BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1298
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 1298 (Jones)
          As Amended August 23, 2007
          Majority vote
           
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          |ASSEMBLY:  |76-0 |(May 24, 2007)  |SENATE: |25-11|(September 5,  |
          |           |     |                |        |     |2007)          |
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           Original Committee Reference:    JUD.  

           SUMMARY  :  Changes existing law relating to the disclosure of  
          personal information, including medical information, maintained  
          by a business or state agency or contained in a credit report.   
          Specifically,  this bill  :  

          1)Expands the application of the Confidentiality of Medical  
            Information Act (CMIA) to include any business organized for  
            the purpose of maintaining medical information in order to  
            make the information available to an individual or a provider  
            of health care for purposes of managing health care  
            information or for treatment or diagnosis, even if the  
            business is not organized for the primary purpose of  
            maintaining medical information for treatment or diagnosis. 

          2)Clarifies that the state's existing security freeze law, which  
            permits a person to place a hold or "freeze" on his or her  
            credit report, does not apply to any information in the report  
            that the credit reporting agency lawfully obtained from public  
            records. 

          3)Expands the definition of "personal information," as that term  
            is used in California's data breach notification laws, to  
            include medical and health insurance information, as defined. 
           
          The Senate amendments  make minor clarifying changes, remove  
          provisions that are duplicative of existing law, and provide  
          that this bill would incorporate changes made by AB 779 that  
          would become operative if both bills are enacted and this bill  
          is enacted after AB 779. 
           
          EXISTING FEDERAL LAW  requires, under the federal Health  
          Insurance Portability and Accountability Act (HIPAA), a health  
          plan, health care clearinghouse, or health care provider that  








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          transmits a person's medical information in electronic form to  
          comply with national privacy standards.  Imposes certain  
          restrictions on the disclosure of medical information and  
          provides further that any entity covered under HIPAA must  
          provide patients or subscribers with certain information about  
          its privacy policies, including a description of how the entity  
          uses and discloses patient information.  
           
          EXISTING LAW  :

          1)Prohibits a provider of health care, health care service plan,  
            or health care contractor from disclosing a person's medical  
            information without first obtaining that person's  
            authorization, except as specified.  Defines "provider of  
            health care" as any corporation organized for the primary  
            purpose of maintaining medical information for treatment or  
            diagnosis.  
             
          2)Provides, notwithstanding #1) above, that a health care  
            provider, health care service plan, or health care contractor  
            shall disclose medical information if required by a subpoena,  
            search warrant, or other court order.  Permits a provider,  
            plan, or contractor to disclose information in other specified  
            circumstances, including for purposes of diagnosis or  
            treatment or as necessary to provide billing or other  
            administrative services to the provider or plan.  Specifies  
            that a provider, plan, or contractor shall not disclose a  
            person's medical information for marketing purposes, or any  
            other purpose not necessary to provide health care services to  
            the patient, without express authorization from that person.  

          3)Permits a person to place a "security freeze" on his/her  
            credit report by making a written request to a credit  
            reporting agency.  Prohibits the credit reporting agency, once  
            a security freeze is in place, from releasing the person's  
            credit report or any information within it without the express  
            authorization of the person who requested the freeze.  

          4)Requires any person, business, or government agency that owns  
            or licenses computerized data that includes personal  
            information to disclose any breach in the security of that  
            data to any California resident whose unencrypted personal  
            information was compromised.  Provides further that notice of  
            breach shall be made in the most expedient time possible,  
            unless a law enforcement agency determines that notification  








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            will impede or compromise a criminal investigation.  

          5)Defines "personal information," for purposes of the breach  
            notification law, to include the person's first and last name,  
            or first initial and last name, in combination with any of the  
            following:  a social security number (SSN), driver's license  
            number, and certain account numbers if disclosed in  
            combination with corresponding access codes.  Specifies that  
            personal information does not include publicly available  
            information that is publicly available in federal, state, or  
            local government records.    

           AS PASSED BY THE ASSEMBLY  , this bill was substantially similar  
          to the version approved by the Senate.

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.

           COMMENTS  :  This bill addresses two distinct issues relating to  
          the disclosure of personal information in two different  
          contexts:  electronically stored medical information and public  
          records information in credit reports. 

          This bill contains two provisions aimed at the problem of  
          medical identity theft and, more generally, a patient's right to  
          keep medical information private.  First, this bill will ensure  
          that all companies that maintain personal health records are  
          covered by California's existing medical privacy law.  Under  
          CMIA, companies are generally prohibited from disclosing medical  
          information about a patient without the patient's prior  
          authorization, subject to certain exceptions.  However, the CMIA  
          presently defines as a "covered entity" any business that  
          maintains medical information for the "primary purpose" of  
          making the information available for purposes of diagnosis or  
          treatment.  However, the author points out that not all  
          businesses that maintain personal medical information are  
          organized for the primary purpose of making that information  
          available for purposes of diagnosis or treatment  The author's  
          rather straightforward solution to this problem is to eliminate  
          the word "primary" from the relevant section of the CMIA so that  
          the law will apply to any company that makes medical information  
          available for purposes of diagnosis or treatment, whether that  
          be its primary purpose or not.  The author reasons that any  
          business that stores and potentially disseminates medical  
          information poses a threat whether it is the only service  








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          provided or whether it is just one of many services provided. 

          This bill's second provision relating to medical privacy would  
          expand the definition of "personal information" to include  
          medical and health insurance information for purposes of the  
          state's data breach notification laws.  Existing law requires  
          businesses and state agencies that maintain personal information  
          to notify affected persons in the event that a breach in  
          security may have compromised the security of that personal  
          information.  Existing law, however, defines "personal  
          information" to include the person's first and last name, or  
          first initial and last name, in combination with any of the  
          following:  a SSN, driver's license number, and certain account  
          numbers if disclosed in combination with corresponding access  
          codes.   In light of recent reports about the growing problem of  
          "medical identity theft," this bill would expand that definition  
          of "personal information" to include medical and health  
          insurance information.  

          In addition to changes in medical information, this bill makes  
          clarifying changes to California's "security freeze" law, which  
          permits an individual to place a hold, or freeze, on his or her  
          credit reports under certain circumstances.  For example, if a  
          person has reason to believe that some sensitive piece of  
          personal information, such as a SSN, has been obtained by an  
          identity thief, that person may request that the credit  
          reporting agency stop selling his or her credit report.  

          However, provisions of California's security freeze law recently  
          came under scrutiny by a California appellate court in UD  
          Registry v. California (2006) 144 Cal App. 4th 405.  In that  
          case, a credit reporting agency claimed that the law  
          unconstitutionally allowed consumers to block the dissemination  
          of public records, and thereby interfered with the reporting  
          agency's commercial free speech rights under both the United  
          States and California constitutions.  Although the court refused  
          to strike down the law entirely, it nonetheless concluded that,  
          as applied in that particular case, the law could not prevent  
          the reporting of information that the agency had obtained from  
          public records.  In short, a person may demand that a credit  
          reporting agency not sell his or her credit report, but he or  
          she cannot prevent the agency from reporting information within  
          the credit report that the agency has lawfully obtained from  
          public records. 









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          This bill will amend existing law to conform to the UD Registry  
          opinion.  It does so by specifying that, notwithstanding the  
          existence of a security freeze, the credit reporting agency may  
          disclose any public record information lawfully obtained by the  
          agency from an open public record.  According to the author,  
          this measure is necessary not only to bring the law into  
          conformity with the court ruling, but to protect the law from  
          any future challenge that could lead to the invalidation of the  
          law in its entirety.  For while the court in UD Registry held  
          that the provision was only unconstitutional as applied, it left  
          open the possibility that a future challenge could find that the  
          law was unconstitutional on its face.  This bill will ensure  
          that the law passes constitutional muster by creating an express  
          exemption for lawfully obtained public record information. 

           
          Analysis Prepared by  :    Thomas Clark / JUD. / (916) 319-2334 


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