Public Comments

We particularly note the Committee’s observation that the non-covered entities “may even sell personal health information without authorization for the purpose of marketing or other purposes that consumers may find objectionable.” The World Privacy Forum agrees with the Committee, and believes that the use of identifiable patient health care information for marketing is a disturbing possibility. New institutions are being developed and implemented to exploit gaps in HIPAA that allow use of patient data for marketing purposes. Action to close those gaps is needed urgently. The Committee’s letter is a small step in that direction.

Our principal concern with iPledge is that the FDA has failed to set privacy standards for the iPledge program [2] or for similar programs that mandate patient tracking. As a result, the iPledge registry has privacy shortcomings that may potentially impact the individuals who take Accutane or Isotretinoin generics.

The World Privacy Forum has filed public comments with the Department of Health and Human Services requesting that its new National Disaster Medical System protect all patient information to at least the baseline protections that HIPAA affords, including the HIPAA security and privacy protections. Currently, the new system does not do this, even though the system is housed at HHS, the agency which promulgated the HIPAA standards. The National Disaster Medical System currently contains overbroad routine uses which could potentially result in significant privacy and even public health issues. For example, public health information will not be able to be disclosed under the National Disaster Medical System as the system is currently organized. Additionally, some of the current routine uses in the system would authorize disclosures that would be illegal under HIPAA. For example, Congressional disclosure of a HIPAA record requires a written authorization, something the new system does not require.

This is a request for records that have originated within the GAO. We are making this request pursuant to GAO’s Public Availability of General Accounting Office Records regulations at 4 CFR Part 81.

The FDA has not paid attention to privacy standards that should be applied to RiskMAP programs. Unfortunately, this lack of FDA attention has resulted in inappropriate and unethical marketing to patients using patient information gathered for treatment purposes. If these marketing activities were being conducted by HIPAA-covered entities, the activities would be illegal. These activities may well be illegal in California, which has a strong state-level medical privacy law that goes beyond HIPAA.