The concern of confidentiality is an important aspect of the anti-fraud provisions of the Kassebaum-Kennedy Act.
State insurance regulators, insurance companies and law enforcement officials share a common dilemma of how to increase the database necessary to prosecute fraud while safeguarding the confidentiality of information.
The Kassebaum-Kennedy Act calls for the establishment of guidelines regarding information furnished by health plans, medical providers and others. Procedures for protection of the confidentiality of information include establishing patient privacy rights.
These guidelines will not be subject to the rulemaking provisions traditionally applied to most federal agencies.
In a recent Mississippi case, the widow of a man who died of AIDS is suing the insurance company. She alleged that her husband was not told that he was turned down for additional life insurance because he tested HIV positive. She stated that he had submitted a written request asking why his application was rejected, and he was refused that information.
Insurance Commissioner Jim Brown put out an alert warning companies that under Louisiana law he will initiate action against them if they withhold such information after receiving a written request from the applicant.
This example illustrates how complex the issue of confidentiality of information and patient privacy rights can be in the health care arena. It also raises the question of continuity from state to state in laws governing privacy issues.