Minutes of September 23, 1998 Meeting

 A meeting of the Law Revision Commission Committee on Confidentiality of Medical Records was held commencing at 4:00 p.m. on Wednesday, September 23, 1998 in Hearing Room 1A in the Legislative Office Building in Hartford, Connecticut. Those attending were: Commission members Committee Chairman Joseph J. Selinger, Jr., William R. Breetz, Mary Anne O’Neill, and Joel I. Rudikoff; advisors Lawrence Berliner, Regina Dacier, Joseph Grabarz, Mary H. Hess, Jennifer Jackson, Peter Kane, Stephen Lewis, Richard J. Lynch, Marybeth Reinhardt, Donald L. Roll for Robert Scalettar, Jeannette C. Schreiber, and Patricia Shea; and Commission staff David Hemond.

Mr. Selinger called the meeting to order.

The minutes of the September 9 meeting were approved.

The committee then reviewed section 2-101 of the Uniform Health-Care Information Act and the following issues were raised:

The committee should consider more comprehensive definitions of health care provider and medical information. Proposed federal definitions, noted in memos prepared by Jeannette Schreiber and David Hemond, were suggested as potentially appropriate. (Schreiber, Breetz, Kane.)

Underlying disclosure standard related to "expectation of privacy", but, given new technology and uses, expectation may not be sufficient. (Shea, Grabarz.)

Determining interrelationship of act with insurers, existing privacy act, and NAIC model is a priority. (Hemond, Kane, others.)

Is scope of review getting too large? If persons voluntarily waive rights or authorize disclosures, should legislature intervene? (Roll, Shea.)

Should "disclose" be defined? Look at NAIC and federal models for possible language. (Grabarz, Shea.)

Should section 2-101 expressly include concept of "persons other than providers" (POPS) who are similarly prohibited from disclosing information legally obtained without written or statutory authorization? (Breetz.)

Should POPS include insurers? employers? others? Is there anyone who would not qualify as a POP if they hold confidential information? Is POP concept restricted to those in the business? (Breetz, others.) Look at federal language and other acts for possible models. (Schreiber.)

How does act treat internal disclosures? Is issue addressed by NAIC draft? Are problems created by mergers? Is purpose of disclosure and integrity of disclosure maintained?

How is integrity maintained when a party wears multiple hats – reviewing, for example, for claims payment and for quality review. Is this a problem?

Best solution, where possible, is to restrict outflow of information from provider. (Kane.)

Restricting outflow often not possible without aggravating claims problems, insurer reticence to pay, fraud. (Groher, Roll.)

Discussion of Massachusetts proposed bill. Creation of third party claims evaluator. Use of coded information.

Discussion of difficulty of restricting flow of information to only what is necessary. Files include irrelevant confidential information integrated with relevant.

Is there any reason that any person who maintains a file should not be covered? (Grabarz.)

Under subsection (b), concerning maintenance of record of disclosures, how long is sufficient? Should record of disclosure be made part of record? What rule should apply for party that briefly holds and discloses confidential information but does not routinely maintain a file?

Is subsection (c) the place to insert a general restriction on redisclosure? (Breetz.) Is this necessary? (Selinger.)

How should this act be integrated with existing law that currently sets higher standard – for example HIV, mental illness? Should single standard apply? Is such a single standard politically feasible?

The next meeting was set for October 7, 1998 at 4:00 p.m. in the Legislative Office Building in Hartford, Connecticut.

The meeting adjourned at 6:05 p.m.

Respectfully submitted,

 /S/ 

David L. Hemond
Reporter/Drafter

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