Cross posted from MiddletownDemocrat.org
by Linda Baum
The Health Insurance Portability and Accountability Act (HIPAA) was passed by the U.S. Congress in 1996 and became effective on July 1, 1997.
The law included a new rule requiring a person’s express approval for release of his or her medical records that is intended to protect a person’s right to privacy with respect to personal health information. And that is only right. However, in what may be a misapplication of the law, HIPAA is often cited by governmental offices to deny access to non-private information.
Because health benefits continue to be one of the greatest cost drivers for municipalities, it’s important that citizens be able to obtain the information needed to evaluate program costs. Further, governmental entities should be required to reveal exactly who is on their rolls for health benefits in order to reduce the potential for fraud and abuse. For example, it is commonly held that appointed professionals are not eligible to receive taxpayer-funded health benefits, and we should be able to verify that they aren’t receiving them.
I’ve learned that, unfortunately, the Open Public Records Act (OPRA) doesn’t guarantee access to non-private health benefits information the way it does to many other public records. In fact, OPRA requests for this information are typically denied.
In 2005, a New Jersey Superior Court ruled in the case of Michelson vs. Wyatt that, with respect to governmental entities, the public has a common law right to information about type of health benefits by name of enrollee for eligible employees, officials, and retirees. Thus, who is on a town’s rolls for health benefits should be public information.
Earlier this year, I submitted a request to Middletown under New Jersey common law for the names of persons who are receiving paid medical benefits from the Township. Adopting a position that other municipalities in New Jersey have rejected, Middletown refuses to provide the information. The Township maintains that the federal HIPAA privacy regulations supercede New Jersey law and bar the release of this information.
That is not only frustrating, but alarming. All New Jersey residents have the right to know the basis for property taxes in their communities. As I believe the Michelson decision established, HIPAA does not deny that right.
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Ms. Baum has been an outspoken advocate for government transparency and fiscal accountability and continues to push for rightful disclosure of information that is in the public interest.
10 comments:
HIPPA protects medical records and documents not who is on insurance rolls. If Middletown is denying access to this information, the someone, or some group, should take legal action. Steve Massell who is running for re-election needs to be asked where he stands on this issue.
May be this letter should be submittede to the Asbury Park Press and The Star Ledger? May be the Asbury Park Press should write an editorial on this one; or, better yet request the information. May be this should be a question for Christie at his next town hall meeting?
May be it is time to give Larry Loigman a call to see if he will take this on?
I don't believe the privacy laws mean that those who pay for other's healthcare have no right to know who is on the rolls. This has nothing to do with "medical" privacy rights. As usual, the cover-up is worse than the crime.
Now she's a lawyer. Linda, stick to writing about the effects of genetically mutated alfalfa.
Taxpayer dollars are being used to cover medical expenses and these expenses have to be accounted for in the budget, so at some level this information is used. As I understand Ms. Baum, she is not requesting personal medical infromation; she is requesting medical expenses paid out by the township, or taxpayers.
So, if each employyee, consultant, contractor, appointee (TOMSA is a good example) is listed by a combination of or variation of name/initials/title/code along with what the township paid out in medical related expenses -- individual and family, then the public/taxpayers would have a clear idea of whether-or-not their tax dollars are being spent appropriately and LEGALLY. We would also have a mechanism to see if Mayor Fiore's very recent health insurance 'reform' is working.
I recall that in 2009, possibly 2010, the township spent about $900,000 in health related expenses, which required an emergency appropriation that was then budgeted and paid for with tax dollars the following year. I also recall Mr. Merchantante saying that emergency appropriations were standard operating procedure for the financial management of medical expenses and spending. The only emergency that should be associated with medical expenses in a visit to the emergency room.
I also recall hearing that the plan administrator is a collegue, or former business associate of Mayor Fiore: is this accurate?
Its time to let the sunshine in and it will probably take legal action to make it happen. Maybe a group of concerned citizens should be put together to pool financial resources to take legal action on this as well as other matters of this nature? Maybe there are some law school students, or interns, who would like to take this kind of issue on for credit or just for the experience of doing it -- could look good on a resume. One person may not have the dollars to do this, where several might be able to make it happen.
Anon 7:00 AM,
What Ms. Baum is doing is a very simple (middle school level project or homework) exercise in civics that doesn't require a law or paralegal degree.
If members of the Sewerage Authority are receiving health or benefits other than the stipend contained in the following township ordinance they are in violation of this ordinance.
§ 47-4. Members; appointment; compensation. [Amended 3-10-1986 by Ord. No. 1856; 1-25-1988 by Ord. No. 2019]
The members and two (2) alternate members of said Township of Middletown Sewerage Authority shall be hereafter appointed by resolution of the Township Committee in the manner provided in N.J.S.A. 40:14A-1 et seq., as amended, and each member shall receive such compensation, not in excess of one thousand seven hundred fifty dollars ($1,750.), and the Chairman not in excess of two thousand one hundred fifty dollars ($2,150.), in any one (1) year, as shall hereafter be determined by said Township of Middletown Sewerage Authority; provided, however, that in no event may any member receive any additional compensation for his services as officer, agent or employee of said Authority.
Hey Linda, how about I come to your workplace and demand to know personal facts about you and your dependents health coverage? Wouldn't like it wouldja?
Anon 8:50,
Get a clue will ya!
Linda never said she wanted personal information about anyone or their dependents.
She wants to know, and rightly so, who are the shadow people that are receiving benefits that shouldn't be.
Anon 8:50 PM,
Smart people take the time to read and understand what is being written, or said.
Note the Michelson decision mentioned in the article established that certain health COVERAGE info is public, not personal health info. Health coverage info would include things like PPO versus HMO selection and whether coverage is for the employee only, family coverage, or something in between.
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