[Med-privacy] Privacy Rule

[Jeffrey A. Williams]

Bob and all,

  I fully agree with you here Bob.  And my aged mother has been
a victim of same...

Bob Gellman wrote:

> peter marshall wrote:
> > Reinstate e-health privacy
> >
> > Dr. William Yasnoff
> >
> > Most people believe the Privacy Rule of the Health Insurance
> > Portability and Accountability Act protects the privacy of health
> > information. Unfortunately, that is a myth. Just as the P in HIPAA
> > does not stand for privacy, the HIPAA Privacy Rule actually eliminates
> > privacy protection in a way that prevents violations from being
> > detected, monitored or audited.
> >
> > Before the HIPAA Privacy Rule was adopted in 2002, a long-established
> > legal principle held that individuals had the right to control all
> > access to their health records. As we make the transition to
> > electronic health records, we need to reinstate that important legal
> > right.
> >
> > The basic provisions of the HIPAA Privacy Rule state that health
> > information cannot be disclosed without a patient’s consent, with
> > three exceptions:
> >
> >     * Treatment (medical care).
> >     * Payment (processing insurance claims).
> >     * Operations (business functions of health care, such as
> > monitoring quality of care).
> >
> <snip>
>
> What's really interesting about Yasnoff's article is his fundamental
> lack of understanding of HIPAA.  This last statement isn't true.  There
> are plenty of other exceptions that allow disclosure without consent.
> Including disclosure for health care oversight, for public health, to
> the cops, to the CIA(!), to researchers, to the courts, and to others.
> Many of these disclosure exceptions are quite expansive.  For the most
> part, TPO disclosures remain subject to HIPAA.  Most of the other
> disclosures result in information that is no longer subject to the HIPAA
> privacy rule.
>
> I don't necessarily disagree with other points in the Yasnoff article.
> But neither HIPAA nor the health care system is so simple that the
> privacy problems can be solved with a simple fix.  Like it or not, we
> have a health care system that functions with the use of identifiable
> patient information for numerous purposes related directly to health
> care and for numerous purposes less related.  That's the current
> reality, and any changes to privacy rules have to confront that reality.
>
> And by the way, there was no general legal principle before HIPAA that
> allowed patients to control all access to their records.  That's a
> myth.  Rights varied with state law, and many of the HIPAA disclosures
> were routine before HIPAA without patient consent.  Patient consent
> usually consisted of an authorization by the patient for the disclosure
> of "any or all" of the patient's health record for any purpose
> whatsoever.  Informed consent was rarely informed and not consensual
> either, since failure to sign the "consent" form meant that you would be
> refused treatment or required to pay for it up front.
>
> Bob
>
> --
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> + Robert Gellman       <bob@bobgellman.com> +
> + Privacy and Information Policy Consultant +
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Regards,

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