HIPAA is a privacy law enacted, passed by Congress and signed by President Clinton in 1996. A state (Maine) cannot implement the law at will to supersede federal because federal laws take priority over state laws due to the supremacy clause of our Constitution.
Under the Privacy Law there are Covered Entities and Business Entities; however, neither list includes veterinarians. The American Medical Association’s web page has this description of HIPAA on it today. Note, this description is on the website of the American Medical Association, which represents human medicine, not the American Veterinarian Association (AVMA) which represents that of animals. Plus neither veterinarians nor their designated staff is bound by HIPAA regulations. How can pet owners who agree to have their personal prescriptions reviewed by someone from a veterinary practice be assured that whatever is seen will remain confidential? They can’t. Whereas in human medicine any HIPAA violations are dealt with appropriately. I think this places an extra burden on a practice, especially a small one. Plus I believe they are as uncomfortable viewing a humans prescriptions as we are knowing the law requires them to.
That gives rise to the question, how can Maine residents be sure their personal data is safe? On March 22, 2017, it was announced that a hacker had breached the Maine Department of Labor’s Job Link, a job matching service. While the service was outsourced to a Kansas company in July 2016, it was reported that the Maine DOL’s computer system is antiquated therefore indirectly played a part in the breach. Officials say the hacker was able to view names, social security numbers, and birth dates of site users. Since July, over 12,000 Maine residents have utilized the site and to date the number of users affected is unknown. So how do we know if the Maine PMP is secure? It’s disturbing alone that a veterinary practice staff member is required to look at consenting humans drug records and that a 5-year window of prescription activity is accessible on the PMP. Now we must also wonder about the security of the electronic system.
Secondly, the state is mandating that veterinarians operate outside their scope of practice since pharmacology is often vastly different between the species. They are expected to make a judgment call when reviewing the owner’s (or anyone picking up the animal) prescription drugs on the PMP database and determining if prescribing a controlled drug for the animal would enable the owner to “potentially” exceed the mandated daily limit of 100 MME. This alone is requiring a doctor trained in animal physiology to understand human physiology. Would you expect your dentist to prescribe medications for your cat’s seizures? Or expect your veterinarian to know how much Vicodin you need following major orthopedic surgery? What if a veterinarian makes the wrong judgment call simply based on the numbers? A pet could be denied much-needed medication. Do legislators really have the power to make such laws where one’s medical privacy is violated and their pet possibly left in pain or distress?The inclusion of veterinarians in this hasty bill is not the answer to the opiate epidemic. Perhaps stricter sentencing should be considered. Recently in my Maine community, during the same court session, a drug trafficker was given a suspended sentence and allowed to freely exit the building whereas someone who embezzled money was sentenced to jail hence escorted out by deputies. The drug he trafficked was Suboxone which is both addictive and has the potential to be fatal if combined with certain other drugs. While I’m certainly not defending someone who embezzled money, as a nurse who worked in a large city teaching hospital, I’ve never heard of someone dying because of it. The stark contrast in sentencing was disturbing and reinforced my belief that including veterinarians in PL 488 is not going to stem the opiate epidemic; appropriate sentencing is.
As a Maine resident who refuses to allow my HIPAA rights to be violated, and as an animal owner who does not want my pet to suffer, I reached out to my elected officials and Augusta, the state capital, multiple times since February 2017 in an attempt to express my concern. My communications have been completely ignored with the exception of Senator Thomas Saviello who was initially helpful but once I began asking more focused questions regarding PL 488, he no longer responds. This is certainly not the reaction I expected from my elected officials nor is it one I’ve experienced while living in other states.
Next ~ Who else is adversely affected by Maine’s PL488?