Medical records rules issued
Opponents say laws are weak

Sat, Aug. 10, 2002

BY AMY GOLDSTEIN
Washington Post Service






WASHINGTON -

The Bush administration Friday issued final rules designed to protect the confidentiality of computerized patient records, for the first time giving Americans certain federal rights over how their medical information is used -- but offering weaker safeguards than consumer advocates have sought.

When they take effect, for the most part next spring, the rules will mandate a host of new protections, including guaranteeing that people may inspect their medical records and correct mistakes, find out who else has looked at them, and seek penalties against anyone who misuses the information.

The final version, however, omits a requirement that patients give written permission before their personal health information can be handled by doctors, hospitals, pharmacies and insurance plans -- a protection that lawmakers and two White Houses have contemplated for years.

The rules go further than the administration previously considered to rein in the use of medical information for marketing products, particularly prescription drugs, by companies that gain entree to individuals' records. Critics in Congress and elsewhere said substantial marketing loopholes remain.

The standards, produced Friday by the Department of Health and Human Services, culminate a debate that has raged in Washington for a decade over how much control patients deserve over proliferating access to their medical secrets. The debate has pitted privacy advocates and civil libertarians against employers and a large bloc of the nation's healthcare industry, which have argued that a free flow of information is essential to deliver medical care economically and well.

While the administration tipped that balance somewhat further towards the interests of healthcare companies, officials said the safeguards remain comprehensive.

''This regulation gives patients the power to protect their privacy and still get efficient care,'' Health and Human Services Secretary Tommy Thompson said.

The rules allow personal medical records to be shared only to treat patients, pay bills and carry out a broad, undefined category of ''healthcare operations.'' Under the new standards, the smallest amount of information should be disclosed for a specific purposes and, when possible, patients' names are to be left out.

These rules will apply to all patient records that are kept in electronic form, but not ones that are on paper. Privacy advocates have been most concerned about the security of computerized records because they can be shared so easily.

Until now, patients' medical privacy has been governed by a spotty patchwork of state laws. The federal laws will override weaker state laws but will not interfere with states that have adopted more aggressive policies to protect consumers.


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