Occupational Health Organizations Ask for HIPAA

February 8, 2001 -- The American Association of Occupational Health Nurses Inc. (AAOHN) and the American College of Occupational and Environmental Medicine (ACOEM) call on the new Congress to address major gaps left by the recently-adopted health privacy regulation. The nation's two largest occupational health organizations urge members of Congress to support legislation which will extend health protections to cover all health information and all health care providers.

"AAOHN and ACOEM are pleased that the Senate Health, Education, Labor and Pensions (HELP) Committee is providing an opportunity to continue the open dialogue about the new health privacy rules," said AAOHN President Deborah V. DiBenedetto, MBA, RN, COHN-S. "The new rules issued by the Department of Health and Human Services (HHS) are a major step towards protecting all American's health information, but still leave large amounts of information vulnerable."

"Despite what has been reported in the media, all health care information is not protected by the new rules," added ACOEM President Robert L. Goldberg, MD, FACOEM. "In fact, most health information related to an individual's employment is not protected and can be accessed by employers. Such information could be used to make decisions about hiring, firing and promotions." Both organizations commend HHS for its work on the new rules, but recognize the statutory limitations the agency had under the 1996 Health Insurance Portability and Accountability Act (HIPAA).

Individuals will visit an occupational heath care provider for many reasons associated with employment: pre-placement physical exams, health promotion activities and medical surveillance, fitness for duty examinations, independent medical examinations, and medical purposes associated with health and safety regulations. Information derived from activities rarely would be transmitted electronically or meet the definition of a standard transaction.

And, since the new rules apply only to those providers engaged in "standard transactions" as defined by HIPAA, the information collected by these providers may not be included in the protections afforded by the new rules. Employers do have legitimate needs to have access to certain personal health information for managing workers' compensation, health and disability benefits, and job accommodations, or considering fitness for work. However, it does not mean they need unfettered access to an employee's entire health record. Unless these large gaps are addressed by legislation, employers will continue to have relatively free access to employee health information.

AAOHN and ACOEM support federal legislation to close the gaps in the HHS rules and extend protections to cover all health information and health care providers-regardless of how information is transmitted and regardless of whether the information results from a HIPAA standard transaction. Otherwise, these gaps will continue to leave large amounts of personal health information unprotected.