Delaware State News
DOVER - State legislators, frustrated with a federal law that keeps medical records under wraps, are looking for ways to get around the restrictions.
House Speaker Rep. Terry R. Spence, R-New Castle, said this week he will ask his chamber's attorneys to research the federal Health Insurance Portability and Accountability Act.
HIPAA, which took effect in April 2004, establishes national standards for protecting certain personal health information.
The law requires almost all heath care providers - from hospitals to doctors to long-term care nursing facilities - to implement strict standards determining how individual patients' medical information is to be shared - or not shared - with other parties.
As legislators delve into the issue of health care for the state's prison inmates, they find HIPAA's restrictions block the Department of Correction and Correctional Medical Services from releasing prisoners' medical records.
The state has a $25.9 million contract with CMS to provide prisoner health care this year.
Rep. Spence decided to call for research into HIPAA after a Monday night legislative public hearing, where scores of inmates or their families lambasted the state agency and the private company for poor care.
"We want to find out if there is a way we can look at some of these records," Rep. Spence said.
"It's very frustrating for us as elected officials because we want to find out what's happening, but it's hard to do that without medical records.
"There might be something we can do legislatively to help the situation."
Ronald D. Smith, the House attorney who will be charged with researching HIPAA, said he is not sure what his efforts will yield.
"HIPAA is a vast undertaking of federal legislation," Mr. Smith said.
"I have some familiarity with it because my wife is involved with medical record-keeping. You either have an exemption or you do not. You are not going to get a lot of give.
"I'll research whatever the speaker wants, but it is going to be tough. The odds of getting any latitude of flexibility are very difficult."
Rep. Robert J. Valihura, R-Wilmington, who attended Monday's hearing, said legal avenues to avoid HIPAA's restriction could be discovered.
One possibility, he said, could be legislation that strips convicts of the privacy rights HIPAA provides.
Persons convicted of felonies already lose other rights, such as voting.
"States can't change federal law, but if there is a mechanism that we can use to access information, we are entitled to pursue that," said Rep. Valihura, one of three lawyers serving in the General Assembly.
"No one commits a crime involuntarily. When you commit a crime, you waive certain rights.
"It might be that one of those rights is the HIPAA law."
Drewery Fennell, executive director of the American Civil Liberties Union's Delaware branch, said HIPAA already allows for patient information to be released.
"HIPAA is intended to protect the patients, not the health care providers," said Ms. Fennell, who is among the activists who have called for an investigation of the prison health care system.
"There are mechanisms by which patients, in this case inmates, can designate friends or family members to receive their medical information."
Finding ways to gain information that HIPAA keeps secret would help the two legislative committees charged with overseeing the state's prison system.
"You have the federal law that gives confidentiality to the inmates' medical records, and that's what makes it difficult to hold a hearing," said Sen. James T. Vaughn, D-Clayton, who chairs the Senate Adult and Juvenile Corrections Committee.
Rep. John C. Atkins, R-Millsboro, chairman of the House Corrections Committee, said additional information could help solve any problems with inmate health care.
"I think it would make it much easier to determine whether the allegations are true or false," Rep. Atkins said.
"We have been hearing all these allegations but we can't get to the bottom of it because of HIPAA.
"It's hard to fix anything if you are only seeing one side of the story. To make an informed decision that will impact taxpayers financially, we need to see both sides."
Staff writer Joe Rogalsky can be reached at 741-8226 or jrogalsky@newszap.com
