New law makes protecting patient privacy easier

While a trio of domestic-violence protections drew wide attention, the General Assembly quietly added another layer of protection for those seeking to keep their health information confidential.

Senate Bill 790, passed at the end of the session, will make it easier for the person who receives medical treatment to ask the insurer to send the “Explanation of Benefits” form directly to that individual, rather than the policy holder.

The bill will protect the privacy of abused spouses as well as young adults still covered under their parents’ health plans.

“This really impacts any patient, male or female, who finds themselves endangered by confidentiality being broken,” said Jenny Black, president and CEO of Planned Parenthood of Maryland. “In particular, that tends to cover domestic violence victims who are wanting to escape situations, but also anyone accessing reproductive health care, mental health care, substance abuse treatment — anything people feel should be kept deeply private.”

Under the terms of the legislation, the Maryland Insurance Commissioner must create a standardized form for patients to request that confidential communications from insurance companies be sent directly to them.

For domestic violence victims who are covered under their abusers’ health insurance, the bill will make it easier for them to, for example, obtain birth control or medical care after an attack, without their abuser knowing, said Laure Ruth, legal director of the Women’s Law Center of Maryland, which supported the bill along with a coalition of other reproductive-rights groups.

“For certain victims of domestic violence, the power and control dynamic includes controlling when and why a victim goes to see a doctor and sometimes they are prevented from getting the care they need,” Ruth said.

While the situation is less extreme, a dependent spouse may also have reason to shield the medical treatment he or she receives under the other spouse’s health plan.

The law will also help young adults under their parents’ health insurance policies who may not want to share their medical information with their family. Their numbers are growing under the Affordable Health Care Act, which allows young adults to stay on their parents’ health insurance until they are 26, said Sen. Delores G. Kelley (D-Baltimore County), who introduced the bill.

Already a right

Usually, health care providers send an explanation of benefits to the primary policy holder.

Those who are not the primary holders can already request confidential communications from their insurance companies under the Health Insurance Portability and Accountability Act, but most people do not know they have this option, Kelley said.

“This is already in federal law, which means it applies to the states, but people are not aware of this and if we were to say, ‘You have this right,’ and don’t help people to exercise it, we are not doing much.”

Under the new law, there will be one form that can be used by all insurance providers, Ruth said.

“This form would just be broadly distributed so people can find out and have a simple way of asking their service provider to send communications to an alternate address.”

Planned Parenthood of Maryland spearheaded the initiative and involved other groups and legislators after hearing, anecdotally, that patients would opt out of health care because they did not want the information to be sent to the policy holder, Black said.

“From our perspective, when people were opting out because of confidentiality, they were becoming effectively uninsured,” Black said. “Clearly, we have a mission to make sure our patients get the care they want and need and lack of insurance is a barrier to care.”

The bill passed in the Senate March 19. The House passed the bill April 4 and Gov. Martin O’Malley signed the bill April 8. It is an emergency bill and is effective upon enactment.

The plan is for the form to be available to health providers that aid domestic violence victims as well as online for people to download, Kelley said.

“People are actually being beaten up by violent family members who control them and who read their mail and who would use any indication that maybe they went for treatment after a domestic violence incident or after they have been beaten to lash out again at them,” Kelley said.

Three other domestic-violence bills passed this session. Senate Bill 333/House Bill 307, which absolves domestic violence victims of having to prove the likelihood of future attacks by clear and convincing evidence in order to obtain a restraining order. SB 334/HB 309 added second-degree assault to the list of crimes that can result in a permanent protective order. The enactment of SB 337/HB 306 would add up to five years to a sentence for violent crimes committed in front of a minor over the age of 2.