For Immediate Release- 8 June 1999
For more information, contact: Leon Hoffman, M.D., cell phone 917/767-6575 or 212/249-1163 or Dottie Jeffries, [email protected] phone 312/782-6960 or cell phone 312/519-0122 (available M-F, as well as Saturday & Sunday) or Jim Pyles, legal counsel to APSA, 202/466-6550
Senate Bill Threatens Patient Privacy and Access to Quality Mental HealthCare--fails to establish federal floor for the privacy of treatment
Patient confidence that communications with their therapist will remainprivate is essential for effective mental health care. The medicalinformation privacy bill currently pending before the Senate HELP Committee fails to preserve that confidence and, therefore, will eliminate access toeffective mental health care." Robert Pyles, M.D., President, APSA
Washington, DC--The Senate Health, Education, Labor, and Pensions Committee (HELP) is holding a crucial hearing on medical records privacy legislationon Tuesday, June 15th 9:30 AM regarding Senator Jefford's Chairman's Mark onS. 578. A bill which covers medical records privacy.
The following are the concerns of the American Psychoanalytic Association about the Chariman's Mark. The following changes need to be made in the current version in order to preserve the privacy that is essential for quality care. If these amendements are not made on Tuesday, June 15TH AT 9:30 AM, American Citizens will suffer an unprecedented loss of privacy.
The Chairman's Mark has overlooked the following essential elements that secure privacy. In order to preserve privacy and quality health care, APSA calls for these to be incorporated into the markup of the bill:
1) DISCLOSURES FOR HEALTH CARE OPERATIONS SHOULD NOT BE THE SUBJECT OF CONSOLIDATED, COERCED CONSENT. The current bill compels patients to consent to the disclosure of identifiable health information to a health plan for the purposes of "health care operations" even if the information is not necessary for the treatment or payment of the patient's condition. Patients who refuse to provide this "blanket consent" will have all of their health care insurance coverage (and even their health care services) terminated. Thus, the bill eliminates access to quality health care for those patients who wish to preserve the privacy of their health information. Health care operations should be conducted using non-identifiable information or identifiable information obtained through "voluntary consent" rather than "compelled consent" which, under law, is nothing more than submission.
2) ACCESS TO EFFECTIVE PSYCHOTHERAPY SHOULD BE PRESERVED FOR THOSE WHO CANNOT AFFORD TO PAY OUT OF POCKET. The bill prevents the disclosure of communications between a therapist and a patient which the 1996 Supreme Court decision in Jaffee v. Redmond found essential for effective psychotherapy, but only in a judicial setting. The patient's confidence in the privacy of these communications is perhaps even more essential outside of judicial setting than within it. As currently drafted, health plans and others could compel the routine disclosure of psychotherapy communications as a condition of enrollment or treatment when they would be barred from obtaining that information in a court of law. Mental health communications that fall within the scope of the therapist-patient privilege should be protected from involuntary disclosure in judicial as well as the
non-judicial settings.
3) ENSURE THE PRIVACY OF THOSE WHO PAY OUT OF POCKET. The blanket consent requirement of section 202(a) would seem to permit a health plan to compel a patient to consent to disclose even protected information about services that the patient paid for out of pocket. The bill should clearly reflect that a patient who pays for items and services out of pocket may restrict or prohibit the disclosure of that information even if the patient has provided the kind of blanket authorization which is necessary to obtain health care insurance coverage.
4) STATE LAWS SHOULD NOT BE PREEMPTED. The protection of medical information privacy is essential for quality health care and for preserving the public's confidence in the health delivery system. Accordingly, it is appropriate for the federal government to establish a "floor" of minimum standards that are deemed necessary to preserve quality and confidence. However, Congress should not preempt and ignore the will of the citizens of the states where stronger privacy protections have been enacted-- this is a matter which sound public policy and the Tenth Amendment to the U.S. Constitution dictate should be left to the states.
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