[Congressional Record (Bound Edition), Volume 145 (1999), Part 11]
[Extensions of Remarks]
[Page 15398]
[From the U.S. Government Publishing Office, www.gpo.gov]




  THE CONSUMER HEALTH AND RESEARCH TECHNOLOGY (CHART) PROTECTION ACT 
                               INTRODUCED

                                 ______
                                 

                         HON. CHRISTOPHER SHAYS

                             of connecticut

                    in the house of representatives

                         Thursday, July 1, 1999

  Mr. SHAYS. Mr. Speaker, today I am introducing the Consumer Health 
And Research Technology (CHART) Protection Act to ensure the 
confidentiality of medical records.
  There is currently no uniform standard to protect the privacy of a 
patients' medical records. There have been a number of startling 
examples of the potential effect of this void on the lives of 
Americans.
  For example, The National Law Journal reported in 1994 that a banker 
who also served on his county's health board cross referenced customer 
accounts with patient information and subsequently called due the 
mortgages of anyone suffering from cancer.
  Under the Health Insurance Portability and Accountability Act 
(HIPAA), Congress set a schedule for action on this issue. Should 
Congress fail to enact comprehensive legislation to protect the 
confidentiality of medical records by August of this year, the 
Secretary of Health and Human Services will be required to promulgate 
regulations.
  Congress must act before the Secretary steps in.
  We need to strike an effective balance between preventing the 
disclosure of sensitive information and ensuring health care providers 
have the information they need to treat individuals and make payments. 
The CHART Protection Act is an effort to achieve such an equilibrium.
  The CHART Protection Act safeguards the confidentiality of medical 
records while protecting legitimate uses. The legislation sets out the 
inappropriate uses of medical information. These prohibitions relate 
specifically to individually identifiable information.
  This is an important departure from the approach taken by other bills 
which seek to restrict the use of health information unless 
specifically authorized for disclosure.
  The CHART Protection Act creates a ``one-step'' authorization process 
for the use of individually identifiable information by providing for 
authorization up front, while allowing individuals to revoke their 
authorization at any time for health research purposes.
  Most other proposals create a ``two-step'' authorization process in 
which treatment, billing and health care operations are covered by one 
authorization, while all other uses are subject to a separate 
authorization, including use of information for research purposes. This 
approach has been the source of much controversy and is likely to 
damage our ability to enhance medical knowledge and improve patient 
care.
  In addition, the CHART Protection Act allows patients to inspect, 
copy and where appropriate, amend their medical records.
  Finally, the bill imposes stiff criminal and civil penalties for 
inappropriate disclosures of individually identifiable information and 
creates a powerful incentive to anonymize data.
  We need to achieve a balance between a person's legitimate 
expectation of privacy and the right of a business to know what it is 
paying for.
  It is my hope that my colleagues on both sides of the aisle will 
recognize the necessity of passing a uniform and comprehensive 
confidentiality law which would serve to balance the interests of 
patients, health care providers, data processors, law enforcement 
agencies and researchers.

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