Changes to the HIPAA privacy regulations proposed late last month would remove consent requirements that might intrude on access to care, allow routine conversations between practitioners and greatly restrict marketing based on individual patient records.
HHS is taking public comments on the proposals this month and expects the changes to take effect Oct. 13, six months ahead of the HIPAA privacy compliance deadline of April 14, 2003.
"It keeps tight what needs to be tight and loosens what needs to be loosened," says Pittsburgh anesthesiologist Carol Rose, M.D., past president of the Pennsylvania Medical Association.
According to physician practice consultant Robert Gellman, "It's a really good thing for patients."
The AMA gave qualified support to the plan, saying in a statement that Congress should extend the scope of privacy laws to "all entities that use medical information."
In a major about-face from previous public statements, HHS wants to require pharmacies, insurers and other covered entities to obtain "specific authorization" before marketing products to patients. Gina Cavalier, healthcare attorney for the Washington law firm Shaw Pittman, says this standard goes beyond simple consent.
HHS attempts to codify an earlier guideline by permitting physicians to discuss treatment options with other practitioners caring for a patient.
Also under the plan, patients would be asked to acknowledge receipt of a notice of privacy rights but not be required to give written consent before the disclosure of information for specific treatment, payment and healthcare operations purposes.
However, patient advocate Joanne Husted, senior counsel for the Health Privacy Project at Georgetown University in Washington, D.C., says, "We're concerned about eliminating prior consent. Eliminating this requirement really strikes at the heart of what the privacy regulations were about."
However, the consent issue is small compared to the marketing provisions, Gellman says. "I think the marketing change far outweighs anything else that they've done."