d_Blaine.jpg (7368 bytes)In the highly regulated clinical lab environment, it comes as less than a total surprise when new government rules turn out to be less than final.The Health Insurance Portability and Accountability Act (HIPAA) is both the topic of our April Lab Economics feature (page 34), and the subject for proposed rules changes in the March 27, 2002 Federal Register.

HIPAA was enacted because more than a quarter of every dollar spent in a tightly stretched health-care economy goes to administrative costs rather than administering care. Standardizing electronic data transmissions will save us billions of dollars in the long run — money we can hopefully spend on improving services.

But the easier it is to zip whole files of information around, the scarier it is to people’s sense of privacy. This is the part of HIPAA that comes under the Office of Civil Rights: national standards that protect the privacy of personal health information. There is bi-partisan agreement that streamlining medical information in electronic files has the potential to leave people vulnerable to discrimination from curious employers or insurers. It was decided by the Clinton administration and approved by the Bush administration that consent would have to be given before any health information could be used or disclosed. Consumer advocates cheered, while hospitals and health plans worried.

The new proposal would remove the requirement for consent forms that supporters say could unintentionally delay care. Detractors of the “roll back” are concerned that the changes could discourage people from seeking sensitive medical treatment and open the door to privacy violations.

Both sides cite the example of minors’ ability to access sensitive treatment such as mental health services, drug or alcohol treatment, or pregnancy-related healthcare. Subject to state laws, the proposed rules assure parental access to their children’s records. Depending on your perspective, this either remedies an unintentional oversight or discourages a vulnerable portion of the population from seeking needed services.

For further information, visit : http://www.hhs.gov/ocr/hipaa/.

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Ellen Blaine