Debate Continues Over Medical Privacy Law’s Reach

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In the Steve McQueen movie “Bullitt,” the St. Louis Post-Dispatch recalls, an opportunistic politician demands to see a patient’s hospital file. A nurse resists – until a police captain flashes his badge as the politician says: “It’s official police business.” Those days are over.

Some hospitals insist on a court order before they will turn over any patient records to law enforcement officers. The privacy rule of the new federal Health Insurance Portability Act (HIPAA) is making them more careful than ever about patient confidentiality. The rule says hospitals and doctors should get a patient’s permission before giving out medical information to anyone. The rule does not require consent to help law enforcement identify or locate a suspect, fugitive, material witness or missing person.

State laws may require hospitals to cooperate with law enforcement. In Missouri hospitals are required to turn over information about gunshot wounds. Nevertheless, the Missouri Hospital Association is warning member hospitals to take a hard line on releasing patient information to law enforcement officers. What can police get? Without a court order or patient permission, “Generally, nothing,” says Gerald Sill of the association.

The hospitals following the hard-line approach are mostly outside of the St. Louis area. Some of their policies have led to complaints by law officers, says the Missouri Police Chiefs Association. In Kansas City, police complained that Truman Medical Center wouldn’t tell them whether an injured man was being treated there. St. Joseph Health Center in Kansas City bars police and bounty hunters from walking the halls until they’ve checked in with security and get permission to talk to a patient.

Some St. Louis hospitals here have their own attorneys, who have not adopted the state association’s hard line. At the 13 hospitals operated by BJC HealthCare, the privacy expert is Melanie Lapidus, a vice president and associate general counsel. She says there’s not much about the new law that’s clear yet. That’s led many to get advice from consultants or attorneys whose nature is to warn against doing anything that could land a client in trouble.


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