Imagine knowing you need to go to the doctor’s – maybe for birth control or an STD test – but you’re afraid someone might find out so you end up delaying or avoiding this care altogether.
This happens all too often – and this fear stems from real incidences of confidentiality breaches and the fact that patient confidentiality is not guaranteed. In fact, patient privacy is routinely – albeit unintentionally – violated when insurance companies send detailed accounts of medical visits, known as an Explanation of Benefits or EOB, to the plan’s subscriber, not to the patient.
As a young person who, until recently, was still on my parent’s health insurance, this issue is particularly important to me. Like many of us, I hold out hope for a world where every person is able to discuss medical health with their parents. I’m lucky that I have that kind of open relationship with my parents but I know so many others do not. Unfortunately, the disclosure of confidential health information for some people can lead to negative consequences including stigma, abuse, and violence.
A Solution to Ensure Patient Confidentiality
Driven by my steadfast belief that medical decisions should remain between a patient and their provider I headed over to the Massachusetts State House recently and attended a hearing for one of the Planned Parenthood Advocacy Fund’s priority bills, An Act Relative to Protecting Access to Confidential Health Care, also known as the PATCH bill, sponsored by Representative Kate Hogan and Senator Karen Spilka.
A common-sense solution, this bill ensures confidential health care information is not shared with anyone other than the patient – even when multiple people are on the same insurance plan.
The PATCH bill will:
- Allow insurers to send ‘member-level’ EOBs to each insured individual (e.g. the patient), rather than to the primary subscriber (e.g. a parent or spouse), and allow an insured individual to choose their preferred method of receiving EOBs, including at an alternate address or through electronic means.
- Establish a policy that EOBs are not issued if no balance remains on a claim, ensuring EOBs are not sent for preventive health services with no cost sharing (e.g., a birth control refill, pregnancy or STI test, or domestic violence counseling session).
- Require EOBs to provide generic information only, such as “office visit” or “medical care” rather than more explicit descriptions.
- Require insurers to clearly inform individuals of their options to request confidential means of receiving EOBs.
The hearing highlighted how deep of a problem this is, deterring individuals from seeking help for a wide range of sensitive issues, include mental health, domestic violence, substance abuse, and sexual health services.
I was particularly moved by Kim Daly, the Associate Director in the Office of Counseling and Health Services at Salem State University, who shared the story of a twenty-five year old graduate student who desperately needed mental health treatment for anxiety and depression. Constrained by the university’s free counseling service, which only offered appointments during her work hours, the student’s only option was to seek care externally. However, this would require utilizing her parent’s health insurance and she knew mental health was not a subject she could bring up with her parents. As a result, the student decided not to seek treatment, a decision which has worsened her overall mental health. This was just one of many stories shared at the hearing that underscored the critical need to improve patient confidentiality.
What You Can Do In Support of PATCH:
Last legislative session, the PATCH bill passed the Massachusetts State Senate – but stalled in the Massachusetts House. This legislative session, we’re working overtime to ensure that this bill is signed into law – and I hope you’ll continue to join us in this endeavor.
Here are three quick ways you can take action for stronger patient confidentiality protections in Massachusetts:
- Email your state lawmakers in support of the PATCH bill and the Advocacy Fund’s other legislative priorities.
- Educate your friends about the PATCH bill and share this blog post with them on Facebook .
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