Medicare and privacy

Public Comments: World Privacy Forum files comments on CMS plan to allow release of patients’ protected health information from Medicare database in some circumstances; benefits do not outweigh the risks

Medicare – CMS — The World Privacy Forum filed extensive pubic comments on the substantive changes to the Medicare database release policy that the Centers for Medicare and Medicaid Services (CMS) has proposed in a System of Records Notice. As it currently stands, CMS is planning to release the individually identifiable protected health information of patients in the Medicare database to third parties in some circumstances. CMS has not established strong enough checks and controls on its release policy, and it has not explained how it is able to do this under HIPAA. The comments state that CMS has an obligation to explain how each routine use in its new policy is consistent with the authority in the HIPAA privacy rule. If a routine use allows disclosures that are broader than those permitted by HIPAA, then the routine use must be narrowed so that it is consistent with HIPAA. The comments also note that nothing in the CMS notice discusses substance abuse rules and other legal restrictions of the protected health data. The World Privacy Forum asked CMS to specify that the qualifications of any data aggregators who may potentially receive the data exclude any entity that sells other consumer data for any general business, credit, identification, or marketing purpose.

Public Comments: October 2007 – Centers for Medicare and Medicaid Services (CMS) System of Records Notice regarding substantive changes to the Medicare database release policy

The World Privacy Forum filed extensive pubic comments on the substantive changes to the Medicare database release policy that the Centers for Medicare and Medicaid Services (CMS) has proposed in a System of Records Notice. As it currently stands, CMS is planning to release the individually identifiable protected health information of patients in the Medicare database to third parties in some circumstances. CMS has not established strong enough checks and controls on its release policy, and it has not explained how it is able to do this under HIPAA. The comments state that CMS has an obligation to explain how each routine use in its new policy is consistent with the authority in the HIPAA privacy rule. If a routine use allows disclosures that are broader than those permitted by HIPAA, then the routine use must be narrowed so that it is consistent with HIPAA. The comments also note that nothing in the CMS notice discusses substance abuse rules and other legal restrictions of the protected health data. The World Privacy Forum asked CMS to specify that the qualifications of any data aggregators who may potentially receive the data exclude any entity that sells other consumer data for any general business, credit, identification, or marketing purpose.

Public Comments: December 2006 – Medical privacy / Medicare Part D World Privacy Forum Requests That CMS Bring Its Medicare Part D Data Activities Under HIPAA and Require Certificates of Confidentiality to Protect Patient Privacy

In comments filed with the Centers for Medicare and Medicaid Services, the World Privacy Forum requested that CMS give effect to data restrictions that Congress has expressly included in the law. WPF also requested that CMS include in its standard agreements for use of CMS data a requirement that the recipient obtain a certification of confidentiality for all identifiable CMS data. WPF also requested that CMS perform a regulatory impact analysis and publish a system of records notice.

Public Comments: June 2006 – Medicaid Program and State Children’s Health Insurance Program Systems Notice

The World Privacy Forum submitted comments to the Centers for Medicare & Medicaid Services requesting that it amend a Systems of Records Notice to address an oversight and address other privacy issues. The Forum requested that CMS add a reference in the system notice to Executive Order 13181 of December 20, 2000, “To Protect the Privacy of Protected Health Information in Oversight Investigations.” The Forum also requested that the routine uses be revised to reflect the HIPAA requirements as appropriate when the disclosures involve HIPAA records.

Public Comments: November 2005 – WPF Files Comments About Proposed Changes to HIPAA

Five groups joined the World Privacy Forum in asking for changes to be made to a proposed rule on how medical healthcare claims attachments are handled electronically. The World Privacy Forum and the EFF, EPIC, Privacy Rights Clearinghouse, Privacy Activism and U.S. Public Interest Research Group (U.S. PIRG) asked that physicians be given more control over what parts of health records they send electronically to insurance companies, that psychotherapy notes not be included when sending health records for insurance payment, and that the HIPAA Privacy Rule be rigorously applied to scanned health records.