
- Under mandatory reporting
requirements, a health care provider may be legally obligated to report a birth
defect or positive test for HIV to public health officials.
- Because many employers provide health
care coverage to employees and their families, employers often have access to
your personal health information.
- Medical information is shared between
companies. A health data clearinghouse collects medical information from
numerous insurance companies and makes it available to member carriers in order
to identify such things as pre-existing conditions, duplicate coverage and
over-utilization.
- Information you provide for "surveys,"
health screenings, and at health fairs may be given to pharmaceutical
companies. In turn, they may use the information for direct marketing of their
product.
- Each day there are new advances in
transmitting and storing health information in an electronic format. There are
online pharmacies that provide prescription services, doctors can
electronically communicate with others in the field and can transmit lab
results and even x-rays. As more information is collected and maintained in an
electronic format, it becomes easier to share the information with others for a
variety of purposes.
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Other
Resources
This is just a brief overview. For more
information on privacy issues check out these resources on the
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The Health Insurance Portability and
Accountability Act
Consumers should be concerned that
they could lose control over their health information, the information
could be given to others without their consent, or the information
may even be used against them. Recent regulation, the
Health Insurance Portability and Accountability Act (HIPAA), now affords
consumers new privacy protections.
The regulation
applies only to specific "entities." Covered entities include health
plans (HMOs, health insurers, group health plans), health care clearinghouses,
and certain health care providers (those who conduct certain financial
and administrative transactions electronically). It covers "protected
health information" in any form that is created or received by a
covered entity. There are a number of elements that must be met
before the information is protected by the regulation.
- Protected information is defined
as any oral or recorded information relating to the physical or
mental health of an individual, the provision of health care to
the individual, or the payment for health care.
- The health information must be individually
identifiable (name, social security number, medical record number,
or address).
- The information must be created
or received by a "covered entity."
Know your rights:
- Individuals have a right to see
and obtain a copy of their health information, including documentation
pertaining to whom the information has been disclosed - some fees
may apply for obtaining a copy of your records.
- Covered entities are required to
give patients a written explanation of how their health information
will be used and shared.
- A patient's written permission is
required for the use or disclosure of their health information.
- Employer access to one's health
information is limited. The regulation will help to ensure that
employers only have limited access to health information for purposes
of paying health insurance.
- Individuals are given the right
to request an entity to amend or supplement the information in
your health record. However, such requests can be denied if the
health record was not created by the covered entity or the record
is determined to be accurate and complete.
Myth: Family members or friends
will no longer be able to pick up prescriptions for others at the
pharmacy.
Fact: HIPAA explicitly provides
that this practice can continue.
Note: The new federal regulation
establishes a baseline of patient protections. However, there are
some states that offer additional protections. In this instance,
the stronger privacy protections will apply. |
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Protect Your
Medical Information and Ensure Its Accuracy
Know your rights and exercise them. Here
are some steps you should take to ensure the accuracy and privacy of your
medical information.
- Talk with your doctor about
confidentiality concerns. Discuss the uses of your health information and what
is required for insurance purposes.
- Read the fine print. Most
authorization forms contain clauses allowing information to be released. You
may be able to restrict some disclosures by revising the form. Hint:
Be sure to initial and date your revisions.
- Request a copy of your medical
records so you know what's in them.
- Register your objections to
disclosures that you consider inappropriate. Contact the specific entity
involved, state office, or the Department of Health and Human
Services.
- Be cautious when providing personal
information for "surveys," health screenings, or "sweepstakes" or on a health
web sites. Be sure to check their privacy policy, ask how the information will
be used and who will have access to it.
Note: Consumers will have the
right to file a formal complaint about violations to the regulation. Complaints
can be filed directly with the
Department of Health and Human Services. HIPAA does not allow individuals to
initiate legal action. However, file a complaint with the appropriate offices
and consult an attorney since violations may be grounds for state legal actions
(see the Consumer Action Handbook for
tips on obtaining legal help).
** The regulation was announced on
April 14, 2001 but covered entities do not have to meet these requirements
until April 14, 2003. |
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