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Of rights and medicine
Medical professionals and health advocates stress the importance of taking charge of your own care by exercising your rights as a patient.
But what exactly are those rights?
There’s currently no federal patient rights law, but each state has some form of legislation addressing the issue.
The Massachusetts Legislature enacted a patient bill of rights in 1979. The law granted patients, among other things, the right to receive prompt emergency life-saving treatment regardless of the ability to pay; the right to participate in making decisions about their own treatment; and the right to inspect their own medical records, and that those records will remain confidential except among those responsible for administering care.
The guarantee of privacy is also a major focus of a federal health care reform law co-sponsored by Sen. Edward M. Kennedy, D-Mass., and former Sen. Nancy Kassebaum, R-Kansas. A section of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), commonly known as the “Privacy Rule,” significantly increases protections for health information, and sets limitations on who can see or receive a patient’s health information.
Under the Privacy Rule, you can read, get a copy (at your expense) of your medical record, and request changes if you identify errors or omissions; decide who can view your record for non-medical purposes; and be informed on how your record was shared and used.
Health professionals involved in your care and a limited number of employees of insurers that pay for your care have complete access without your permission, as well as certain public authorities. For instance, the Massachusetts Department of Public Health, during the recent measles outbreak, had the right to the information on those infected in order to protect the public’s health and safety.
But for the most part, individual health information cannot be released for non-medical purposes without your written permission. This means that your file should not be shared with marketers, a life insurer, a bank, or your employer unless you grant permission.
While privacy is a critical element of HIPAA, another part of the act limits the restrictions that a group health plan can place on benefits for pre-existing illnesses when a person changes health plans.
Prior to the passage of HIPAA, an individual who changed jobs and applied for group health insurance at the new job was often denied coverage for a pre-existing illness for a defined period of time, usually a year. This restriction applied only to pre-existing illnesses, and did not affect the treatment for other conditions.
This meant, however, that a person with diabetes would have to pay for treatment for the disease for a year until the health plan began picking up the charges. This process was repeated with each job change, often forcing people with serious illnesses to stay put rather than face the burden of expensive health care.
HIPAA prohibits group health plans from denying coverage for pre-existing medical conditions if the person can demonstrate uninterrupted health care insurance for at least a year prior to enrollment in the new plan. Upon job termination, an individual’s current health insurer verifies uninterrupted coverage to ensure continuation of payment for the pre-existing illness.
There are limitations to this law, so it is a good idea to check with your benefits department before making a move to make sure your level of coverage continues at your new job.
Although it has limits, HIPAA is a landmark bill, and marks a significant advancement toward the protection of consumer health care rights and privileges. |
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