Patient Privacy Rule Is SoftenedPatient Privacy Rule Is Softened

Rules governing the privacy of patient records continue to evolve, sometimes in surprising ways. Tell any health-care exec who worries about federal privacy regulations that those provisions might actually be loosened and you'll see a fine example of skepticism.

And yet, concerted business pressure, public attention, and some political will forced the Department of Health and Human Services to reform one counterintuitive regulation. The rule in question prevented health-care workers from seeing a patient's health-care information unless the patient first gave them written permission.

Now, caregivers need only make a good-faith effort to get the consent before setting about their jobs. The original rule, like the Health Insurance Portability and Accountability Act of which it is a part, was well-intentioned. But, at least in the case of the consent regulation, implementation resulted in negative side effects.

In 2001, the Office of Management and Budget asked the public to suggest rules in need of reform or outright elimination, says Susan Dudley, director of the Regulatory Studies Program at George Mason University's Mercatus Center. The center recommended 44 of the 71 nominations that came in.

Finding out how--or if--each nomination was addressed by the relevant agency has proved difficult. It doesn't appear that OMB itself knows the outcome in all cases. OMB categorized 14 of Mercatus' nominations as "high priority," Dudley says. However, the center is unable to ascertain the status of five of those high-priority suggestions. It's possible that a more-complete accounting of the nominations by OMB will be given to Congress by month's end.

For clarification, OMB has no enforcement powers. It passed along the suggestions but can't require changes. "This is more of a 'let's pause and look back before we enact more regulation,' " Dudley says. And even as such, OMB has called for nominations from the public only three of the last four years.

At least Dudley and the Mercatus Center will keep the focus on effective and needed regulation, right? Maybe. She didn't rule out submitting nominations again, but, "we're like everyone else. We pick our topics and then we move on."