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New Massachusetts Law Increases Patient Privacy for Dependents

On March 30, 2018, Massachusetts Governor Charlie Baker signed into law a bill intended to provide individuals with more privacy protection from their health insurance companies.

The “Protecting Access to Confidential Health Care” Act (PATCH Act) gives patients the right to control who receives a summary of payment form after care is provided, helping patients who may have health insurance coverage as dependents of another person maintain confidentiality regarding the care they received.

Improved Confidentiality Protection for Dependents

Summaries of payment are typically sent to the primary policy holder, outlining the care received by any enrollee in the policy, including spouses and dependent adult children. The form is meant to explain how and when an insurance plan is being used, however, in providing a form after services have been provided, insurance company may unintentionally compromise patient confidentiality for enrolled dependents who may not want the primary policyholder to know what care has been provided.

The PATCH Act provides confidentiality protection to these individuals by letting patients:

  • Opt out of receiving a summary payment form if no money is due,
  • Select an address for the form to be sent to
  • Choose to be the ones to receive the form rather than the policyholder

Additionally, certain sensitive health care services will not be able to be identified on the form. The Division of Insurance has been tasked with issuing regulations that define what constitutes “sensitive health care services”.

The PATCH Act provides that the Division of Insurance will develop a plan to educate providers and consumers regarding the rights of insured members and the responsibilities of insurance carriers to promote compliance with this the new law.

Important Information for Providers About the PATCH Act

Note: Aside from participation in such education plan, the PATCH Act does not impose burdens on health care providers, like hospitals or physicians. It applies to health plans. However, there are provisions of HIPAA, and potentially Massachusetts confidentiality laws, that can provide similar protections for vulnerable patients.

© 2019 Foley & Lardner LLP

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About this Author

Alexis Bortniker, Health Care Attorney, Foley Lardner Law Firm
Partner

Alexis Bortniker is a senior counsel and health care lawyer with Foley & Lardner LLP. Her practice focuses on transactional and regulatory matters with an emphasis on counseling health systems, hospitals, and other providers in managed care and physician contracting. Ms. Bortniker is a member of the firm’s Health Care Industry Team.

Previously, Ms. Bortniker was an associate with Choate Hall & Stewart LLP where she gained experience working directly with health care organizations on regulatory and corporate compliance issues, including...

617.226.3177
Lawrence W. Vernaglia, Health Care Attorney, Foley Lardner Law Firm
Partner

Lawrence Vernaglia is a partner and health care lawyer with Foley & Lardner LLP and serves as chair of the firm’s Health Care Industry Team – named “Health Law Firm of the Year” for three of the past four years on the U.S. News - Best Lawyers® "Best Law Firms" list. Mr. Vernaglia represents hospitals, health systems and academic medical centers and a variety of other health care providers. Mr. Vernaglia's practice involves regulatory and transactional matters, including Medicare/Medicaid reimbursement compliance advice and appeals; mergers, acquisitions and financings; state regulatory issues including licensing, change of ownership, and CoN/DoN; survey/certification appeals; fraud & abuse/Stark law analyses; managed care contracting; and general corporate and business planning in health care. He runs strategic planning programs for senior management and governing boards. He regularly serves as local counsel on health care transactions in New England for multi-state projects.

617-342-4079