BILL ANALYSIS Ó SENATE COMMITTEE ON HEALTH Senator Ed Hernandez, O.D., Chair BILL NO: AB 1755 AUTHOR: Gomez AMENDED: March 28, 2014 HEARING DATE: June 18, 2014 CONSULTANT: Marchand SUBJECT : Medical information. SUMMARY : Revises provisions of law requiring licensed health facilities to prevent disclosure of patients' medical information by extending the deadline for health facilities to report unauthorized disclosures from five business days to 60 calendar days after detection of a breach, and by establishing several exemptions to when a breach of medical information is required to be reported based on unintentional disclosures where no further use was made of the patient's medical information. Existing law: 1.Licenses clinics, health facilities, home health agencies, and hospices through the California Department of Public Health (CDPH). 2.Requires a licensed clinic, health facility, home health agency, or hospice to prevent (collectively, licensed health facilities) unlawful or unauthorized access to, and use or disclosure of, patients' medical information, as defined in the Confidentiality of Medical Information Act (CMIA). 3.Permits CDPH, after investigation, to assess an administrative penalty of $25,000 per patient whose medical information was unlawfully accessed or disclosed, and up to $17,500 per subsequent occurrence of unlawful access or disclosure of that patient's medical information. 4.Requires a licensed health facility to report any unlawful or unauthorized access to, or use or disclosure of, a patient's medical information to CDPH no later than five business days after the unlawful or unauthorized access, use, or disclosure has been detected by the facility. 5.Requires a licensed health facility to report any unlawful access or unauthorized access to, or use or disclosure of, a patient's medical information to the affected patient or the Continued--- AB 1755 | Page 2 patient's representative at the last known address, no later than five business days after the unlawful access, use, or disclosure has been detected, except under specified circumstances. 6.Specifies that for purposes of the provisions of existing law in 2) through 5) above, internal paper records, electronic mail, or facsimile transmissions inadvertently misdirected within the same facility or health care system within the course of coordinating care or delivering services does not constitute unauthorized access to, or use or disclosure of, a patient's medical information. 7.Establishes the CMIA, which prohibits a health care provider, health care service plan, or contractor from disclosing medical information regarding a patient without first obtaining authorization. Defines "medical information" as any individually identifiable information, in electronic or physical form, in possession of, or derived from, a health care provider, health plan, pharmaceutical company, or contractor regarding a patient's medical history, mental or physical condition, or treatment. 8.Authorizes, under CMIA, administrative fines and civil penalties, ranging from $1,000 to $250,000, against any person or entity that negligently discloses, or knowingly and willfully obtains, discloses, or uses medical information in violation of its provisions. Authorizes the Attorney General, any district attorney, any county counsel acting pursuant to an agreement with the district attorney, or a city attorney, to seek civil penalties for violations of CMIA. This bill: 1.Revises provisions of law requiring licensed health facilities to prevent disclosure of patients' medical information, by deleting the use of the term "prevent unlawful or unauthorized access to, and use or disclosure of, patients' medical information," and replacing it with the term "prevent breaches of a patients' medical information" as required under specified provisions of existing law. 2.Extends the deadline for a licensed health facility to report any unlawful or unauthorized access of a patient's medical information to CDPH from no later than five business days after the unlawful access or use has been detected, to instead require this reporting to be done without unreasonable delay AB 1755 | Page 3 and in no case later than 60 calendar days after the breach has been detected. 3.Extends the deadline for a licensed health facility to report unlawful access or use of a patient's medical information to the affected patient or the patient's representative from no later than five business days after detection, to instead require this report be done without unreasonable delay and in no case later than 60 calendar days after the breach has been detected. 4.Permits the reporting to the affected patient or the patient's representative to be made by an alternative means or at an alternative location, rather than the last known address, as specified by the patient or the patient's representative in writing pursuant to specified federal regulations. Permits this notice to be provided by e-mail only if the patient has previously agreed in writing to electronic notice by e-mail. 5.Defines "breach" as the acquisition, access, use, or disclosure of unsecured medical information in a manner not permitted under state or federal health information privacy laws that compromises the security or privacy of the medical information. 6.Exempts from the definition of "breach" any of the following: a. Any unintentional acquisition, access, or use of medical information by a workforce member or person acting under the authority of a licensed health facility, or a business associate, if that acquisition, access, or use was made in good faith and within the scope of authority and does not result in further use or disclosure in a manner not permitted under state or federal health information privacy laws; b. Any inadvertent disclosure by a person who is authorized to access medical information at a licensed health facility or a business associate to another person authorized to access medical information at the same facility or business associate, or organized health care arrangement in which the licensed health facility participates and the information received as a result of the disclosure is not further used or disclosed in a manner not permitted under state or AB 1755 | Page 4 federal health information privacy laws; and, c. A disclosure of medical information when a licensed health facility or business associate has a good faith belief that an authorized person to whom the disclosure was made would not reasonably have been able to retain the information. 7.Specifies that unless otherwise exempted from the definition of a breach of medical information, an acquisition, access, use, or disclosure of medical information in a manner not permitted under state or federal health information privacy laws is presumed to be a breach unless the licensed health facility or business associate, as applicable, demonstrates that there is a low probability that the medical information has been compromised based on a risk assessment of the following factors: a. The nature and extent of the medical information involved, including the types of identifiers and the likelihood of reidentification; b. The unauthorized person who used the medical information or to whom the disclosure was made; c. Whether the medical information was actually acquired or viewed; and, d. The extent to which the risk to the medical information has been mitigated. 8.Defines "business associate," "workforce," and "organized health care arrangement" as having the meanings specified in the federal Health Information Portability and Accountability Act of 1996 (HIPAA). 9.Defines "detected" as meaning that sufficient facts are known about an incident such that a reasonable person would believe that a breach of a patient's medical information has taken place. 10.Defines "unsecured medical information" as medical information that is not rendered unusable, unreadable, or indecipherable to unauthorized persons through use of a technology or methodology specified by the United States Secretary of Health and Human Services (HHS), as specified. FISCAL EFFECT : This bill has been keyed non-fiscal. PRIOR VOTES : AB 1755 | Page 5 Assembly Health: 19- 0 Assembly Floor: 75- 0 COMMENTS : 1.Author's statement. According to the author, this bill improves California's notice requirement specific to breaches of medical information by streamlining the protocol to more closely align with federal law. By increasing administrative efficiency, this bill removes unnecessary costs to the health care system and state administration while ensuring patients are adequately alerted to serious medical information breaches. This bill will improve California's notice requirement specific to breaches of medical information by moving it closer to federal law and removing an extra administrative layer that requires health facilities covered by state and federal laws to analyze all potential breaches under both schemes and take different action depending on the circumstances of the potential breach. The bill adopts the Health Information Technology for Economic and Clinical Health Act (HITECH) standard, which was adopted in January 2013 after extensive public comment and negotiation. It would clarify what must be reported, change the timing of the notification to "as soon as reasonably possible but no later than 60 calendar days after discovery of the breach," and given the sensitivity of medical information, ensure that patients have the option of designating an alternate address where notice may be sent or received. 2.Background on federal law. HIPAA established federal protections for patient's health information held by "covered entities" and any "business associates" that the covered entity that a covered entity engages to help it carry out its health care activities. A covered entity can be a provider, a health plan, or a health care clearinghouse that processes health information it receives from another entity. While HIPAA establishes a federal floor for minimum privacy protections, states are permitted to enact laws that provide greater privacy protections or rights. In 2009, as part of the American Recovery and Reinvestment Act, the HITECH Act was enacted to promote and expand the adoption of health information technology. Among other provisions, the HITECH Act, under the implementing regulations adopted in January 2013, requires HIPAA covered entities to provide notification to affected individuals within 60 days following AB 1755 | Page 6 the discovery of a breach of medical information. If the breach affects 500 or more individuals, the covered entity must report this breach to the media and to the Secretary of HHS within 60 days. Breaches affecting fewer than 500 individuals are required to be reported to HHS on an annual basis. Under the HITECH Act, there are three exceptions to the definitions of "breach," that, when these exceptions apply, would not trigger the reporting and notification requirements. The first exception applies to the unintentional acquisition, access, or use of protected health information by a person acting under the authority of a covered entity, if the access or use was made in good faith and within the scope of that authority, and the information is not further used or disclosed. The second exception applies to the inadvertent disclosure of protected health information by a person authorized to access protected health information at a covered entity to another person authorized to access protected health information at the covered entity or organized health care arrangement in which the covered entity participates. Again, in this second exception, the information cannot be further used or disclosed. Finally, there is an exception if the covered entity has a good faith belief that the unauthorized person to whom the impermissible disclosure was made would not have been able to retain the information. This bill is attempting to align California's medical privacy breach reporting and notification requirements to the recently adopted federal HITECH requirements, which allow for more exceptions to what would trigger a notification and report, and a much longer timeframe for the notification and report (from 5 business days to 60 calendar days). 3.Double referral. This bill is double referred. Should it pass out of this committee, it will be referred to the Senate Judiciary Committee. 4.Prior legislation. AB 541 (Alquist), Chapter 605, Statutes of 2008, required health care facilities to prevent unlawful or unauthorized access to, use, or disclosure of, patients' medical information and established safeguards to protect the privacy of patients' medical information. AB 541 also authorizes CDPH to levy administrative penalties against facilities for failure to prevent unlawful or unauthorized access, use, or disclosure of patients' medical information, AB 1755 | Page 7 and for failure to report instances of unlawful or unauthorized access, use, or disclosure of information. AB 211 (Jones), Chapter 602, Statutes of 2008, established an Office of Health Information Integrity to ensure the enforcement of state confidentiality of medical information, to impose administrative fines for the unauthorized use of medical information upon referral from CDPH, and required health care providers to establish and implement appropriate administrative, technical, and physical safeguards to protect the privacy of patient's medical information. AB 439 (Skinner), Chapter 437, Statutes of 2012, provided an affirmative defense for civil actions taken under CMIA, such that the plaintiff may not be awarded nominal damages if the defendant establishes that defense, as specified. 5.Support. This bill is co-sponsored by Planned Parenthood Affiliates of California (PPAC) and the California Medical Association (CMA). PPAC states that both federal and state law require health care providers to protect patient medical information by preventing unlawful or unauthorized access, require notification to a patient if their medical information has been breached, and apply penalties for not complying with these requirements. However, PPAC and CMA state that there are significant differences between the two laws and licensed health facilities are accountable under both schemes, making compliance with the various provisions more complicated. PPAC states that the California law requiring reporting of unauthorized disclosure was enacted in 2008 following several high profile incidents involving celebrity medical records that were improperly accessed by hospital staff. PPAC states that a number of provisions in that law place tremendous administrative costs on both providers and the state while doing little to add to the protection and security of patient information. PPAC notes that California law does not allow for a risk assessment, requiring health facilities to send a patient notification even in the event of a minor breach, resulting in over notification that can undermine patient trust in their provider and the health care system. PPAC states that better aligning state law with the updated and thoroughly vetted federal regulations will reduce the administrative burden on health facilities. CMA states that making state law requirements consistent with federal regulations will create one clear, objective standard for AB 1755 | Page 8 medical information breach notifications. 6.Oppose unless amended. The American Civil Liberties Union (ACLU) is opposed unless amended, stating that this bill weakens the data breach reporting and notification standards for medical information at a time when public concern over data breaches is high. ACLU states that it sympathizes that the five day report and notification period is difficult to comply with, but states that two months is too long a period of time, and suggests a window closer to the five day timeframe. ACLU also opposes the provisions of this bill that would exclude certain disclosures that "do not result in further use or disclosure in a manner not permitted under state or federal health information privacy laws." ACLU states that this means the bill would exempt from medical data breach reporting rules some instances of patients' medical information having been compromised. ACLU states that this exemption is especially problematic because this bill defines "detect" in such a way that detecting a data breach is only possible at the conclusion of an investigation into the compromise of medical information, which would change the trigger point so that the health facility would only need to report and notify after concluding its investigation and determining that a breach occurred. The Consumer Federation of California (CFC) also opposes this bill unless amended, stating that this bill undermines the existing privacy standard by establishing a new concept of a "breach" that is defined to eliminate virtually every instance of medical privacy violations except for willful criminal theft of records, and further exonerates most willful violations by entitling the health facility to use its own internal, subjective, and ill-defined process to conclude that there is a likelihood that no harm to a patient resulted. CFC states that this bill greatly delays the reporting of those few "breaches" that survive the bill's various new reporting exemptions from the current five business days to 60 calendar days after "detection." CFC states that this lengthy delay is an invitation to those health care providers who are already failing to adequately secure patient records to relax their vigilance even further. 7.Opposition. The Electronic Frontier Foundation (EFF) opposes this bill, stating that the most obvious problem is that any breach reporting will be greatly delayed, from the current five business days to 60 calendar days. EFF states that more significantly, however, this bill will weaken existing data AB 1755 | Page 9 breach reporting regulations by excluding certain disclosures. 8.Policy comment. The author and sponsor indicate that this bill is intended to more closely track with recently adopted federal notification and reporting requirements for medical information breaches, and in doing so, it adopts a definition of "breach" that includes several exemptions. One of the exemptions is when an unauthorized disclosure was made to someone whom the health facility has a "good faith belief?would not reasonably have been able to retain the information." It is unclear how the health facility would be able to make a determination as to whether the person is able to retain information. Additionally, this bill creates a new definition of "detected" that is the basis for triggering any notification and reporting of a breach of medical information. Under this new definition, in order for a breach to meet the definition of "detected," sufficient facts would have to be known about an incident "such that a reasonable person would believe that a breach of patients' medical information has taken place." As opponents have pointed out, this would mean that an investigation would first be necessary to collect "sufficient facts," and determine whether these facts meet the "reasonable person" definition, before even starting the 60 calendar day clock. If part of the rationale of having a longer period of time to notify and report on a breach is to allow time to first determine if the breach rises to the level of notification and reporting, it is unclear why this definition of "detection" is even necessary, since it would mean breaches wouldn't be required to be reported until after the conclusion of an investigation, plus an additional 60 days. 9.Amendments in discussion. The author's staff, supporters, and opponents have been meeting and working to resolve differences. Opponents are requesting language that would restore much of the language back to existing law (removing the new "breach" language, and restoring existing "unauthorized disclosure" language). To accommodate the problems that proponents are trying to address, opponents have offered language that would exempt from immediate reporting to CDPH the "inadvertent" disclosure of a patient's medical information to an unauthorized individual on the premises, where the medical information does not leave the premises, and the entity promptly retrieves the information. Negotiations are also ongoing about the period of time entities are AB 1755 | Page 10 required to notify patients, and report to CDPH, any unauthorized disclosure; opponents have offered 20 days, rather than the 5 days in current law, but less than the 60 days in the current version of this bill. However, at the time of this writing, no agreement on amendments had been reached. SUPPORT AND OPPOSITION : Support: California Medical Association (co-sponsor) Planned Parenthood Affiliates of California (co-sponsor) California Association of Health Facilities California Hospital Association California Primary Care Association California Society of Anesthesiologists Oppose: American Civil Liberties Union (unless amended) Consumer Federation of California (unless amended) Electronic Frontier Foundation -- END --