Tuesday, August 20, 2002

Unless Minnesota citizens object, detailed personal medical information will soon start flowing into the Minnesota Department of Health (MDH). On Monday, health officials released a proposal to require hospitals and health insurance companies to electronically transmit individually-identifiable medical, psychological and prescription data to the department. No patient consent is required.

"State health officials will have access to confidential medical information. They will know who goes to the doctor, what for, who treats them, with what, and for how long. The department will be able to profile patients and practitioners. The Department has gone so far as to require insurers to provide them with the date a pregnancy begins," says Twila Brase, president of Citizens' Council on Health Care, a Minnesota health care policy organization.

This data reporting requirement was buried in the 174-page MinnesotaCare health care reform bill which became law in 1993. The health department initially implemented an emergency rule to begin data collection shortly thereafter, but experienced problems with lack of uniformity of data. The collection was discontinued and a 5-year pilot project to test the best manner of collection was begun in cooperation with Medica and Blue Cross Blue Shield of Minnesota. After holding several public meetings last fall and this spring - attended primarily by health officials and health plan representatives - health officials are now ready to collect the data from most of the state's health insurers and hospitals.

According to the proposed rule, hospitals must transmit at least 42 data elements and health insurers must transmit at least 50 data elements, including an indication of whether the insurance claim and data elements are for chemical dependency services, mental health services, and pharmacy services. In addition:

• All data will include patient name, address, and medical record number. Principle and other diagnosis codes must be reported, along with detailed information on drug prescriptions provided to patients (number of days' supply, quantity, product code, whether it's formulary or nonformulary, whether it's an original fill or a refill, and who prescribed it)

• Cause of injury, employment status, date of birth, gender, race and ethnicity of patients, marital status, health status at discharge, discharge and admission date, codes for procedures performed, length of hospital stay and type of public coverage (Medicare/Medicaid) must be also be reported.

• Health plans must report where patients received services, the source of payment for services, the number of service units (days, visits, miles, or injections), the type of bill, the dollar charge for each service and the total amount of the bill.

Until September 18, 2002 at 4:30 p.m. members of the public have an opportunity to make comments or request that a hearing be held before an Administrative Law Judge. If there are at least 25 requests for a hearing, the hearing is scheduled to take place on October 4, 2002 at 9:00 a.m. If no hearing is held, the rule can take effect as early as September 19, 2002, with the first submission of data (from year 2003) required to begin on July 1, 2004 - unless Governor Ventura decides to use his new authority to veto the rule.

TO COMMENT OR REQUEST A HEARING: Comments and requests for a hearing are being taken by Tracy Johnson, Minnesota Department of Health, 121 East Seventh Place, Suite 400, St. Paul, MN 55101. Her email address is Tracy.L.Johnson@health.state.mn.us (Phone: 651-282-5650, Fax: 651-282-5628). All submissions must include name and address, be in writing, and must either identify the objectionable portion of the rule or state that the writer opposes the entire rule. If the submission does not include these requirements, the submission is considered invalid. The proposed rule can be found at: http://www.comm.media.state.mn.us/bookstore/stateregister/278.pdf

"The public has until September 18th to protect their medical privacy from state intrusion. If the public does not speak up now, Minnesota health officials will gain whole scale access to private medical records," warns Brase.

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CCHC is an independent non-profit free-market health care policy organization located in St. Paul, Minnesota