Frustrated by continued haggling, a Senate committee last week shelved medical-records privacy legislation and said it may let the Clinton administration impose its own standards.
Senate Health, Education, Labor and Pensions Committee Chairman James Jeffords (R-Vt.) indefinitely postponed any action on his measure because members still were at odds over whether to allow patients to sue providers and insurers that illegally release their medical records.
In addition, members also were discussing whether health insurance underwriters should be required to obtain a separate authorization to see records for purposes of reviewing medical histories and setting premiums.
Also at issue is whether law-enforcement officials would need to obtain subpoenas before they could inspect individuals' medical records and how they would be required to preserve confidentiality should medical records become part of courtroom evidence.
In the bill's current form, patients would be able to sue providers and insurers for illegally releasing confidential medical records. Law enforcement officials would need to obtain subpoenas, warrants or other investigative orders before they could see medical records, and they would be required to preserve privacy.
However, underwriters would not have to obtain separate authorization to view records.
If Congress doesn't act on the legislation by August, HHS has the authority to develop privacy standards on its own under the provisions of a 1996 health insurance reform law.
Meanwhile, states continue to debate and enact their own privacy laws, creating a legal tangle across the country that providers and insurers don't want.