WASHINGTON -- President Clinton plans to propose in a speech Friday broad new medical privacy regulations controlling access to electronic information.
The proposed rules will control how hospitals, physicians, and health care plans may collect and disclose personal records stored in electronic form.
Clinton, who cited the need for government action in his State of the Union address, said this week that "I will use the power of my office to [propose this] in the coming days. I think that's a very important issue."
"As we move to an electronic age, the basic point is we have to create structures where people have privacy rights," said a senior administration official, who asked not to be identified by name.
Except in cases related to law enforcement, national security, or in emergencies, doctors, hospitals, and health plans will be required to seek written consent to release personal information for purposes not related to payment and treatment.
Because Congress did not act by August, under a 1996 law the Department of Health and Human Services has until 21 February 2000 to finalize the regulations. Comments are due within 60 days.
The 632-page rule, which applies only to electronic records, will not give individuals the right to sue their medical provider, but the administration says HHS officials will bring lawsuits for violations of the regulation. Paper records are not covered, but privacy protections will apply as they move into electronic form.
The proposed regulation provides additional disclosure prohibitions when psychiatric records are involved. In such situations, the patient must specifically consent to the release.
It does not preempt existing state laws, which may be more restrictive. One area that has already drawn fire from civil libertarians is the easy access police would have to medical records.
Medical providers must hand records over to state and federal law enforcement after receiving an administrative request -- in other words, a formal note on agency letterhead. The request must be specific and not overly broad, and it must state why the information is relevant to an investigation.
But no court order is required, a legal standard that the Justice Department has long opposed. "We've been trying to strike a balance with law enforcement," the administration official said.
Police may also get ready access to information such as name, address, and type of injury for the purposes of identifying a fugitive, suspect, or missing person.
The regulation also requires medical providers to disclose information for "national security" or "emergency" reasons.
Free-market groups say the complex proposal is too regulatory.
"I really, really hope nobody is hurt because they failed to sign a consent form giving access to medical history and didn't realize the consequences," says Solveig Singleton, a lawyer at the Cato Institute. "I hope the costs of medical insurance don't soar because of the additional red tape."
