Provider-patient trust could be put to the test if a proposed amendment to HIPAA by the U.S. Department of Health & Human Services Office for Civil Rights goes into effect.
The amendment--sent this week to the Office of Management and Budget, according to Health Data Management--looks to soften privacy regulations that currently prevent states from reporting patient information to the National Instant Criminal Background System (NICS).
In a statement issued following the release of an advanced notice of proposed rulemaking for the amendment in April, OCR Director Leon Rodriguez said that NICS was "not a mental health registry," and that the rulemaking process would not create such a registry.
"The database that houses information on individuals prohibited from possessing firearms for reasons related to mental health … does not contain medical or mental health records," Rodriguez said. "When federally licensed firearms dealers request a NICS background check for a potential buyer, the only information they get back is that the potential buyer is approved, denied, or additional investigation is needed. The dealer does not receive any information about why an individual is denied and does not ever have access to any records of potential buyers, including health records."
The American Medical Association and a handful of other organizations all expressed concern about the proposed amendment after it initially was made public in April, the Wall Street Journal reported. In particular, the National Association of State Mental Health Program Directors said, in a letter to HHS, that the proposal would "exacerbate the stigma faced by people with mental illnesses and could potentially have a significant chilling effect," on individuals' willingness to share information with providers.
In January, physicians received clarity about their right to ask patients about gun ownership when President Obama signed an executive order promising further guidance explaining that the Affordable Care Act does not prohibit or regulate communication about firearms between clinicians and patients.
"Doctors and other healthcare providers ... need to be able to ask about firearms in their patients' homes and safe storage of those firearms," the administration said in a statement, "especially if their patients show signs of certain mental illnesses or if they have a young child or mentally ill family members at home."