OASIS

[Peter Marshall <techdiff@ix.netcom.com>]

> SUE BLEVINS: A threat to medical privacy
> 
> Copyright © 1999 Nando Media
> Copyright © 1999 Scripps Howard News Service
> 
> >From Time to Time: Nando's in-depth look at the 20th century
> 
> (November 21, 1999 4:00 a.m. EST http://www.nandotimes.com) - More than 8
> million Americans may soon find federal health nannies pouring over their
> most private medical records and, unless Congress says no, there is nothing
> they can do about it. Adding insult to injury, those who are most at risk
> are also the most vulnerable among us: the elderly, disabled and chronically
> ill patients.
> 
> The medical-privacy threat comes from a new data collection system being
> implemented by the federal Health Care Financing Administration (HCFA),
> which oversees the wide-ranging Medicare program. Called the Outcome and
> Assessment Information Set (OASIS), the new rules require patients receiving
> home health-care services to provide the government with detailed
> information about their medical conditions, financial situation and
> lifestyle. Government contractors are required to collect information such
> as whether the patient has expressed "depressive feelings" or has used
> "excessive profanity" - in his own home.
> 
> What's even more alarming is that the government is not only collecting
> information on homebound patients, but on their caregivers, too. That
> includes husbands, wives, children and anyone else who assists patients in
> their homes. Home-care patients really don't have any options to protect
> their medical confidentiality and home privacy. If patients refuse to share
> personal medical and lifestyle information, then their health-care workers
> are required to act as proxies. This means total strangers will be permitted
> to speak for seniors and non-elderly disabled patients if they won't divulge
> personal information.
> 
> What's more, home-care patients covered under Medicare effectively have been
> stripped of their ability to pay privately for medical services they would
> rather keep confidential. A controversial provision of the 1997 Balanced
> Budget Act says that the only way Medicare-participating doctors (96 percent
> of all U.S. physicians) can accept private payment for Medicare-covered
> services ($200 billion annually) is if the doctors stop seeing all Medicare
> patients for a two-year period. The U.S. Court of Appeals for the District
> of Columbia, in United Seniors Association vs. Shalala, recently reaffirmed
> this fact, ruling that Medicare recipients may contract privately only for
> services not covered under the program.
> 
> If patients divulge their private medical information to the government,
> then they run the risk of having their medical records accessed every day,
> with or without their consent, by medical researchers, the Department of
> Justice, courts, HCFA contractors and other state or federal agencies.
> 
> Medicare officials stress the federal government is working hard to protect
> beneficiaries' medical privacy. However, the General Accounting Office(GAO)
> recently reported to Congress that at the sites of 12 Medicare contractors
> in fiscal year 1998, auditors were able to penetrate security and obtain
> access to sensitive Medicare information at five of them. Also, GAO reported
> that a HCFA employee was accessing Medicare beneficiary files more
> frequently than appeared necessary for performing his job. When approached
> about the possible confidentiality violation, the employee admitted that he
> was looking through the files of famous people.
> 
> With the further implementation of OASIS, the number of medical-privacy
> breaches will only increase. Congress, if it cares about medical privacy,
> should act to stop further implementation of OASIS.
> 
> It should also make sure individuals will be able to sue if their medical
> privacy is breached. The Clinton administration released its proposed
> medical privacy regulations Nov. 3. They claim to give citizens new rights
> to privacy, but they don't give individuals the right to sue if their
> privacy is breached. How do you have a right if you can't enforce it? You
> don't.
> 
> As long as government pays for home health-care services, it will want to
> review beneficiaries' claims records. That is why Congress should make sure
> Medicare-covered home health-care patients interested in keeping their
> medical information confidential are free to pay privately - if they so
> choose - for health care services.
> 
> Rep. Patrick Toomey, R-Pa., recently introduced the the Senior Health Care
> Freedom Act of 1999, which would fix the restrictive Medicare system to
> allow all seniors the freedom to contract privately for all health care
> services. This type of reform would guarantee all Americans the option of
> protecting their personal medical information. Let Americans choose to pay
> privately for home health-care services, as this is the only way truly to
> protect their medical confidentiality and home privacy.
> 
> Sue Blevins is president of the Washington, D.C.-based Institute for Health
> Freedom. Distributed by Scripps Howard News Service
                         
Copyright © 1999 Nando Media