From: American Civil Liberties Union of Massachusetts jwrclum@aol.com Re: Privacy Rights Alert Date: November 20, 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 confidentiality. 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 sent). - 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 circumstances. - Release to Public Health Agencies under certain circumstances. - 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 option). - 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 option). -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 Americans.] 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:\\thomas.loc.gov (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 now....