Health Care Reform:

Patient Privacy Rules -- What Is Going On in Washington?

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Not true, says Goldman, who also participated in Thursday's hearing. She tells WebMD, "They are overreacting. For prescriptions to be filled and for relatives to pick up prescriptions, the government intended that, and they say that [in the rule]."

Moreover, she says, pharmacies are not directly treating patients and do not need to get written consent. "If the doctor gives the prescription to the pharmacist, or if they send it with a patient, that then creates an indirect treatment relationship," she says.

According to John Clough, MD, director of health affairs for the Cleveland Clinic Foundation, by requiring that patients give their consent for release of their records, "routine practices by providers will be disrupted, from sending out reminder notices about appointments to conducting disease management and maintaining quality assurance programs."

But Goldman tells WebMD, "The regulation is very clear that you can get consent as it's practical to get it after the two-year period, that you get it as you can get it. The next time a patient comes in for care, you can get it. In the meantime, you can use their information."

Health providers are also raising cost concerns. John Melski, MD, a medical director at Wisconsin's Marshfield Clinic, said, "We will have to explain the consent and notice to each patient. We wonder who will explain these forms to our patients. We suspect that we will need to hire and train informed consent counselors who must staff our regional centers on a full-time basis."

On the other hand, Mary Foley, president of the American Nurses Association, said Thursday, "The concern for our patients must be our overriding concern, not whether the rule will be inconvenient for hospitals or practitioners or staffers who handle insurance paper work."

Rep. Michael Bilirakis (R-Fla.), who chaired Thursday's hearing, said he was concerned that the rule would divert dollars from patient care into compliance efforts.

But earlier this week on Tuesday, several dozen Democratic lawmakers wrote Thompson urging that the rules go into effect. According to the letter, "Further delay of these crucial protections would be a major setback in years of effort to grant Americans the privacy they have demanded for so long."