THIS SEARCH THIS DOCUMENT THIS CR ISSUE GO TO
Next Hit Forward Next Document New CR Search
Prev Hit Back Prev Document HomePage
Hit List Best Sections Daily Digest Help
Doc Contents
The Treasury Department is not only making policy that it has no right to make, it is also making bad policy. Our bill places a moratorium on this lawmaking. It also directs the Treasury
[Page: S2506] GPO's PDF
By Mr. LEAHY (for himself, Mr. KENNEDY, Mr. DASCHLE, and Mr. DORGAN):
S. 573. A bill to provide individuals with access to health information of which they are a subject, ensure personal privacy with respect to health -care-related information , impose criminal and civil penalties for unauthorized use of protected health information , to provide for the strong enforcement of these rights, and to protect States' rights; to the Committee on Health , Education, Labor, and Pensions.
MEDICAL INFORMATION PRIVACY AND SECURITY ACT
Mr. LEAHY. Mr. President, today, I am pleased to be joined by Senators KENNEDY, DASCHLE and DORGAN in introducing the Medical Information Privacy and Security Act (MIPSA). I am also pleased that a companion bill will be introduced in the House by Congressman EDWARD MARKEY.
The Millennium Bug is not the only computer-related problem Congress confronts this year. We face the deadline that Congress set for itself of August 21, 1999, to solve the multitude of privacy glitches in the handling of our medical records.
At a time when some states are selling driving license photos and information , when our leading computer chip and software companies have built secret identifiers into their products to trace our every move in cyberspace without our consent, it is time for Congress to wake up to the privacy rights and expectations of all Americans before it is too late.
The trouble is this: If you have a medical record, you have a medical privacy problem.
A guiding principle in drafting this legislation has been that the movement to a more integrated system of health care in our country will only continue to be supported by the American people if they are assured that the personal privacy of their health care information is protected. In fact, without the confidence that one's personal privacy will be protected, many will be discouraged from seeking medical help.
Most of us envision that our medical records are held in a manila file folder under the watchful care of our health care provider. If this is what you are picturing, you are sorely mistaken. Increased computerization of medical records and other health information is fueling both the supply and demand for our personal information . I do not want advancing technology to lead to a loss of personal privacy , and I do not want the fear that confidentiality is being compromised to deter people from seeking medical treatment or to stifle technological or scientific development.
The traditional right of confidentiality between a health care provider and a patient is at risk. This erosion may reduce the willingness of patients to confide in physicians and other practitioners and may inhibit patients from seeking care.
Unlike some, I believe that computerization can assure more privacy to individuals than the current system, if MIPSA is enacted. But if we do not act the increased potential for embarrassment and harassment is tremendous.
The ability to compile, store and cross reference personal health information has made our intimate health history a valuable commodity. In 1996 alone, the health care industry spent an estimated $10 to $15 billion on information technology.
This data can be very useful for quality assurance, and to provide more cost effective health care. But I doubt that the American public would agree with a Fortune magazine article which lauded a health insurer that poked through the individual medical records of clients to figure out who may be depressed and could benefit from the use of the anti-depressant Prozac. Are we now encouraging the replacement of sound clinical judgment of doctors with health insurance clerks who look at records to determine whether you are not really suffering from a physical illness, but a mental illness?
Just a few days ago The Wall Street Journal wrote about a company that is ``seeking the mother lode in health `data mining.' '' This company wants to get medical data on millions of Americans to sell to any buyer. Currently there are no laws constraining the creation of large data bases filled with sensitive personally identifiable information on any of us. Our information is like gold to these ``data miners.''
If this battle is between American families who want some privacy and big business buying access to their personal medical records, I will stand with American families every time.
Last year, an article in the Washington Post described the story of a woman whose prescription purchases were tracked electronically by a pharmacy benefits management company two states away, hired by her employer. With every swipe of her prescription-drug card she saved 50% on her prescriptions. At the same time, however, without her knowledge her sensitive health information was being compiled. Her doctor was soon informed that she would be enrolled in a ``depression program,'' watched for continued use of anti-depression medications, and be targeted for ``educational'' material on depression. All of this was done at the behest of her employer who had unfettered access to all of her personal health information.
This woman was not suffering from a depression-related illness; her doctor prescribed the medication to help her sleep. This woman had no idea that by signing up for her managed care plan she was signing up to have her personal health information disclosed to individuals she had never even met.
Employer access to personal health information of their workers is a real problem. A recent University of Illinois study found that 35 percent of all Fortune 500 companies regularly review health information before making hiring decisions. On-work-site health care providers have testified before Congress that they are routinely pressured for employee health information and must comply or lose their jobs.
What MIPSA makes clear is that there must be a ``fire wall'' between those within a company involved in providing health services and benefits, and other managers. The goal of privacy legislation is to be the first line of defense, so that individuals are not put in the situation of possibly being discriminated against. Our bill complements other laws and proposed legislation that bar discrimination based on health status.
We must not let privacy slide to the point that the only way for a person to ensure confidentiality
is to avoid seeking medical treatment.
The simple fact is that many patients will not agree to participate in health research or to be tested if they fear the information that is revealed in the course of the research could be released, bringing them harm. In genetic testing studies at the National Institutes of Health, thirty-two percent of eligible people who were offered a test for breast cancer risk declined to take it, citing concerns about loss of privacy and the potential for discrimination in health insurance.
The bill we are introducing today, the Medical Information Privacy and Security Act, would be the first comprehensive federal health privacy law.
Our bill is broad in scope: It applies to medical records in whatever form--paper or electronic. It applies to each release of medical information, including re-releases. It comprehensively covers entities other than just health care providers and payers, such as life insurance companies, employers and marketers and others who may have access to sensitive personal health data.
It gives individuals the right to inspect, copy and supplement their protected health information.
It allows individuals to require the segregation of portions of their medical records, such as mental health records, from broad viewing by individuals who are not directly involved in their care.
It gives individuals a civil right of action against anyone who misuses their personally identifiable health information. It establishes criminal and civil penalties that can be invoked if individually identifiable health information is knowingly or negligently misused.
It creates a set of rules and norms to govern the disclosure of personal
[Page: S2507] GPO's PDF
We have been very careful to balance the right to privacy with the needs of providers and health care plans, who can use medical information to improve the care of patients. MIPSA does not force patients to sign a blanket authorization allowing their information to go to anyone for any purpose in order to receive care. Unfortunately, individuals now have no choice but to sign away their rights if they want any health care treatment at all.
MIPSA changes the authorization procedure by requiring that providers, health plans and hospitals clearly lay out to patients how their protected health information will be used, who will have access to their protected health information, and for what purpose. If anyone wants to use or disclose personally identifiable health information for a purpose that is not directly related to their treatment or billing, the patient has that right to say no without losing the ability to receive needed health care.
It also takes special care to make sure that important medical research continues. MIPSA extends the protective practices currently followed by the National Institutes of Health (NIH) to all health research efforts--whether publicly or privately funded.
It establishes a clear and enforceable right of privacy for all personally identifiable medical information including information regarding the results of genetic tests.
We have tried to accommodate legitimate oversight concerns so that we do not create unnecessary impediments to health care fraud investigations. Effective health care oversight is essential if our health care system is to function and fulfill its intended goals. Otherwise, we risk establishing a publicly sanctioned playground for the unscrupulous. Health care is too important a public investment to be the subject of undetected fraud or abuse.
It prohibits law enforcement agents from searching through medical records without a warrant. It does not limit law enforcement agents in gaining information while in hot pursuit of a suspect.
We also require anyone who maintains your medical information to have strong safeguards in place. And MIPSA offers strong enforcement provisions and remedies for the misuse of medical information.
It sets up a national office of health information privacy to aid consumers in learning about their rights and about how they can seek recourse for violations of their rights.
Most importantly, our bill does not preempt any federal or state law or regulation that offers stronger privacy safeguards. We propose a floor rather than a ceiling, achieving two goals:
First, a strong federal privacy law will eliminate much of the current patchwork of state laws governing the exchange of medical information, and will replace the patchwork with strong, clear standards that will apply to everyone.
Second, MIPSA makes room for the many possible future threats to medical privacy that we may not even anticipate today. As medical and information technology moves forward into the next century we must maintain the public's right to seek stronger medical privacy laws closer to home.
The elements of MIPSA are essential to any strong medical privacy effort.
I am encouraged that a variety of public policy and health professional organizations, across the political spectrum, are signaling their intentions to step forward to join forces with consumers during this debate.
We have 164 days to implement a strong federal medical privacy law. With the clock ticking toward the August deadline, let us act sooner rather than later.
Mr. KENNEDY. Mr. President, we are here today to propose legislation to protect the privacy of personal medical information in our rapidly changing health care system. Today, video rental records have greater protection than sensitive medical information. Last month, we learned that the University of Michigan Medical Center posted information from thousands of patient records on the Internet, without any password protection or other safeguards. In many other cases, individual patients have been harmed by improper release of their private medical records.
The legislation that Senator DASCHLE, Senator LEAHY, Congressman MARKEY, and I are introducing today--the Medical Information Privacy and Security Act--puts patients first, while allowing for legitimate uses of medical information to improve health care.
Congress recognized the need to act to protect the privacy of medical information when we passed the Kassebaum-Kennedy Act in 1996. That legislation contained a provision requiring Congress to pass legislation on the issue by August of this year. If the deadline is not met, the Administration has the power to act by regulation.
The measure we are introducing ensures strong protections nationwide. It also allows individual states to take additional action. Stronger state laws are not pre-empted.
The goal of these protections is to safeguard the confidential relationship between patients and physicians. Patients concerned about their privacy are less likely to disclose important information to their physicians. A recent survey by the California HealthCare Foundation found that one in six adults has taken steps to protect their personal medical information, such as providing inaccurate information in their medical history, or asking physicians not to include certain information in their medical records.
Our legislation recognizes the fundamental right of patients to limit disclosure of personally-identifiable medical information. We have balanced that right with the needs of providers and health care plans to use medical information to improve patient care. Our proposal does not force patients to sign a blanket authorization in order to receive care. Instead, it contains a flexible framework that can be modified to fit different situations.
Medical research is essential for progress against disease. But it is also essential for patients to have confidence that research is beneficial, not an invasion of privacy. In genetic testing studies at the National Institutes of Health, 32 percent of eligible people who were offered a test for breast cancer declined to take it, because of concerns about loss of privacy and the potential for discrimination in health insurance.
Currently, most federal health research is governed by the ``Common Rule'', which includes evaluations by Institutional Review Boards in order to protect patients involved in the research. Our proposed legislation strengthens the privacy provisions in the ``Common Rule,'' and extends those protections to all health research.
These issues are important, and I am optimistic that Congress will act in time to meet the August deadline. We have a responsibility to enact strong protections for privacy in all aspects of health care, and now is the time to act.
By Mr. CLELAND (for himself and Mr. COVERDELL):
S. 575. A bill to redesignate the National School Lunch Act as the ``Richard B. Russell National School Lunch Act''; to the Committee on Agriculture, Nutrition, and Forestry.
RICHARD B. RUSSELL NATIONAL SCHOOL LUNCH ACT
Mr. CLELAND. Mr. President, I rise today to introduce a bill to rename the National School Lunch Act after Senator Richard Russell. I am pleased to have Senator COVERDELL as a original co-sponsor.
Having met Senator Russell over 30 years ago when I was an intern on Capitol Hill, I gained a deep respect and reverence for the ``Senator from Georgia'' Richard B. Russell. Since being elected to the Senate over two years ago, I have been looking for a way to appropriately honor and express my appreciation for the contributions of Senator Russell. Honestly, I, like many others, usually associate Senator Russell with military issues and the work he did to provide our nation with a strong national defense. However, in researching his history in the Senate, I noticed that, time and again, Senator Russell stated that he viewed his proudest achievement in the Senate as the School Lunch Act.
[Page: S2508] GPO's PDF
On February 26, 1946, speaking on the Senate floor, Senator Russell noted that the School Lunch Program, ``has been one of the most helpful ones which has been inaugurated and promises to contribute more to the cause of public education in these United States than has any other policy which has been adopted since the creation of free public schools.'' Strong words, not only about the school lunch program, but about Senator Russell's commitment to the same.
Starting the first grade in 1947, I, like some of you, have always considered myself to be a true product of the national school lunch program. The program has been woven into the fabric of the American family. Today, the National School Lunch Program operates in more than 95,000 public and nonprofit private schools and residential child care institutions throughout the country, providing nutritionally balanced, low-cost or free lunches to more than 26 million children each school day. The knowledge that every one of our children is ensured a healthy and affordable meal every school day provides us all with a great deal of comfort and satisfaction. The program is available in almost 99 percent of all public schools, and in many private schools as well. About 92 percent of all students nationwide have access to meals through the National School Lunch Program. As cited in several studies, a well fed child is more likely to do better in school and is less likely to misbehave--both highly desirable outcomes.
Senator Russell was a tireless champion for establishing a program to deliver a healthy meal to our nation's schoolchildren. Senator Russell began his campaign to make school feeding programs available in the mid 1930's by utilizing Section 32 funds of the Act of August 24, 1935. As Chairman of the Subcommittee on Agricultural Appropriations, Senator Russell exerted a great deal of influence and was a vigilant advocate of directing the Section 32 food surpluses towards school feeding programs. In the early 1940's, Senator Russell introduced several bills authorizing a national school lunch program. And, after several unsuccessful attempts, Senator Russell sponsored and pushed through the National School Lunch Act in 1946.
THIS SEARCH THIS DOCUMENT THIS CR ISSUE GO TO
Next Hit Forward Next Document New CR Search
Prev Hit Back Prev Document HomePage
Hit List Best Sections Daily Digest Help
Doc Contents