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HIPAA Changes in H.R. 1
The American Recovery and Reinvestment Act of 2009

Relationship to Other Laws
House bill Sec. 4421
Senate bill Sec. 13421
Conference agreement Sec. 13421

This text is from the Conference Committee Report

Current Law

Under Section 1178 of the Social Security Act, as amended by HIPAA, the security standards preempt any contrary provision of state law, with certain specified exceptions (e.g., public health reporting). Pursuant to HIPAA Section 264, however, the privacy rule does not preempt a contrary provision of state law that is more protective of patient medical privacy. Psychotherapy notes (i.e., notes recorded by a mental health professional during counseling) are afforded special protection under the privacy rule. Almost all uses and disclosures of such information require patient authorization.

House Bill

The House bill would apply the preemption provisions in SSA Section 1178 to the requirements of this subtitle and preserve the HIPAA privacy and security standards to the extent that they are consistent with the subtitle. The Secretary would be required by rulemaking to amend such standards as necessary to make them consistent with this subtitle.

Senate Bill

The Senate bill includes the same provisions; with the additional requirement that the Secretary revise the definition of psychotherapy notes to include test data that are part of a mental health evaluation.

Conference Agreement

The conference agreement takes language from the House bill. The provision related to psychotherapy notes is moved in the conference report.