Source: Houston Chronicle, page 2A
(http://www.chron.com/content/chronicle/nation/97/09/10/medicine.20.html)
Contact: viewpoints@chron.com

Plan would provide police greater access to medical records

By ROBERT PEAR, New York Times

WASHINGTON Bowing to federal and state lawenforcement
authorities, Clinton administration officials will soon propose
legislation that would allow police officers to gain broad access
to patients' medical records, with hardly any restrictions on use
or redisclosure of the data.

While lawenforcement authorities frequently negotiate access to
such materials now, the administration recommends that health
care providers and those who pay for such care be explicitly
"permitted to disclose health information without patient
authorization" when the records are sought by federal or state
investigators.

The proposal is significant because federal and state officials
have, in recent years, placed a high priority on investigations
of fraud in the trilliondollar health care industry. They sift
through tens of thousands of patients' records while
investigating suspected abuses by hospitals, doctors, nursing
homes, laboratories, health plans and suppliers of medical
equipment. Health care fraud investigations by the FBI alone
tripled over the last five years, to more than 2,200 in 1996, as
officials tried to save money for the government by cracking down
on fraud.

"We recommend that providers and payers be permitted to rely on
the statement of lawenforcement officials that an inquiry meets
these standards," the administration says in a report drafted for
submission to Congress.

Donna Shalala, the secretary of health and human services, plans
to announce the proposals at a congressional hearing Thursday.

The administration will propose safeguards that limit access to
medical records by employers, researchers, drug manufacturers and
directmarketing companies, among others. It would establish
civil and criminal penalties for misuse of records.

But lawenforcement agencies would be exempt from most of the
standards. Under the administration's proposal, it would be
easier for investigators to have access to medical records than
to records of banks, cable television, video rental stores or e
mail users, all of which are protected by federal privacy
statutes.

Under a 1996 law intended to make health insurance more readily
available to millions of Americans, the secretary was required to
develop comprehensive recommendations on medical privacy.

The administration proposal would not require lawenforcement
agencies to get court orders or to notify patients when they seek
medical records. Patients would not be assured of an opportunity
to challenge the disclosure of their files, though the records
could later be used against them in investigations or
prosecutions.

Officials at the Department of Health and Human Services said
Shalala had not resisted the demands of lawenforcement
authorities.