Washington President Clinton is issuing sweeping new rules today that restrict health care providers and insurers from sharing confidential information about their patients, creating the first federal fines and prison time for violators.
The regulations, which end nearly a decade of debate on how to protect Americans' medical privacy, were described to The Associated Press by government and private officials who received briefings on them Tuesday.
The new rules, which take effect in two years, will cover nearly all health care providers and insurance companies, barring them from disclosing private health information for non-health-related purposes, the officials said.
Doctors will have to get written permission from their patients before information for routine matters such as billing and treatment can be shared with others, said the officials, who spoke on condition of anonymity.
And the rules prohibit employers from perusing medical information about employees and job applicants. If an employer administers its own health care plan, it is barred from using medical information for anything other than health care.
The rules cover both electronic and paper records a major change won by privacy advocates after an earlier draft of the rules would have limited the requirements to electronic records, officials said.
Violators would face fines of $100 per violation up to a total of $25,000 per year. In the most egregious cases, the rules would allow for criminal penalties up to $250,000 and 10 years in prison, the officials said.
Law enforcement agencies could obtain access to records with an administrative subpoena or summons, but would not have to go to court, the officials said.
And, in a change won by industry, the administration deleted from the final rule a provision that could have opened the door for patients to sue if their records were improperly released.
The regulations were fashioned after nearly a decade of debate on how to protect the privacy of medical records. While federal law protects bank, video rental, credit and other records, there has been no federal protections for medical records. That left patients to rely on a patchwork of state rules.
"This regulation is the most sweeping privacy law in decades," said Janlori Goldman, who directs the Health Privacy Project at Georgetown University. "It will have a major impact on health care."
President-elect Bush could undo the rules by issuing a new regulation, although many think that's unlikely. Congress also could overturn the rules, but lawmakers are unlikely to agree on that.