- A new 253-page Obamacare rule issued late Friday requires state, federal and local agencies as well as health insurers to swap the protected personal health information of anybody seeking to join the new health care program that will be enforced by the Internal Revenue Service.
- Protected health information, or PHI, is highly protected under federal law, but the latest ruling from the Department of Health and Human Services allows agencies to trade the information to verify that Obamacare applicants are getting the minimum amount of health insurance coverage they need from the health “exchanges.”
- PHI includes an individual’s medical history, test and laboratory results, insurance information and other data.
- The ruling, explained on pages 72-73 of the book-thick guidance, does not mention any requirement that applicants first OK the release of their PHI. HHS already allows some exchange of PHI without an individual’s pre-approval, especially when for a “government program providing public benefits.” Officials said the swapping of information is simply meant to help figure the best insurance coverge of Obamacare users.
- Explaining the PHI release ruling, HHS said Obamacare “is a government program providing public benefits, is expressly authorized to disclose PHI … that relates to eligibility for or enrollment in the health plan to HHS for verification of applicant eligibility for minimum essential coverage as part of the eligibility determination process for advance payments of the premium tax credit or cost-sharing reductions.”
The new ruling surprised some congressional critics. “This sounds as if HHS will have access to protected health info to me,” said one top Hill aide worried about how well the administration will protect that information. Conservative groups including Americans for Tax Reform have raised questions about the release of PHI in the aftermath of the IRS scandal.
The new rule said that appropriate privacy laws will be followed. “The exchange would submit specific identifying information to HHS and HHS would verify applicant information with information from the federal and state agencies or programs that provide eligibility and enrollment information regarding minimum essential coverage. Such agencies or programs may include but are not limited to Veterans Health Administration, TRICARE, and Medicare,” said the new rule, which HHS is seeking public comment on.
“HHS will work with the appropriate federal and state agencies to complete the appropriate computer matching agreements, data use agreements, and information exchange agreements which will comply with all appropriate federal privacy and security laws and regulations. The information obtained from federal and state agencies will be used and re-disclosed by HHS as part of the eligibility determination and information verification process,” added the rule.
*Modified from a Washington Examiner article