A state law designed to protect the privacy of medical records is confusing, costly and should be repealed, according to a majority of those who testified at a Senate hearing yesterday.
The Senates Committee on Commerce, Consumer Protection and Housing held the first in a series of public meetings in a packed conference room yesterday at the State Capitol. About 20 people testified.
The hearings are being held statewide to determine the future of a law passed in 1999 that allows medical information to be transferred among doctors, hospitals and health insurers that need it to treat patients and pay health-care providers. The law requires patients to sign release forms before the information can be given to other entities.
The measure was to have taken effect in July, but lawmakers in a special session last year extended the effective date until July 1, 2001, because of confusion over the law.
The privacy bill calls for fines and prison time for violators, and many in the health-care and insurance fields were confused over what information could be released and to whom. The result, many testified yesterday, was chaos.
"Physicians and others who regularly handle medical information simply stopped releasing health information for workers compensation claims, prescriptions and other routine matters out of the fear of being penalized," said Hawaii Medical Association spokeswoman Cynthia Goto. "This occurred despite public assurance by state Attorney General Earl Anzai that his agency would only prosecute those who criminally violated the law beyond a reasonable doubt."
The head of the Hawaii Civil Rights Commission said the law would hinder his agencys ability to investigate allegations of discrimination. Commission chairman Harry Yee said protected health information often is needed to determine if a person was treated differently.
Yee called for the Legislature to exempt the commission from the state law.
Among those calling for the repeal of the measure was Lt. Gov. Mazie Hirono, who testified that a federal law aimed at protecting the privacy of medical records should be allowed to take effect first.
"By monitoring the effect of the federal regulations, we will be able to identify areas of deficiency, if any, and at that point develop a finely tuned response in those areas that require stricter regulatory efforts," Hirono testified.
But George Fox of Advocates for Consumer Rights said no one knows what will happen to the federal Health Insurance Portability and Accountability Act once the Clinton administration leaves office. Fox said the state should not wait for the federal act to take effect.
"Consumers need to be protected from the misuse of their medical information," Fox testified. "This protection can only come from the enactment of a tough, fair law which carries criminal sanctions for criminal acts."
The only other person to speak in favor of keeping the law was Moya Gray, head of the state Office of Information Practices and the Medical Privacy Task Force, which was created by the Legislature to evaluate the law.
Gray said the task force is recommending several major changes, including a proposal that would allow a broader disclosure of protected health information.
She told the committee that the state should proceed with its own law because "it is too early to determine what impact HIPAA (the federal law) will have on Hawaii."
Gray also suggested that the Legislature change the effective date of the law to Jan. 1, 2002, to allow the health-care industry and others time to comply with the law. She said the penalties and sanctions provisions in the law should be delayed until Jan. 2, 2003.