The Washington Post discusses privacy questions that may arise with implementation of provisions of the Affordable Care Act, such as the provision allowing young adults to stay on their parents’ health insurance through age 26:
Elizabeth Nash was 21 and just finishing her junior year at the College of William & Mary when she had a miscarriage. She planned to tell her parents about it in person, but her insurer beat her to it when, as a matter of routine, it mailed them a form that described the medical treatment she’d received.
Nash says the experience “caused a rift that took a while to repair.”
Nash, now 38, recently co-authored an analysis of state laws on health-care confidentiality for insured dependents for the Guttmacher Institute, a reproductive health organization, and was surprised to find that state laws in this area are “so lacking and vague and mushy.”
Under the Affordable Care Act, which allows adult children to stay on their parents’ plans until they reach age 26, breaches of privacy such as the one Nash experienced may become a growing problem. […]
The privacy rule of the federal Health Insurance Portability and Accountability Act (HIPAA), which took effect a decade ago, generally prohibits the unauthorized disclosure of individuals’ medical records and other health information. But there’s a catch. Health-care providers and insurers can generally use such information when trying to secure payment for treatment or other services.
And that can be problematic. Providers submit bills to insurers, which process them and generate a document, often an Explanation of Benefits (EOB) form, that tells the insured or the policyholder how much the insurer paid and what, if anything, is owed on the bill.
These communiques are important to combat fraud and identity theft, and many states require that they be sent, according to Nash.
But the documents do not always go to the person who was treated. “The notice could go to your parents or to you, depending on state law, insurance contracts and insurance policy,” says Abigail English, director of the Center for Adolescent Health and the Law, and lead author of the analysis published by the Guttmacher Institute.
Read the full article to learn more about federal privacy regulations for medical data and some insurance companies’ confidentiality provisions.