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| Medical Records: Privacy Issues |
Most people think what's said inside a doctor's office doesn't leave the room. But if you're not paying for the visit with cash, think again.
Say you go in for an annual check-up and tell your doctor you've been depressed lately. Or you discuss plans to start a family. Or you ask about Viagra. Or the doctor finds a lump on your breast.
After the visit, if you're like 157 million other Americans who get health insurance through their jobs, you have to sign a consent form for billing purposes. At that point, doctor-patient confidentiality can fly out the door. The doctor must disclose information about the visit so that the health insurer will cover the costs. Once the information goes to the insurer, though, it leaves the protection of federal rules and regulations.
Your medical records could end up in the hands of your boss.
Many employers can legally review their employees' medical records covered by the company's health plan - which sometimes includes hospital records, previous worker's compensation claims and possibly even credit records. And the employee may never even know.
What happens if an employer finds out a worker has cancer, suffers from manic depression, has a sexually transmitted disease or is trying to get pregnant? It's illegal to discriminate against an employee for those reasons under the Americans with Disabilities Act, but it happens.
In the past few years, the Equal Employment Opportunity Commission brought charges against businesses that asked for a worker's medical history on job applications, kept employee medical records with personnel records or denied a person a job because of a disability.
Watch What You Share
Businesses can legitimately review employees' medical records only if it's job-related. Pilots are usually required to take psychological exams. Police officers are often required to have physicals. Truck drivers may have to take vision tests. Peace Corp volunteers usually must undergo physical exams as well. Under the Americans with Disabilities Act, however, employers can't require just one worker to get a medical exam without requiring all other employees to do so as well.
Federal Standards
The federal Department of Health and Human Services has issued privacy standards which health plans, health care clearinghouses and health care providers who use electronic billing and funds transfers must comply with.
Under these federal standards:
- Health care providers who see patients must get patient consent before sharing their information for treatment, payment and health care operations
- Health care information can't be used for purposes not related to health care- such as disclosures to employers to make personnel decisions, or to financial institutions- without explicit authorization from the patient
- Disclosures of medical information are limited to the minimum necessary for the purposes of the disclosure
Tips for Employees and Job Applicants
Privacy advocates suggest taking these steps now to secure your medical records:
- See a doctor not covered under your company's health plan and pay for the visit with cash.
- If this isn't an affordable option, you can also edit the consent form to specify what information can be passed to whom.
Other ways to protect your privacy at work include:
- Getting your medical records and checking for mistakes.
- Asking your manager or human resources department about the company's privacy policy.
- Finding out who has access to your medical records.
- Asking if medical records are stored with personnel files (it's illegal under the Americans with Disabilities Act.)
- Complaining and telling co-workers if you don't like what you hear.
- Asking your health care physician about his or her privacy policies.
- Finding out what information is included in your medical record.
- Requesting the same information from the health insurance companies.
Your best protection is to stay informed and not blindly sign your privacy away.
Related Web Links:
Equal Employment Opportunity Commission
National Coalition for Patient's Rights
U.S. Department of Health and Human Services
Health Insurance Association of America
Health and Human Services Info On Medical Record Privacy
Privacy Rights Clearinghouse
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