Medical privacy, S. 1360 [cr-95/10/28]


TAP-INFO - An Internet newsletter available from •••@••.•••
November 1, 1995

-    Senator Robert Bennett and several cosponsors introduce legislation
on medical records privacy.  S. 1360 would allow millions of law
enforcement officials, social workers, graduate students and other health
care researchers, government fraud investigators and probably
congressional staff to obtain access to computer databases with the
medical records for most Americans who pay for care under health insurance
programs.  The Center for Patient Rights, the Massachusetts ACLU, EPIC,
and the Consumer Project on Technology (CPT) have expressed opposition to
the bill, as have several privacy experts. However, the legislation is
enthusiastically endorsed by the Center for Democracy and Technology
(CDT), which was involved in the drafting of the bill, and some other
groups have apparently endorsed the legislation.  The Consumer Project on
Technology is working on a statement about the legislation.  Here is the
statement about the legislation released yesterday by the Massachusetts
ACLU.  jamie <•••@••.•••>


    Subject: Privacy Rights Alert
    From:  American Civil Liberties Union of Massachusetts

    Re:    Privacy Rights Alert
    Date:  October 31, 1995

    c 1995 ACLUMA

     We at the American Civil Liberties Union of Massachusetts
want to alert you to the fact that the right to medical privacy
of all Americans is imperiled by a bill just introduced in the
U.S. Congress.  This bill, which is claimed to be a "Medical
Records Confidentiality Act," in reality may turn out to be
profoundly destructive of your right to privacy.
     Although Part I does contain certain aspects which could
help privacy, Part II undercuts the very fabric of patient-doctor
     First, it preempts many state law and common law protections
which currently exist.
     Second, it pushes the further computerization of medical
records, and will bring about the creation of "Health Information
Services"  --- corporate entities which would receive, process,
and serve as  libraries for actual on-line medical records
forwarded from hospitals, clinics, and individual doctors.  It
appears that this will take place without any requirement for
individual patients' authorization or consent.
     As we all know, computerized data bases are not immune from
being accessed by both unauthorized  "outsiders"  and
unauthorized  "insiders."   Centralization of data storage,
especially in electronic form, simplifies its being accessed.
     But aside from that, the bill would actually authorize
access to the medical records in these data bases by a host of
government and non-government entities.  Each of our medical
records would thus become part of a computerized "lending
library"  --- an internet of medical records.
         For example, the bill would permit release of your
medical records from "Health Information Services" (the on-line
data base holders) and "Health Information 'Trustees'"
(providers, hospitals, health plans, employers, insurers, and
health oversight agencies) to the following (among others):
     -    Release to researchers (along with your medical
          history, it is possible that identifying information
          including your name, address, and phone number would be
     -    Nearly-automatic release, to the opposing party in a
          lawsuit, of your entire medical history, if your
          health, physical or mental, has been raised by you as
          an issue in that lawsuit.
     -    Release to law-enforcement authorities under certain
     -    Release to Public Health Agencies under certain
     -    Release based on Judicial Warrant --- you would be
          notified by mail within 30 days after execution of the
          warrant (90 days or more with the government's ex parte
     -    Release based on Judicial Subpoena, Grand Jury
          Subpoena, or Administrative Agency (e.g. Social
          Security) Subpoena --- you would be notified on or
          before the date of its execution (or within 90 days
          thereafter [or longer] with the government's ex parte
     -    A special variant of this, where the identity of the
          patient is "unknown," would allow the search of records
          (plural) in order to  identify the person being sought.
          [In essence, this would allow "fishing" expeditions,
          using a computerized net, into the private lives of

     In some of these situations, you, the patient, will only be
informed after the records have been released.

     You may, in some circumstances, have the legal right to
"attempt to quash" the subpoena (etc.) by seeking a court's
intervention.  However, the standard by which the court is to
reach a decision on this will be mandated by this bill to be a
consideration of whether the government's interest in obtaining
the information outweighs the privacy interest of the individual.

     We would encourage you to pull up a copy of the actual bill
and view it yourself.  This can be done through the Library of
Congress internet site at http:\ (104th Congress,
Senate bill number  S 1360 ).
     Alternatively, a hard copy by mail can be requested from the
U.S. Senate Documents Room, by faxing to 202-228-2815 a note
containing the bill number and your mailing address.

     All our voices need to be heard in order to help make
certain that this bill is not passed by Congress.

         Possible actions include:
     (1) Letters to your Senators  and congresspersons, and to
     the House and Senate leadership.
     (2) Letters to local newspapers and other media.
     (3) Forwarding the contents of this message to places where
     you feel it will be of interest and have impact.

         This document may be re-distributed freely, provided it
remains in its entirety.

         If you value your right to privacy, the time to act is

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