American College of Physicians: Internal Medicine — Doctors for Adults ®

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From the April 1999 ACP-ASIM Observer, copyright 1999 by the American College of Physicians-American Society of Internal Medicine.

Online pharmacies undergoing scrutiny

A group of U.S. congressmen has asked the General Accounting Office (GAO) to review the growing online pharmacy business.

In making the request, four members of the House Commerce Committee said that they were concerned about online pharmacies that allow physicians to consult with patients they have never treated in person.

The congressmen asked the GAO to determine how many prescription services are on the Internet, how many prescriptions filled resulted from a face-to-face encounter with a physician and which federal and state agencies are regulating the services.

Deadline for a national privacy policy nears

The race is on to create a national privacy policy regulating medical information.

According to the Health Insurance Portability and Accountability Act of 1996, Congress must pass confidentiality legislation by Aug. 21 of this year. If Congress does not act by then, the Department of Health and Human Services (HHS) must enact its own privacy policy by Feb. 21, 2000.

Last month, Sen. Patrick Leahy (D-Vt.) introduced the Medical Information Privacy and Security Act, which would set minimum privacy standards for both paper and electronic records. The bill, which was co-sponsored by Sen. Edward Kennedy (D-Mass.), would give patients the right to inspect, copy and add material to their medical records. The bill would also give patients the right to know who has access to their records before the records are disclosed to anyone, and would limit the disclosure of health care information to those directly involved in the patient's care.

The bill would not preempt any federal or state law that offered stronger privacy protections, and it would require law enforcement agencies to obtain a warrant, a federal subpoena or a court order in order to access an individual's medical records.

In addition, Sen. James Jeffords (R.-Vt.) and Sen. Christopher Dodd (D-Conn.) introduced the Health Care Personal Information Nondisclosure (PIN) Act. The bill bears some strong similarities to the Leahy bill. Analysts say that it would permit stronger state laws regulating confidentiality to override the federal legislation.

HHS is preparing its own privacy proposal in case Congress does not pass the Leahy-Kennedy bill or any other privacy legislation. HHS officials have said that they would have to publish any proposed rule for comment later this summer in order to meet the February deadline.

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