GOP Congressman Claims Health Law Will Hand Over ‘Private Health Care Data’ To ‘Federal Bureaucrats’

Rep. Tim Huelskam (R-KS) is alleging that a new Affordable Care Act regulation could require insurers to fork over personal patient information to the government” and force companies to “share sensitive information about their business models.” The rule — which is not yet finalized — is the result of a provision in the law that establishes a “risk adjustment” mechanism to compensate insurers who take on too many sick patients; it’s intended to level the playing field and discourage companies from cherry-picking applicants.

But Huelskam — along with Fox News — are suddenly raising privacy concerns about the rule:

“We think the rule is stepping well beyond where we should be,” Huelskamp told FoxNews.com Tuesday. “There was never any indication that I know that this private health care data would be in the hands of federal bureaucrats.”…”The end result is a bureaucrat would have access to individual claims data,” he said. [...]

“Folks out there would love to see their individual business records … and that would hurt their market competition as a result of that,” he said, reflecting the concerns of the insurance company that contacted him. “The risk modeling by which they determine their premiums, by which they determine who qualifies … they spent many years and many dollars putting together their model.”

HHS insists that it is committed to ensuring patient privacy and is currently soliciting comments from the health care industry and the general public about how best to bolster patient confidentiality. As Media Matters’ Justin Berrier pointed out yesterday, HHS recognizes that, “this approach may raise concerns related to consumer privacy and standard submission formats. Accordingly, we propose national standards to address each of these issues. We seek comment on the proposed approach, as well as comments on the potential advantages and disadvantages of the alternative approaches.” The reinsurance provision in the ACA strikes a similar tone: ” The State, or HHS on behalf of the State, must make relevant claims and encounter data collected under risk adjustment available to support claims-related activities as follows…(1) Provide HHS with de-identified claims and encounter data for use in recalibrating Federally-certified risk adjustment models.”

HHS has extended to comment period for the proposed rule to Oct. 31 and will issue a final regulation shortly thereafter.