Re: CPT's March 1 Recommendations on S. 1360 Changes

[Lewis Lorton <llorton@jobe.shell.portal.com>]

  >2.   Sec. 203, Authorizations for Disclosure of Protected
  >     Information.
  
  >     We believe that it is important to protect persons from
  >request for consent to disclose records when coercion is present. 
  
  >     In the AHIMA meetings it was pretty clear that good lawyers
  >will devise clever consent forms that will undermine a patients
  >right to privacy.  To address this, we propose a new subsection
  >(e), which reads:
  >
  >     e) The Secretary, after notice and opportunity for public
  >     comment, shall adopt rules which prohibit or limit requests
  >     for consent for access to protected health care information
  >     for purposes of employment, acceptance to a school or
  >     university, or for other purposes for which a request for
  >     consent may involve undue coercion. 
  
  As I understand this (I am at a slight disadvantage because my first
  language is English) an employer might not have the right to know  a
  prospective employee's relevant health history.  - Ah yes - Mr Hinkley - we
  do have a post for a firearms instructor.
  
  
  >     Sec. 112 (c).  If a health care trustee purges identified
  >     records, the following procedure shall be followed to
  >     determined who will maintain the accounting for disclosure
  >     records:
  >
  >     (1)  If the original record proscribes a patient authorized
  >          custodian of the record, the accounting of disclosures
  >          of the record shall be sent to the custodian of the
  >          record,
  >
  >     (2)  If the record does not proscribe a patient authorized
  >          custodian of the record, the person who purges the
  >          record shall send the accounting for disclosure to the
  >          patient or to the person from whom the record was
  >          previously obtained.
  
  Doesn't  "proscribe" mean denounce?
  
  As I understand this addition, if a health information service receives
  500,000 records for dissemination to the various payors;  the service must
  then send 500,000 messages to the originator  saying "we sent them" and to
  whom.  Both the service and the originator must then keep the records of the
  transactions in a easily retrievable format - as opposed to the inexpensive
  tape storage currently used.  This would seem to multiply the current costs
  of maintaining transaction records.
  >
  >We also want a subsection (d) for statistical reports:
  >  
  >     Sec. 112 (d).  The Secretary shall proscribe for certain
  >     health information trustees annual  statistical reports on
  >     disclosures, which report the number of records that are
  >     accessed, the types of persons or entities who obtain
  >     access, the sections of the law under which access was
  >     obtained, and the purposes for which the information was
  >     used. The Secretary shall make  these reports available to
  >     the public.
  >
  >     Without these reports, the public will be largely in the
  >dark about the extent of non-consensual access to their medical
  >records by third parties.  The proposed language will help
  >further policy makers identify the major players who use medical
  >records.
  >
  
  I looked it up. "Proscribe" does mean denounce.
  Excessive subtlety defeats itself.  Perhaps you should get one of the
  "clever lawyers" referred to above to proof your text.
  
  The possible outcome of this study would show how many zillions (a technical
  term) of disclosures there are - and so few the reports of any problems.
  
  In deference to Gordon Cook, who was dismayed at my long signature, I will
  close as,
  
  Lewis Lorton
  
  private citizen
  defender of the weak
  fighter against injustice
  lover of chocolate cupcakes