A Logical Method for Policy Enforcement over Evolving Audit Logs

We present an iterative algorithm for enforcing policies represented in a first-order logic, which can, in particular, express all transmission-related clauses in the HIPAA Privacy Rule. The logic has three features that raise challenges for enforcement --- uninterpreted predicates (used to model subjective concepts in privacy policies), real-time temporal properties, and quantification over infinite domains (such as the set of messages containing personal information). The algorithm operates over audit logs that are inherently incomplete and evolve over time. In each iteration, the algorithm provably checks as much of the policy as possible over the current log and outputs a residual policy that can only be checked when the log is extended with additional information. We prove correctness and termination properties of the algorithm. While these results are developed in a general form, accounting for many different sources of incompleteness in audit logs, we also prove that for the special case of logs that maintain a complete record of all relevant actions, the algorithm effectively enforces all safety and co-safety properties. The algorithm can significantly help automate enforcement of policies derived from the HIPAA Privacy Rule.Comment: Carnegie Mellon University CyLab Technical Report. 51 page

Legal Solutions in Health Reform: Privacy and Health Information Technology

Identifies gaps in the federal health privacy standard and proposes options for strengthening the legal framework for privacy protections in order to build public trust in health information technology. Presents arguments for and against each option

Privacy and Health Information Technology

The increased use of health information technology (health IT) is a common element of nearly every health reform proposal because it has the potential to decrease costs, improve health outcomes, coordinate care, and improve public health. However, it raises concerns about security and privacy of medical information. This paper examines some of the “gaps” in privacy protections that arise out of the current federal health privacy standard, the Health Insurance Portability and Accountability (HIPAA) Privacy Rule, the main federal law which governs the use and disclosure of health information. Additionally, it puts forth a range of possible solutions, accompanied by arguments for and against each. The solutions provide some options for strengthening the current legal framework of privacy protections in order to build public trust in health IT and facilitate its use for health reform. The American Recovery and Reinvestment Act (ARRA) enacted in February 2009 includes a number of changes to HIPAA and its regulations, and those changes are clearly noted among the list of solutions (and ARRA is indicated in the Executive Summary and paper where the Act has a relevant provision)

Double Secret Protection: Bridging Federal and State Law To Protect Privacy Rights for Telemental and Mobile Health Users

Mental health care in the United States is plagued by stigma, cost, and access issues that prevent many people from seeking and continuing treatment for mental health conditions. Emergent technology, however, may offer a solution. Through telemental health, patients can connect with providers remotely—avoiding stigmatizing situations that can arise from traditional healthcare delivery, receiving more affordable care, and reaching providers across geographic boundaries. And with mobile health technology, people can use smart phone applications both to self-monitor their mental health and to communicate with their doctors. But people do not want to take advantage of telemental and mobile health unless their privacy is protected. After evaluating the applicability of current health information privacy law to these new forms of treatment, this Note proposes changes to the federal regime to protect privacy rights for telemental and mobile health users

Double Secret Protection: Bridging Federal and State Law To Protect Privacy Rights for Telemental and Mobile Health Users

Mental health care in the United States is plagued by stigma, cost, and access issues that prevent many people from seeking and continuing treatment for mental health conditions. Emergent technology, however, may offer a solution. Through telemental health, patients can connect with providers remotely—avoiding stigmatizing situations that can arise from traditional healthcare delivery, receiving more affordable care, and reaching providers across geographic boundaries. And with mobile health technology, people can use smart phone applications both to self-monitor their mental health and to communicate with their doctors. But people do not want to take advantage of telemental and mobile health unless their privacy is protected. After evaluating the applicability of current health information privacy law to these new forms of treatment, this Note proposes changes to the federal regime to protect privacy rights for telemental and mobile health users

How Private Health Coverage Works: A Primer 2008 Update

Provides an overview of the definition, role, delivery, and regulation of private healthcare coverage. Discusses the features of employer-sponsored and individually purchased health coverage, and explains the state and federal regulations governing them

Health Insurance Exchanges: Legal Issues

Health insurance exchanges (HIE) are entities that organize the market for health insurance by connecting small businesses and individuals into larger pools that spread the risk for insurance companies, while facilitating the availability, choice and purchase of private health insurance for the uninsured. While there are legal issues that warrant consideration under a federal, state, or private exchange framework, those issues are not insurmountable barriers to implementation

William H. Sorrell, Attorney General of Vermont, et al. v. IMS Health Inc., et al. - Amicus Brief in Support of Petitioners

On April 26, 2011, the US Supreme Court will hear oral arguments in the Vermont data mining case, Sorrell v. IMS Health Inc. Respondents claim this is the most important commercial speech case in a decade. Petitioner (the State of Vermont) argues this is the most important medical privacy case since Whalen v. Roe. The is an amicus brief supporting Vermont, written by law professors and submitted on behalf of the New England Journal of Medicin

Watching You: Systematic Federal Surveillance of Ordinary Americans

To combat terrorism, Attorney General John Ashcroft has asked Congress to "enhance" the government's ability to conduct domestic surveillance of citizens. The Justice Department's legislative proposals would give federal law enforcement agents new access to personal information contained in business and school records. Before acting on those legislative proposals, lawmakers should pause to consider the extent to which the lives of ordinary Americans already are monitored by the federal government. Over the years, the federal government has instituted a variety of data collection programs that compel the production, retention, and dissemination of personal information about every American citizen. Linked through an individual's Social Security number, these labor, medical, education and financial databases now empower the federal government to obtain a detailed portrait of any person: the checks he writes, the types of causes he supports, and what he says "privately" to his doctor. Despite widespread public concern about preserving privacy, these data collection systems have been enacted in the name of "reducing fraud" and "promoting efficiency" in various government programs. Having exposed most areas of American life to ongoing government scrutiny and recording, Congress is now poised to expand and universalize federal tracking of citizen life. The inevitable consequence of such constant surveillance, however, is metastasizing government control over society. If that happens, our government will have perverted its most fundamental mission and destroyed the privacy and liberty that it was supposed to protect