Closing a confidentiality gap [Commentary]

An absolute right to privacy in health care is enshrined in the oath all medical professionals must take. Providers understand they cannot effectively treat a patient if that patient cannot trust that his or her medical information will remain confidential.

Certain types of insurance communications can inadvertently compromise medical privacy, such as the Explanation of Benefits (EOB) sent to policy-holders whenever an insurance policy is used by a family member. The Health Insurance Portability and Accountability Act (HIPAA) requires health plans to redirect insurance communications to an alternate address when an individual has safety concerns. However, this right is not well known by consumers, providers or advocates. Last year, only a handful of Marylanders requested to have their explanation of benefits diverted, a striking fact that underlines the lack of knowledge around existing privacy protections.

Yet many are covered under the insurance of others, be it their spouses, partners or parents. In fact, there will may be up to be 52,000 more young adults insured in Maryland through their parents' policies with the implementation of the Affordable Care Act. As a leading provider of health care to women, Planned Parenthood of Maryland regularly meets patients who cannot use their health insurance for birth control, well women exams, STD testing or other family planning services because of fear that their private medical information will be revealed by an explanation of benefits statement. Indeed, for safety concerns, patients may delay seeking routine treatment until they have a more complicated medical condition, or decide to avoid preventive care altogether. Alternatively, patients may choose to incur medical costs and pay for services out of pocket rather than risk disclosing private medical information to the policy holder. Without privacy protections, these patients are effectively uninsured.

As staunch advocates of patient rights, Planned Parenthood of Maryland led the successful campaign for passage of Senate bill 790 — Communications Between Carriers and Enrollees, Conformity with HIPAA. This legislation closes a wide gap in confidentiality laws to help protect the privacy of health care information for all Maryland women and families. During the 2014 legislative session, the Maryland General Assembly unanimously passed SB 790, advancing the use of privacy protections already in place under HIPAA. Gov. Martin O'Malley signed the bill into law last week.

The Maryland General Assembly deemed the bill "emergency legislation," meaning that it goes into effect immediately now that it has been signed into law. Implementation of SB 790 will put into practice a new standard procedure to offer a form, created by the Maryland Insurance Administration, which will allow any Marylander endangered by information revealed in insurance communications to redirect EOB's and other insurance documentation to an alternate, private address. The form will make it easier for consumers to access privacy protections, particularly with the support of health care providers, behavioral health advocates and organizations that work for survivors of domestic violence and sexual assault.

While such privacy protections exist in HIPAA, they are not well known because there have been no standard ways to access the protection. With this new form, we hope that this legislation will encourage more women and families to seek the care they need, confident that they can exercise control over their own private medical information. To raise awareness and engage more women and families about this new form and increased protections for privacy, Planned Parenthood of Maryland has trained volunteers to educate our patients about their rights while they are waiting to be treated. Our dedicated volunteers are committed to informing our patients about the importance of privacy protections and have been successfully engaging patients for the past year about the Affordable Care Act.

In an age when women's health and access to reproductive care is under attack across the country by so many state legislatures, Maryland remains a positive example of expanding health care access for all individuals. This bill is a victory for patient rights advocates and survivors of domestic violence who need privacy protections to ensure they receive care, no matter what.

Jenny Black is President & CEO of Planned Parenthood of Maryland. She can be reached at

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