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Confidentiality allows patients to make personal decisions about their health care without fear of outside pressure, harassment, or shame. Everyone has a right to high-quality, confidential health care – but many young adults and spouses routinely have their privacy violated.

We want to change that. We must take action on an important state bill — An Act to Protect Access to Confidential Health Care, or the PATCH bill. This commonsense legislation would protect patient privacy and close this loophole in patient confidentiality.

 

The Problem: Many Massachusetts residents do not have access to confidential care

As it stands, insurance companies routinely mail a document called an “Explanation of Benefits” (EOB) to the primary subscriber of the insurance plan, informing them of the medical services received by dependents, even when there’s no payment due. Often insured on a family member’s insurance plan, dependent subscribers like young adults and spouses are frequent victims of this breach in confidentiality. Many fear their parents, spouses, or others will learn about the doctors they saw, the services they received, or the medicines they were prescribed.

Because of these concerns, many people pay out-of-pocket or forgo the care they need altogether. In fact, 9 percent of young adults and nearly 20 percent of teens do not seek sexual and reproductive health care services because of concerns that their parents might find out. For those with abusive relationships, disclosing sensitive information to a spouse or family member could worsen the abuse.

Our Solution: PATCH protects patient privacy

To better protect patient confidentiality, PATCH would:

  • Give dependent subscribers the opportunity to request ‘member-level’ EOBs, sent directly to the dependent subscriber who received the care, rather than to the primary subscriber on the insurance plan.
  • Allow dependent subscribers to receive EOBs at an alternate address or over email.
  • Prevent EOBs from being issued if no payment is due, ensuring EOBs are not sent for preventive health services (e.g., a birth control refill, pregnancy or STI test, or domestic violence counseling session).
  • Require insurers to use generic information about sensitive health care services on EOBs, such as “office visit” or “medical care” rather than more explicit descriptions of services.
  • Require insurers to clearly inform all subscribers of their options to request confidential EOBs.

 

We must act now to pass the PATCH bill

Confidentiality is an as essential component of health care, and PATCH is a commonsense policy that will strengthen patient privacy. Unless we take action, this gap in confidentiality and related fears of being shamed or harmed will continue to deter people from seeking out birth control, STD testing, or even domestic violence counseling services.

 

Bill Information

An Act Relative to Protecting Access to Confidential Health Care

SD 1174, HD 3059

Sponsored by Senator Karen Spilka and Representative Kate Hogan