Tenth House Republicans have voiced opposition to new restrictions on military parents’ access to their children’s medical records, calling the policies “reprehensible” and saying they restrict a parent’s ability to make decisions for their children. of health.
The government’s April amendment to the Health Insurance Portability and Accountability Act (HIPAA) privacy regulations has changed the circumstances under which personal health information can be disclosed, particularly regarding reproductive health care.
This change followed the Supreme Court’s 2022 decision to overturn Roe v. Wade and prohibits doctors, insurance companies and other health care organizations from disclosing patient information to government officials for investigations or civil or criminal prosecutions.
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Shortly before the transition, the Defense Health Center published guidance that, in the military health system, parents of children 12 and under have full access to their children’s health records. on MHS Genesis, the Department of Defense’s electronic health records system, but sponsors ages 13 to 17 will only have access to appointment information, messages, immunization records and allergy care.
Although the HIPAA privacy law allows parents to access medical records of minors, there are exceptions, depending on state laws, that protect minors seeking mental or sexual health care, including and birth control and pregnancy, and other reasons.
The DoD’s Parent Disclosure of Protected Health Information Memorandum for Unemancipated Children, published last year, said the agency will follow federal and state privacy laws within the United States, while the March memo 2023 of the DoD allows dependent children to receive care at military hospitals and clinics overseas. for birth control, reproductive health conditions and sexually transmitted diseases without parental consent.
The new DoD limits have come under fire from Republican lawmakers who say the policies allow providers to determine whether young people are capable of making their own health decisions and violate parental rights.
According to the group, led by Rep. Mark Alford, R-Mo., said the lack of access is “a problem” and “causes unnecessary burdens on these parents.”
“Adolescents or young people under the age of 18 are prohibited from voting, drinking alcohol, using tobacco and many other activities by federal and state law because they are not of legal age. enough to make the right decisions about their well-being should not be different,” the lawmakers wrote in the Aug. 5 to the Deputy Secretary of Defense for Health Affairs Dr. Lester Martinez-Lopez.
The group also says the changes prevent parents from “finding out if their child ‘identifies’ as another gender.”
According to the letter, a minor child can also be considered a mature person and seek care such as “removal of his reproductive organs” without requiring parental notification.
The DoD policy specifically states that there are situations in which a donor “may be required to notify” a parent or legal guardian, including life-threatening conditions that require the removal of reproductive organs or behavior. which involves potential harm to themselves or others.
But lawmakers say the language of the records policy means there could be situations in which military parents overseas don’t have a chance to talk to their child about a life-changing decision before a dependent. with him about to do the operation.
“However, the provider may not decide that it is necessary to inform the child’s parents. This policy is guilty,” they wrote.
Lawmakers asked Martinez-Lopez to reconsider the policies.
Adam Greene, a former director of the Department of Health and Human Services and a partner at the Washington, DC-based law firm Davis Wright Tremaine, said the military policy is “really very common.”
“We have this difficult relationship where HIPAA refuses to preempt state law on whether a child … needs parental consent, but HIPAA will rule based on the outcome of whether the parent has access,” Greene said. interview Thursday with Military.com.
State laws vary greatly when it comes to allowing teens to make their own health decisions, but most allow teens to make their own decisions about reproductive care, mental health, and substance use disorders. of drugs, or diseases such as sexually transmitted diseases that young people may not want. parents to know or whether disclosure could cause harm to the patient.
The creation of patient portals – the connection between providers, electronic health records and patients with access to electronic health records – there are difficult privacy issues related to medical care , according to Greene.
In a perfect world, portals would have an option where providers can click a box for patients under 18 to hide protected medical care while allowing parents to see treatment for conditions acute or chronic non-individuals, said Greene.
But technology is not built that way.
“This is a bipartisan concern — security concerns, and on the liberal side, distracting attention — perhaps — not giving parents immediate access to portals, for example, information on their oncology child. I think the key is improved technology,” Greene said.
A study published in the Journal of Pediatrics in 2022 found that differences in national laws “complicate their interpretation” when considering HIPAA rules and health care standards.
According to the main author Dr. Marianne Sharko, with the Department of Population Health Sciences and Pediatrics at Weill Cornell Medicine, evidence “shows that young people may seek health care for potentially sensitive issues such as sexual intercourse , mental health and substance abuse if they give their consent and trust that their health information is private.”
“However, parents and caregivers also have responsibilities related to caring for young patients,” he wrote.
Officials at the Defense Health Center did not respond to a request for comment on the letter by press time.
In a statement accompanying the press release about the plan in March, however, Dr. Anmarie Widener, director of the Office of Privacy and Civil Liberties of the Centers for Disease Control and Prevention, said the new HIPAA Privacy Rule “provides clear guidance” on protecting the personal information of Americans, including children. minors are included in the law.
Officials also encouraged patients to check their state’s laws regarding the ability of young people to consent to medical treatment without parental notification.
“Each of the 50 states, US territories, and the District of Columbia have their own laws governing whether a minor can consent to the care they receive. DHA upholds those state laws by government under all circumstances,” DHA officials wrote.
In addition to Alford, the letter was signed by Republican Reps. Elise Stefanik of New York, Michael Waltz and Cory Mills of Florida, Doug Lamborn of Colorado, Rich McCormick of Georgia, Ben Cline of Virginia, Harriet Hageman of Wyoming, Pat Fallon of Texas, and James Moylan of Guam.
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