The Line Between Medical Privacy and Legal Disclosures

Jun 25, 2014

In recent years, we’ve seen a big push towards better consumer protections. Whether it’s the rigid HIPAA law or parts of the ACA that allows patients/consumers to request their doctors to not report diagnoses to insurance companies, you can be sure it has a lot to do with our technological advances. Specifically, it has a lot to do with the privacy concerns associated with those advances.

Even as we’re seeing more efforts by lawmakers, medical professionals and legal advocates to keep up with the technology, there’s one new law that went into effect June 1 that will affect Medicaid and Medicare recipients.

That law is the Physician Payments Sunshine Act.  Its purpose is to first, ensure transparency in the relationships between drug makers and equipment manufactures and those doctors, hospitals or teaching hospitals they do business with. Second, the information gathered by this law will provide invaluable information for consumers by the way of a massive database that will be maintained by the Centers for Medicaid and Medicare. It will be made public September 1, 2014. If you’re wondering why anyone would be interested in seeing the details of the lunches, swag and other incentives traded between drug makers and doctors, consider this: many of those transactions bring “unethical” to a new level. It’s a lucrative deal in many of these relationships. More importantly, you may be paying for it with higher drug costs, Medicare premiums and even your health.

Earlier this year, CMS let us know just how massive the release of this information will be. The data will show how “880,000 distinct health care providers collectively received $77 billion in Medicaid and Medicare payments in 2012”.  What is stinging most is the realization that as many in the industry are clocking in massive gifts, in order for seniors to qualify for Medicaid coverage, they must face the spend down rule and the 5 year look back period.

The public will see a massive number of analyses that compare and contain at least 6,000 different types of services and procedures provided. Also available will be payments received by individual health care providers. In an interview with Newsweek, Eric Campbell, a spokesperson for the Massachusetts General Hospital said, “Conflicts of interest and financial relationships between drug companies are ubiquitous in almost every single aspect of medical practice and medical research and medical education in the U.S.”

“It’s actually hard to find areas where people don’t have a frequent and often very lucrative financial relationship,” he continued. In the March issue of The Journal of American Medical Association, it was revealed that nearly half of the largest pharmaceutical companies in the country have at least one academic medical center leader on their boards. These are part time positions and none earn less than a quarter of a million dollars.

Now though, the public can take that information as it becomes available and use it to make important decisions on who they want to treat them. Already, supporters are saying the information can even be used for online reviews. We’ve seen the damaging repercussions of poor customer service in restaurants, car dealerships, dry cleaners – why not have important physician information at the ready for everyone to use as they choose?

As estate planning lawyers, we understand the importance of choosing ethical medical professionals. The vast majority of our clients have carefully planned for the future while putting into place important protections for their estate and any assets they wish to leave to loved ones. It’s that same attention to detail that will serve them well as they explore the data in order to make informed healthcare choices.

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