The Impact of Federal Stimulus Efforts on the Privacy and Security of Health Information in California

Deven McGraw


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This is archived content, for historical reference only.

Health privacy laws govern the control and use of a patient’s medical information. In California, health privacy involves a combination of federal law (primarily, the Health Insurance Portability and Accountability Act of 1996 [HIPAA]) and state law (the California Confidentiality of Medical Information Act [CMIA]). HIPAA rules set the baseline, with California law expanding patient protection where it provides more stringent regulation than HIPAA.

The recently enacted economic stimulus legislation (the American Recovery and Reinvestment Act of 2009 [ARRA]) includes a number of improvements to federal health privacy law, in some cases providing stronger protections than those that previously existed for patients in California. It is not yet clear, however, how regulators and courts will interpret all of the new ARRA health privacy provisions. Moreover, significant gaps in patient protection will remain despite the new federal privacy protections provided by ARRA.

This issue brief analyzes the health privacy legal landscape in California before 2009 and discusses changes made by enactment of ARRA. The brief covers the following elements of health privacy law:

  • Who is covered
  • Types of health information covered
  • Access, use, and disclosure of health information
  • Patient rights, including accounting of disclosures, record access, and control over use of information for marketing
  • Patient notification in the event of a breach
  • Enforcement of the laws

The brief also identifies a number of significant gaps in privacy protection that remain unaddressed by state and federal law and that merit further attention from policymakers.

The complete issue brief is available under Document Downloads.

In addition, author Deven McGraw presented her findings at a legislative briefing in Sacramento, California, on June 26, 2009. The audio of that presentation and accompanying slides are available through the Related CHCF Pages below.