Take these steps to protect the confidentiality of your medical records

Medical records may contain information about your family history, substance abuse, sexual behavior, and mental illness. You depend on these records being kept confidential. But think about the number of people who might have access to your medical records, just in the course of one visit to a health care provider: doctor, nurse, receptionist, billing office, pharmacist, health insurer. If you’re hospitalized or you visit the emergency room, the number of people increases. If your employer administers your benefits, human resource staff members may also have access to your medical records. What’s more, the Department of Health and Human Services plans to set up a “unique health identifier” number to link all your health records to one, universal number ID. All of this probably doesn’t sound as though your records are “confidential.” They’re not.

Medical Information Bureau (MIB)

The Medical Information Bureau (MIB), a clearinghouse for information on individual medical records, provides medical information about individuals to approximately 600 life insurance companies, many of which also offer health and disability coverage. When an individual applies for life, health, or disability insurance, the applicant’s medical records are likely to become part of MIB’s database. Sometimes members of small groups, late enrollees, and applicants requesting additional coverage may end up in the database as well.

Insurers pay a membership fee to MIB and a fee each time they verify applicants’ information. Insurers also report individuals’ medical conditions to MIB to add to its database. When you apply for an insurance policy and the insurer checks with MIB, you may end up paying higher premiums because of information MIB reports to the insurer. In an extreme case, you may not be hired for a job or you may lose a job because of a condition that shows up on your medical record.

Insurance companies are supposed to notify you if they intend to check your record at MIB when you apply for insurance. Ask your agent when you apply whether the company uses MIB.

Protecting your privacy

You can take steps to protect the confidentiality of your medical records:

- Ask your health care providers, in writing, for a copy of your medical records. Correct any errors. Find out to whom these providers give access to your records.

- Instead of signing a blanket release waiver, give permission to release only records that relate to a specific treatment or condition.

- Be stingy with the information including your Social Security number that you give out on surveys and questionnaires, especially over the phone.

- Check whether MIB has a record on you and make sure that the record is accurate, which is your right under the Fair Credit Reporting Act. You can write to MIB at P.O. Box 105, Essex Station, Boston, MA 02112; phone 617-426-3660; Web site www.mib.com.

- Tell MIB in writing not to release your information without your notarized consent. Withdraw all prior consent.

- Get copies of company policies covering medical records if your employer is self-insured and therefore subject to ERISA regulations. Storing medical records in personnel files is illegal make sure that the company policies specify that.

- Giving your doctor all the information necessary for your treatment is important. However, consider holding back information that isn’t relevant to your health.

- Call or write your congressional representative. Ask for a medical privacy law that limits medical information to health care providers and insurers and doesn’t include a universal “health identification number.”

Federal law states that medical records are confidential. Under the Americans with Disabilities Act, companies must not use medical records to make employment decisions.

Employers can find out even more from credit records that reflect billing for health care services and from bankruptcy records.

Genetic testing, which can indicate predisposition to inherited diseases, may become another area of concern in the privacy issue. If your insurers pay for genetic testing, their records will include the results.