BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2191
                                                                  Page  1

          Date of Hearing:   April 23, 2002

                           ASSEMBLY COMMITTEE ON JUDICIARY
                               Ellen M. Corbett, Chair
                    AB 2191 (Migden) - As Amended:  April 1, 2002
           
          SUBJECT  :   MEDICAL RECORDS: CONFIDENTIALITY

           KEY ISSUES  :  

          1)SHOULD THE CONFIDENTIALITY OF MEDICAL INFORMATION ACT (CMIA)  
            BE AMENDED SO THAT PHARMACEUTICAL COMPANIES, LIKE HEALTH CARE  
            PROVIDERS, HEALTH PLANS AND CONTRACTORS, MAY NOT DISCLOSE  
            MEDICAL INFORMATION REGARDING A PATIENT WITHOUT FIRST  
            OBTAINING AUTHORIZATION, EXCEPT IN SPECIFIED CIRCUMSTANCES?

          2)SHOULD PHARMACEUTICAL COMPANIES BE PROHIBITED, LIKE HEALTH  
            CARE PROVIDERS, HEALTH PLANS, AND CONTRACTORS UNDER CURRENT  
            LAW, FROM REQUIRING A PATIENT, AS A CONDITION OF RECEIVING  
            PRESCRIPTION DRUGS, TO SIGN A WAIVER THAT WOULD PERMIT THE  
            DISCLOSURE OF MEDICAL INFORMATION?

                                      SYNOPSIS
          
          This bill amends the CMIA to provide that pharmaceutical  
          companies, like health care providers, health plans, and  
          contractors, may not disclose medical information regarding a  
          patient without first obtaining authorization except in  
          specified circumstances.  The bill also prohibits pharmaceutical  
          companies from requiring a patient, as a condition of receiving  
          health services, to sign an authorization, release, consent or  
          waiver permitting the disclosure of medical information.  The  
          author and her supporters argue that pharmaceutical companies  
          should be held to the same confidentiality standards as other  
          health care providers and assert that the bill is needed to also  
          ensure that consent cannot be required of patients as a  
          condition of receiving needed medications. 

          The analysis suggests amendments to ensure that the author's  
          intent to hold pharmaceutical companies to the same  
          confidentiality standards as doctors, health insurers and  
          pharmacists is carried out.  In addition, the author has agreed  
          to amend the bill to address concerns regarding the bill's  
          definition of pharmaceutical company to avoid duplicative  
          treatment of certain entities.








                                                                  AB 2191
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           SUMMARY  :   Seeks to enhance the confidentiality protections of  
          the Confidentiality of Medical Information Act.  Specifically,  
           this bill  :  

          1)Adds pharmaceutical companies to the list of entities that may  
            not disclose medical information regarding patients without  
            first obtaining authorization except in specified  
            circumstances.

          2)Defines "pharmaceutical company" as any company or business,  
            or an agent or representative, that manufactures, sells, or  
            distributes pharmaceuticals, medications, or prescription  
            drugs.

          3)Adds pharmaceutical companies to the list of entities that may  
            disclose medical information in specified circumstances.

          4)Adds pharmaceutical companies to the list of entities that are  
            prohibited from requiring a patient, as a condition of  
            receiving health care services, including pharmaceuticals,  
            medications, or prescription drugs, to sign an authorization,  
            release, consent, or waiver that would permit the disclosure  
            of medical information that otherwise could not be disclosed  
            under the CMIA.

           EXISTING LAW  :  

          1)Prohibits, under CMIA, a provider of health care, health care  
            service plan, or contractor from disclosing medical  
            information regarding a patient of the provider of health care  
            or an enrollee or subscriber of a health care service plan  
            without first obtaining an authorization, except as specified.  
             (Civil Code section 56.10(a).  All further statutory  
            references are to this Code.)

          2)Requires a provider of health care, health care service plan,  
            or contractor to disclose medical information if the  
            disclosure is compelled as specified.  (Section 56.10(b).)   
            Existing law also permits a provider of health care or health  
            care service plan to disclose medical information in specified  
            circumstances.  (Section 56.10(c).) 

          3)Prohibits a provider of health care, health care service plan  
            or contractor from requiring a patient, as a condition of  








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            receiving health care services, to sign an authorization,  
            release, consent, or waiver that would permit the disclosure  
            of medical information that otherwise could not be disclosed  
            under the CMIA.  (Section 56.37.)

          4)Defines "contractor" as any person or entity that is a medical  
            group, independent practice association, pharmaceutical  
            benefits manager, or a medical service organization and is not  
            a health care service plan or provider of health care.   
            "Contractor" does not include insurance institutions or  
            pharmaceutical benefits managers licensed pursuant to the  
            Knox-Keene Act.  (Section 56.05.)
           
          FISCAL EFFECT  :   The bill as currently in print is keyed fiscal.  


           COMMENTS  :   This bill was heard and approved by the Health  
          Committee on April 16, 2002 by a vote of 18-0.  In support of  
          the measure, the author writes: 

               AB 2191 would simply extend the Confidentiality of  
               Medical Information Act (CMIA) to include pharmaceutical  
               companies and require that they be held to the same  
               confidentiality standards as doctors, health insurers and  
               pharmacists.  Further, pharmaceutical companies, like  
               other providers of health care, would be prevented from  
               requiring medical information as a condition of  
               dispensing drugs that may otherwise not be disclosed  
               under any other provision of law. ? 

               Currently, pharmaceutical companies collect  
               patient-identifiable information for the purposes of  
               managing the distribution of drugs that are limited in  
               supply; coordinating free medication under various  
               patient-assistance programs; and managing participation  
               in clinical trials of new drugs.  These practices leave a  
               potentially dangerous loophole within the CMIA because  
               pharmaceutical companies or their representatives can  
               collect sensitive medical information but are not held to  
               the same confidentiality standards that other health care  
               providers must adhere to under the law. 

           Ensuring author's intent is carried out.   This bill extends the  
          confidentiality protections of the CMIA by adding pharmaceutical  
          companies to the list of entities that may not disclose medical  








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          information regarding patients without first obtaining  
          authorization except in specified circumstances.  The author's  
          intent is to ensure that pharmaceutical companies are held to  
          the same confidentiality standards as doctors, health insurers  
          and pharmacists.  In order to ensure this intent is carried out  
          and pharmaceutical companies are included in the CMIA in the  
          same manner and to the same extent as health care providers,  
          health plans and contractors,  the Committee may wish to discuss  
          with the author the benefits of amending the bill to also add  
          pharmaceutical companies to several other important CMIA  
          sections.
           
          Should the author and Committee agree, the bill should be  
          amended to add pharmaceutical companies to the following:

           Civil Code section 56.101, dealing with the preservation of  
            confidentiality of records;
           Civil Code section 56.11, relating to requirements for  
            authorizing release of medical information; and 
           Civil Code section 56.12, providing for a copy of an  
            authorization to the patient.  
           
          Amendments to address duplicative treatment.   This bill adds a  
          new definition of pharmaceutical company to the CMIA, providing  
          that a pharmaceutical company means "any company or business, or  
          an agent or representative thereof, that manufactures, sells or  
          distributes pharmaceuticals, medications or prescription drugs."  
           Three pharmaceutical benefit management companies, AdvancePCS,  
          Express Scripts, and Merck-Medco, have raised concerns about  
          this definition, arguing that they are already included under  
          the CMIA's current definition of contractor and they should not  
          now also be covered under the new definition of pharmaceutical  
          company.  In addition, the companies argue that if defined as a  
          pharmaceutical company, they would be subject to an increased  
          level of restriction in discharging their responsibilities and  
          their ability to administer drug benefits would be disrupted.   
          In order to address these concerns, the author has agreed to  
          amend the bill as follows:

            On page 3, line 27 after "drug." add:  "Pharmaceutical company  
            does not include a pharmaceutical benefits manager, as  
            included in subdivision (c) or a provider of health care as  
            included in subdivision (i)."
           
           With these amendments, AdvancePCS and Express Scripts remove  








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          their opposition and are neutral on the bill.  Although it has  
          not been verified, it appears that Merck-Medco's concerns have  
          been addressed by the most recent amendments to the bill as  
          well.

           ARGUMENTS IN SUPPORT  :  Privacy Rights Clearinghouse supports the  
          measure stating, "The ability to control the use and flow of  
          confidential medical information is one of the most frequently  
          expressed consumer concerns.  Potential adverse effects from  
          unfettered flow of such sensitive information are many."

          In support of the measure, Hepatitis C Action & Advocacy  
          Coalition writes: 

               People should not have to fear that a drug company would  
               sell, share, or use their personal medical information  
               for marketing or other purposes.  Nor should they be  
               coerced into providing such information to a drug company  
               or its representatives in order to be provided prescribed  
               medication or treatment.  This bill will help protect our  
               privacy, especially about personal health information.

          The Congress of California Seniors supports the measure, noting  
          that it is "important that this consumer information be  
          protected as it is with other groups covered by CMIA."

           Prior Related Legislation.   SB 19 (Figueroa), Ch. 526, Stats. of  
          1999 significantly strengthened the CMIA by: (1) applying the  
          rules regarding disclosure of medical information to any  
          contractor with providers of health care providers; (2)  
          prohibiting an HMO from conditioning health care services upon  
          the enrollee waiving medical information confidentiality  
          protections; (3) prohibiting health care service plans and their  
          contractors from using medical information for  commercial  
          purposes; and (4) increasing the sanctions for unauthorized  
          disclosures.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          American Civil Liberties Union
          California Academy of Family Physicians
          California School Employees Association 
          City and County of San Francisco 








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          Congress of California Seniors
          Foundation for Integrative Aids Research 
          Frontline Hepatitis 
          Hep C Advocate Network 
          Hepatitis C Action & Advocacy Coalition 
          Planned Parenthood Affiliates of California
          Privacy Rights Clearinghouse
          Project Inform
          Survive Aids 

           Opposition 
           
          AdvancePCS (unless amended)
          Express Scripts (unless amended)
          Merck-Medco (prior version)
           
          Analysis Prepared by  :    Saskia Kim / JUD. / (916) 319-2334