Health plans typically send a Summary of Payments (SOP) form detailing the type and cost of medical services received to the primary policyholder each time an enrollee on the plan accesses care. The SOP form is meant to explain how and when an insurance plan is being used and is not a medical bill. In some instances, the SOP form may contain information on sensitive health care services, such as care related to domestic violence or sexual assault, mental health or substance use disorders, sexual and reproductive health or HIV/AIDS, and can unintentionally compromise patient confidentiality for anyone enrolled as a dependent on another person's health insurance policy, such as a young adult or spouse.
The Protecting Access to
"Health Care For All is very grateful for the support of the
The PATCH Act establishes a number of mechanisms to ensure confidentiality. These protections include sending SOP forms directly to the patient rather than to the primary policyholder; allowing patients to choose their preferred address and method for receiving SOPs; providing only general information about certain sensitive services or visits; and providing patients the option to opt-out of receiving SOPs if no payment is due. Those provisions can be particularly important to those seeking contraceptive care and other reproductive health services.
Additional concerns arise in the context of violence and abuse when the primary policyholder may be the coercive, controlling or abusive party. Fear that the controlling partner or family member will learn of the treatment and further exacerbate the abuse may deter many from seeking care altogether.
"Enactment of the PATCH bill marks a critical step in assuring that survivors of sexual and domestic violence can access the health care they need without compromising their confidentiality or risking their safety," observed
The law additionally provides confidentiality protections for those receiving other sensitive medical services.
"An Act to protect access to confidential healthcare will significantly improve patient access to HIV care, including testing and treatment," said
"Healthcare privacy is a critical issue for LGBTQ youth, who face a great deal of stigma in receiving routine care and who need to know that what is confidential at the doctor's office won't be made public when the paperwork gets sent home. LGBTQ youth of color in particular face both heightened health disparities and significant social stigma, and the government should do all it can to protect their right to get the care they need," stated
This new law is also welcomed by health care providers.
"NASW-MA supports the PATCH Act because social workers see the negative effects of this privacy loophole firsthand. Individuals will choose to not seek treatment for substance use or mental health issues for fear of their health insurance policyholder, often a spouse or a parent, finding out" said
The health insurers in
"We are proud to support this important legislation to create new privacy protections for residents of the Commonwealth," said
"Thank you to everyone who worked so hard on this important legislation, especially