HealthLawProf Blog

Editor: Katharine Van Tassel
Case Western Reserve University School of Law

Friday, August 29, 2008

New Oversight, Stiffer Penalties Approved for Snooping into Patient Records

The Los Angeles Times reports that the California Senate is moving to clamp hospital files shut following breaches of celebrities' confidential files.  Patrick McGreevy writes,

Files2Alarmed by breaches in which UCLA Medical Center employees snooped in the confidential records of celebrities including Britney Spears, Farrah Fawcett and California First Lady Maria Shriver, state lawmakers moved Tuesday to clamp hospital files shut with new oversight and stiffer penalties.

Legislators also approved a bid to extend healthcare coverage to those with preexisting medical conditions.
The Assembly did not meet Tuesday. But the state Senate approved a measure that would require hospitals to draft a plan to safeguard patient information and set up a new state Office of Health Information Integrity with power to review plans and violations and assess fines of up to $250,000 against people who violate patient privacy.

A companion bill, which the Senate has yet to act on, would allow fines of up to $250,000 against healthcare providers in case of breaches.

"Our current system of protecting patient privacy has not served as a sufficient deterrent to stop repeated and damaging breaches of patient confidentiality," said Sen. Elaine Alquist (D-Santa Clara), author of the companion bill.
Alquist noted that one person at UCLA viewed confidential patient information more than 900 times.

Monica Wagner, a deputy director of the state Department of Public Health, said 30 snooping cases have been reported statewide in the last two years, and more are believed to be occurring but go unreported.

Earlier this month, the state said there was evidence that in the case of UCLA, 127 employees peeked at celebrities' records.

The safeguarding bill, AB 211 by Assemblyman Dave Jones (D-Sacramento), passed Tuesday, 29 to 7. The Assembly has not voted on it.

Some of the Republican lawmakers who voted against it, including Sen. Roy Ashburn of Bakersfield, said they support patient privacy but worry that a hospital fined $250,000 would pass that cost on to patients.

In addition, said Sen. Sam Aanestad, a Grass Valley oral surgeon, "we shouldn't be establishing another bureaucracy." He noted that medical and dental boards already exist to review misconduct.

The administration of Republican Gov. Arnold Schwarzenegger co-sponsored both bills.

Dale Tate, a spokeswoman for UCLA Medical Center, said the hospital is not permitted to take positions on legislation. She said the institution has taken steps to address the problem of confidentiality breaches, including worker education, improved computer safeguards and more audits.

The Jones bill, which is supported by the California Hospital Assn., would hold individual employees accountable for rogue behavior in cases in which hospitals have done everything possible to keep records private.

"Those breaches should never have happened," said Jan Emerson, a spokeswoman for the hospital association.

Alquist's measure, SB 541, would increase fines against individuals and health facilities for serious medical errors from the current maximum of $50,000 to a limit of $125,000. The Assembly has already approved it.

In the Senate on Tuesday, lawmakers also approved AB 2 by Sen. Mervyn Dymally (D-Compton), which would extend healthcare coverage to those considered medically uninsurable because of preexisting medical conditions.

The bill would require insurance companies to either insure those people or pay into a state account that would subsidize insurance for them.

Sen. Sheila Kuehl (D-Santa Monica) said there are more than 1,000 Californians on a waiting list to get such coverage.

Aanestad said the current health insurance system needs fixing, but the legislation could increase costs for patients.

"The cost is going to be passed on to consumers," he said.

The Senate rejected a bill that would have required a review of fire retardants used in automobiles, cribs, toys and other products to determine whether they are toxic and should be banned or restricted.

The bill, SB 706 by Assemblyman Mark Leno (D-San Francisco), received 18 votes, three shy of the number needed for passage, after it was strongly opposed by chemical companies and other businesses.

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