Posts Tagged ‘HIPAA’

An emergency bonfire of the regulations

So as to deploy medical services more effectively during the COVID-19 emergency, the Department of Health and Human Services has announced that it will forgo enforcement of rules restricting telemedicine, both by waiving HIPAA prohibitions on the use of everyday communications technologies like Skype and FaceTime, and by removing a requirement that reimburseable services be provided by the holder of an in-state license. At the same time, as I noted last week, many states have been relaxing rules prohibiting practice by out-of-state medical professionals (partial list here).

That’s part of a pattern in which governments are slashing many old regulations that they realize get in the way of crisis response and complicate the lives of ordinary citizens trying to work and shop under difficult conditions. My Cato colleague Chris Edwards links some of them in this post, including compilations by the Competitive Enterprise Institute and Americans for Tax Reform. (More: R Street Institute; Katherine Timpf, National Review. Hospitals and medical professionals aside, suspended rules include hours of service rules for truckers driving emergency medical supplies, requirements that Florida insurance agents keep public offices, rules forbidding the combined transport of food and liquor in Texas trucks, and federal standards restricting universities’ use of online classes. How many of these rules were unnecessary or unwise in the first place?

While movement of persons between communities may pose a danger during epidemics, movement of goods remains vital to prosperity and mutual exchange. Simon Lester points out in a Cato podcast that easing trade restrictions is a direct way to address difficult bottlenecks in emergency medical supplies. Relatedly, recent tariffs on medical supplies haven’t been helpful, encouraging large factories overseas to prioritize customers outside the U.S. (earlier).

In a reaction to the financial strains caused by the outbreak, the feds have been flooding the banking system with liquidity, both by relaxing regulations and through central bank operations. Cato’s Diego Zuluaga in a podcast distinguishes between liquidity objectives and (what is rightly more controversial) bailout objectives.

NYPD employees charged with selling confidential 911 caller info to claims-fraud ring

“Prosecutors estimate that as many as 60,000 car accident victims may have had their confidential information improperly disclosed” in a scheme in which New York Police Department employees accepted money to pass information about 911 callers to an outfit that would then urge them to visit prearranged medical clinics and lawyers. “He told his fraudulent call center not to target victims in Manhattan, court documents said, because ‘those people got attorneys.’… ‘We want all the bad neighborhoods.’” With bonus HIPAA content: the ringleader of the scheme, besides paying off police personnel, allegedly “bribed employees at hospitals and medical centers to violate the Health Insurance Portability and Accountability Act, known as HIPAA, and disclose confidential patient information for car accident victims, the documents say.” [Ali Watkins, New York Times]

Medical roundup

January 9 roundup

  • Maker of Steinway pianos threatens legal action against owners who advertise existing instruments for sale as used Steinways if they contain other-than-factory replacement parts [Park Avenue Pianos]
  • When the Securities and Exchange Commission settles with defendants, it extracts gag orders forbidding them to talk about the experience. Is it constitutional for the government to do that? [Peggy Little, New Civil Liberties Alliance/WSJ] Update: Cato is suing about this on behalf of former businessman who wants to write book about his experience in court against the SEC [Clark Neily]
  • Judge preliminarily enjoins New York City ordinance requiring home-sharing platforms like AirBnB to turn over to authorities “breathtaking” volume of data about users [SDNY Blog]
  • U.S. Chamber’s top ten bad lawsuits of 2018 [Faces of Lawsuit Abuse] “The Most Important Class Action Decisions of 2018 and a Quick Look at What’s to Come” [R. Locke Beatty & Laura Lange, McGuire Woods]
  • “Small aircraft engines are much less reliable than automobile engines. Why? Well, they all must be FAA certified, and it’s not worth the cost to certify, say, a new model of spark plug.” [John Cochrane, who gives HIPAA and military examples too]
  • “Why logos and art are sometimes blurred on reality TV shows” [Andy Dehnart, Reality Blurred, 2017]

Crime and punishment roundup

  • Sorry, Denver cops, but you can’t keep a journalist from photographing an arrest on the street by telling her she’s violating the health-privacy law HIPAA [Alex Burness, Colorado Independent on handcuffing of editor Susan Greene]
  • Conor Friedersdorf interviews Scott Greenfield, criminal defense blogger and longtime friend of this blog, at the Atlantic;
  • Claim in new article: “extremely broad criminal statutes, no less than vague and ambiguous criminal statutes, are constitutionally problematic for depriving ordinary people of ‘fair notice’ about how the legal system actually works” [Kiel Brennan-Marquez guest series at Volokh Conspiracy: first, second, third]
  • “We Cannot Avoid the Ugly Tradeoffs of Bail Reform” [Alex Tabarrok; Scott Greenfield] New York should learn from Maryland on risks of unintended consequences [New York Post, and thanks for mention] And a Cato Daily Podcast on bail reform with Daniel Dew of the Buckeye Institute and Caleb Brown;
  • In Little Rock and elsewhere, police use of criminal informants creates disturbing incentives that can challenge both probity and accountability [Jonathan Blanks, Cato on Radley Balko account of Roderick Talley raid episode]
  • Call to scrap juries in UK rape trials (because they acquit too often) is met with criticism [Matthew Scott, Spectator]

Medical roundup

Lawsuit recruiters lure women into unneeded surgery

New York Times deep dive into the ethical morass of pelvic-mesh-suit recruitment, in which lawsuit shops recruit women into often unnecessary and sometimes dangerous surgery to remove implanted material, a step needed for claims to be lucrative. [Matthew Goldstein and Jessica Silver-Greenberg, New York Times] Opening paragraphs:

Jerri Plummer was at home in Arkansas, watching television with her three children, when a stranger called to warn that her life was in danger.

The caller identified herself only as Yolanda. She told Ms. Plummer that the vaginal mesh implant supporting her bladder was defective and needed to be removed. If Ms. Plummer didn’t act quickly, the caller urged, she might die.

And how, in the age of HIPAA, did the recruiter on the phone come to know so very much about the medical history of the woman being pitched? What follows is a story of conduct that is shocking, appalling, unethical — but neither surprising nor unusual to those of us who have been writing about the abuses of the litigation business for many years. Plaintiffs suing over back pain after accidents, for example, are regularly steered into unnecessary back surgery, and plaintiffs in the breast-implant litigation were steered into removal surgeries for which the only indications were legal, not medical. These alas are the incentives of injury litigation: run up the medicals (the higher the bill for testing and therapy, the higher the claim value) and if you’re suing over a drug or therapy itself, maybe disengage from it to show your fears are genuine.

All that said, congratulations to the Times and reporters Goldstein and Silver-Greenberg for an investigation that shines a bright light on the need for reform. More: Beck.

Medical roundup

  • Burdensome though it is in other ways, HIPAA does not create a private right of action, so no big-ticket damage suits. Connecticut high court rides to rescue by creating new tort for breach of medical confidentiality [Steven Boranian, Drug and Device Law]
  • Details of cases aside, once again, should federal law really be requiring healthcare employers to grant religious exemptions to staff unwilling to undergo flu vaccination? [Department of Justice press release on suit against Ozaukee County, Wisconsin; earlier on EEOC settlement against North Carolina hospital]
  • First Amendment should come into play when FDA bans drug providers from making truthful statements about their therapies [Henry Miller and Gregory Conko, Reason] And a Cato panel discussion on FDA regulation of speech with former Vascular Solutions CEO Howard Root (author of “Cardiac Arrest”), Christina Sandefur of the Goldwater Institute, and Jessica Flanigan of the University of Richmond, moderated by Cato’s Michael Cannon;
  • “Uberizing Nonemergency Medical Transportation” [Ann Marie Marciarille, Prawfsblawg]
  • “Protecting Reasonable Physician Choice in Medical Product Cases” [Luther Munford, Drug and Device Law]
  • Britain’s National Health Service lurches toward crisis in negligence payouts [BBC, Paul Goldsmith, Centre for Policy Studies]

Privacy a casualty in war on opioids

Law enforcement officials in some states are seeking warrantless access to prescription databases. A New Jersey bill “would require officials to ‘certify’ that they are engaged in a specific investigation,” seeking to calm fears that enforcers will begin trawling data for people to investigate. Rhode Island Gov. Gina Raimondo has already signed a similar bill. “In California, the Supreme Court ruled recently that the state Medical Board can dig through prescription drug records without a warrant or subpoena.” [Associated Press via Scott Shackford, Reason]