Happy Anniversary PATCH Act!

The Protecting Access to Confidential Health Care (PATCH) Act is officially two years old! Signed into law March 30, 2018, the PATCH Act has been a direct source of increased confidentiality in Massachusetts healthcare. Before this law was passed, health insurance companies would send Summaries of Payment (SOPs) or Explanations of Benefits (EOBs) to the insurance policyholder, even if it was a dependent and not the policyholder receiving care. This caused a large breach of privacy for dependents; parents or spouses of dependents on their healthcare plan would be able to see a list of services the dependent was provided in these SOPs or EOBs, greatly affecting patient confidentiality. Research has shown that teens and young adults are much less likely to seek sexual and reproductive health services when they are on a parents’ insurance plan. The PATCH Act sought to fill this previously unaddressed gap in patients’ privacy. Under this law, patients can opt to have SOPs and EOBs addressed and sent to them directly, rather than the policyholder (1). There are various means of receiving SOP and EOB information, including a secure online portal or having the statements mailed to the patient’s address if they live separately. Additionally, the information listed on the SOP/EOB is not specific as to what services were provided, but gives a general description such as “office visit” (2). When no cost-sharing with insurance is required for a visit or service, patients can opt-out of receiving a SOP altogether (3). All Massachusetts patients benefit from this increase of privacy in healthcare. In order to utilize the confidentiality initiatives of the PATCH Act, patients must contact their insurance companies and request it; insurance companies are required to let subscribers know that requests for confidentiality can be made. 

“We’re so grateful to have this option available for anyone in the Commonwealth who is covered by someone else’s insurance plan,” said Jill Clark, Director of the Division of Child/Adolescent Health and Reproductive Health at the Department of Public Health.  “In addition to reducing barriers to care for young people seeking many different types of sensitive services, the PATCH Act provides important safety protections for individuals experiencing intimate partner violence who are covered by a partner’s plan.”

PATCH Act Provider Fact Sheet: https://www.hcfama.org/sites/default/files/provider_fact_sheet_-_final_patch.pdf

PATCH ACT Patient Fact Sheet: https://www.hcfama.org/sites/default/files/patient_fact_sheet_patch.pdf

References:

  1. https://blog.mass.gov/masslawlib/new-laws/privacy-protection-of-health-insurance-information/
  2. https://www.hcfama.org/confidentiality-protection
  3. https://www.hcfama.org/confidentiality-protection