The Trump administration is seeking unprecedented access to medical records for millions of federal workers and retirees and their families. A proposed rule from the Office of Personnel Management would require 65 insurance companies covering more than 8 million Americans to provide monthly reports with identifiable health data on their members. The regulation would require insurers to provide “service use and cost data,” including “medical claims, pharmacy claims, encounter data, and provider data.”
The proposal is prompting unease from insurers and health policy experts concerned about the legality of OPM acquiring such a sweeping database of sensitive health information and its ability to safeguard it. The notice, posted and sent to insurers in December, does not instruct them to redact identifying information, instead stating that insurers are legally permitted to disclose “protected health information” to OPM. Several health policy and law experts interpreted the request to mean the Trump administration was seeking identifiable data.
Privacy and HIPAA Concerns
Health law ethicist Sharona Hoffman at Case Western Reserve University noted potential risks: “They are going to get very, very detailed and granular data about everything that happens. The concern here is the more information they have, they could use it to discipline or target people who are not cooperating politically.”
The Health Insurance Portability and Accountability Act (HIPAA) requires certain organizations maintaining identifiable health information to protect it from disclosure without patient consent. Even when disclosures are permitted, HIPAA mandates provision of only the minimum information required. OPM argues in its notice that it is entitled to the information from insurers “for oversight activities,” but several experts questioned whether this explanation is sufficient.
Industry Response
CVS Health executive Melissa Schulman urged the federal agency to reconsider, writing: “OPM’s request raises substantial HIPAA compliance issues.” The Association of Federal Health Organizations, representing dozens of federal health plan carriers, filed a 122-page comment opposing the notice. Among their concerns: insurers are bound by HIPAA to safeguard personal health information, and detailed tracing of even de-identified records to individuals may be possible.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://us.headtopics.com/news/trump-s-personnel-agency-seeks-access-to-federal-workers-81989037