AMA Promotes Strengthening Confidentiality for Patients Insured as Dependents

DALLAS - Nov. 10, 2014 - Health insurance companies should strengthen their privacy policies to prevent the potential disclosure of sensitive medical information outside of the confidential patient-physician relationship, according to new policy adopted by the nation’s physicians at the American Medical Association’s Interim Meeting.

Health insurers routinely issue claim processing forms - known as an explanation of benefits (EOB) - directly to the primary policyholder containing the payment status for any medical services provided to individuals covered under the policy. The standard practice of issuing these notices directly to the primary policyholder may disclose sensitive information about the medical care of other covered individuals.

“The disclosure of potentially sensitive medical information on standard insurance forms has become more of a concern as the Affordable Care Act allows an increasing number of young adults to obtain health insurance as dependents of their parents, guardians, spouses or domestic partners,” said AMA President Robert M. Wah, M.D. “The AMA’s new policy promotes a multipronged approach to protect the privacy interests of patients and preserve the financial interests of policyholders.”

Maintaining confidentiality is especially important to patients seeking treatment for sensitive issues such as mental health, substance use, sexual or reproductive health and intimate partner violence. It is widely acknowledged that a lack of, or perceived lack of, confidentiality is a primary factor inhibiting adolescents and young adults from seeking medical care for sensitive issues.

To promote confidential access to health services, the AMA believes that health insurers should be required to:

  • Develop a method of listing health care services on EOB forms that would preserve confidentiality for all insured individuals;
  • Communicate clear procedures to all insured dependents on how to request confidential communications; and
  • Create privacy protections for all insured individuals on electronic information that is available through patient portals maintained by health insurers.

The new AMA policy encourages physicians to inform patients that they can request confidential communications with a Health Insurance Portability and Accountability Act (HIPAA) Privacy Rights Request Form. The AMA has developed a model HIPAA Privacy Rights Request Form, available online, for physicians to provide to their patients.

The AMA also advises physicians to collaborate with parents or guardians to develop individualized treatment plans for minors aged 12-17 that sets expectations for a transition toward increased medical privacy as the minor ages into adulthood.

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Robert J. Mills
AMA Media & Editorial
(312) 464-5970

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