[Med-privacy] HIPAA Privacy-Rule Opponents Get Their Day in Court from Psychiatric News

[DPeelMD@aol.com]

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</TD></TR></TBODY></TABLE><!-- beginning of outer tables --><!-- end of oute=
r content box --><FONT size=3D-1><EM>Psychiatric News</EM> January 16, 2004<=
BR>Volume 39 Number 2<BR>=C2=A9 2004 <A href=3D"http://pn.psychiatryonline.o=
rg/misc/terms.shtml">American Psychiatric Association</A><BR>p. 2 </FONT><BR=
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<H3>Legal News<BR></H3></TD></TR></TBODY></TABLE>
<H2>HIPAA Privacy-Rule Opponents Get Their Day in Court </H2><STRONG></NOBR>=
<NOBR>Ken Hausman</NOBR> </STRONG>
<P><B>Opponents of HIPAA=E2=80=99s lax patient-privacy protections await a j=
udge=E2=80=99s decision on the future of their lawsuit against the federal g=
overnment and a rule they insist is unconstitutional.</B>=20
<P>Psychiatrists and other medical privacy advocates are waiting<SUP> </SUP>=
to hear whether a federal judge will rule in their favor in<SUP> </SUP>their=
 suit against the U.S. Department of Health and Human Services<SUP> </SUP>(H=
HS) over privacy rules in the Health Insurance Portability<SUP> </SUP>and Ac=
countability Act (HIPAA).<SUP> </SUP>
<P>The psychiatrists and other plaintiffs contend that HIPAA=E2=80=99s<SUP>=20=
</SUP>rules regarding the release of patients=E2=80=99 medical records<SUP>=20=
</SUP>constitute an egregious breach of patients=E2=80=99 constitutional<SUP=
> </SUP>privacy rights.<SUP> </SUP>
<P>The federal government insists that the rules in fact go a long<SUP> </SU=
P>way toward controlling who can access electronic medical records<SUP> </SU=
P>and under what circumstances.<SUP> </SUP>
<P>The suit focuses on a section of the HIPAA law that HHS amended<SUP> </SU=
P>late in the regulatory process. The plaintiffs maintain that<SUP> </SUP>th=
is change negated a requirement in the original notice of<SUP> </SUP>propose=
d rule making that patients had to consent to the release<SUP> </SUP>of thei=
r medical records in most instances if the release was<SUP> </SUP>to extend=20=
beyond the doctor=E2=80=99s office or hospital in which<SUP> </SUP>they were=
 being treated.<SUP> </SUP>
<P>The plaintiffs filed suit in U.S. District Court for the Eastern<SUP> </S=
UP>District of Pennsylvania, which is located in Philadelphia.<SUP> </SUP>Th=
ey chose that location, attorney Jim Pyles said in an interview<SUP> </SUP>w=
ith <I>Psychiatric News</I> soon after the suit was filed, because<SUP> </SU=
P>"there are fundamental constitutional issues at stake, and we<SUP> </SUP>t=
hought they either ought to be preserved or come to end where<SUP> </SUP>the=
y began."<SUP> </SUP>
<P>Pyles is the counsel for the American Psychoanalytic Association,<SUP> </=
SUP>part of the coalition of organizations that brought the suit,<SUP> </SUP=
>which is known as <I>Citizens for Health v. Tommy Thompson</I> <I>(Psychiat=
ric<SUP> </SUP>News,</I> May 16, 2003).<SUP> </SUP>
<P>The coalition of plaintiffs consists of 10 state and national<SUP> </SUP>=
associations and nine individuals.<SUP> </SUP>
<P>Texas psychiatrist Deborah Peel, M.D., heads one of those coalition<SUP>=20=
</SUP>members, Appeal for Patient Privacy, and has been a vocal advocate<SUP=
> </SUP>on behalf of the suit and of patients=E2=80=99 rights to control<SUP=
> </SUP>the fate of their medical records. In a December 10 press release<SU=
P> </SUP>coinciding with a hearing on the plaintiffs=E2=80=99 request for<SU=
P> </SUP>the judge to grant summary judgment in their favor, Peel stated<SUP=
> </SUP>that the case addresses the foundation on which health care<SUP> </S=
UP>is built=E2=80=94that is, "whether patients can get back their<SUP> </SUP=
>right to control who sees and uses the most personal information<SUP> </SUP=
>that exists: medical records about their minds and bodies."<SUP> </SUP>
<P>As a result of the HIPAA rules, she asserted, patients have<SUP> </SUP>be=
en forced to cede control of their medical records to "employers,<SUP> </SUP=
>private corporations, and government agencies."<SUP> </SUP>
<P>The plaintiffs=E2=80=99 suit argues that not only do the weak<SUP> </SUP>=
confidentiality protections constitute a violation of individuals=E2=80=99<S=
UP> </SUP>constitutional privacy rights guaranteed in the Fifth Amendment,<S=
UP> </SUP>but that President George W. Bush and HHS Secretary Tommy Thompson=
<SUP> </SUP>"misled the public about the extent to which their medical recor=
ds<SUP> </SUP>could be disclosed=E2=80=94even without the patient=E2=80=99s=20=
consent."<SUP> </SUP>
<P>They also allege that the final HIPAA rules violate Congress=E2=80=99s<SU=
P> </SUP>legislative intent in passing the law, which was to enhance<SUP> </=
SUP>protections for the content of electronic medical records. The<SUP> </SU=
P>plaintiffs charge as well that the amended HIPAA rule violates<SUP> </SUP>=
federal rulemaking requirements by failing "to consider relevant<SUP> </SUP>=
factors and evidence when HHS reversed its position on the right<SUP> </SUP>=
to medical privacy and consent."<SUP> </SUP>
<P>The December federal court hearing marked the first time the<SUP> </SUP>c=
ourt heard oral arguments on both sides=E2=80=99 motions for<SUP> </SUP>summ=
ary judgment. A decision by the judge is likely early this<SUP> </SUP>year,=20=
since the case is on an expedited schedule. The government<SUP> </SUP>wants=20=
summary judgment based on its contention that the plaintiffs<SUP> </SUP>do n=
ot have standing to file this suit, since the amended rule<SUP> </SUP>has no=
t caused them any direct harm. <IMG alt=3D{blacksquare} src=3D"http://pn.psy=
chiatryonline.org/math/squf.gif" border=3D0><SUP> </SUP>
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