Repro rights lobby eyes ways to shield medical records, prescriptions

Yahoo

4 days ago

BOSTON (SHNS) – Scouring for ways to fortify a 2022 law, reproductive care providers and supporters are advising lawmakers to tighten protections around electronic medical records, omit certain information in a prescription monitoring database, and modify prescription labels.
The Legislature passed the abortion and gender-identity shield law soon after the Supreme Court overturned Roe v. Wade, with the aim of protecting providers and patients, including those traveling to Massachusetts for care, from out-of-state-legal action. Republican Gov. Charlie Baker signed that law in July 2022.
But with President Donald Trump back in the White House House and restrictions on abortion access — including emergency abortion care — escalating across the country, Massachusetts Democrats have shown a heightened interest in revisiting the shield law to address what some see as lingering threats.
'Though the Attorney General's Office believes firmly in the strength of our shield law and stands ready to defend it should the need arise, we recognize that the national landscape has shifted since its original passage, and that there are gaps in the shield law that urgently need to be closed to ensure Massachusetts providers and patients are protected,' Allyson Slater, director of the office's reproductive justice unit, told the Senate Committee on Steering and Policy on Wednesday .
'By way of example, we know that states like Texas and Louisiana have initiated civil and criminal cases against a shield law provider in New York. We're watching these cases closely,' Slater continued. 'Further, Project 2025 has called for increased surveillance of abortion, weaponizing state data collected by states to further restrict and undercut access to this care, even in states that protect it.'
While the Senate committee hearing did not focus on an explicit piece of legislation, discussion closely hovered around a bill (S 2522) that chair Sen. Cindy Friedman filed with AG Andrea Campbell in mid-April to install additional protections around reproductive and transgender care. Friedman, who helped author the original shield law, was named this year to helm efforts by Senate Democrats to respond to the Trump administration.
Friedman told the News Service her colleagues were interested in hearing about the 'content of the bill, which is around making sure that we do everything we can to protect legally sanctioned health care in this commonwealth, and it's especially being attacked around reproductive health and gender-affirming care.'
Asked about areas where the shield law has fallen short, the Arlington Democrat said, 'The law has worked out.'
'There's more to be done,' Friedman said. 'For instance, around prescribing and realizing now a doctor's name is on a bottle for mifepristone, and that's something that somebody who's out to get that doctor can get access to.'
Putting the name of the provider's practice on the label, rather than the specific prescriber, adds a 'critical layer of anonymity for providers,' said Claire Teylouni, senior director of policy and programs at Reproductive Equity Now. Echoing Slater's warning, Teylouni also invoked Dr. Maggie Carpenter, the New York doctor facing a hefty penalty from Texas and a felony charge from Louisiana for prescribing medication abortion.
'We can act now to hopefully prevent any Massachusetts provider from also being identified with their personal information on a prescription,' Teylouni said.
Friedman's proposal blocks state agencies from cooperating with or providing information for federal or out-of-state investigations into legally protected health care activities here. It also curtails the sharing of electronic medical records with out-of-state entities, and blocks insurance companies from discriminating against nonprofits that provide reproductive and gender-identity care.
According to Senate President Karen Spilka's office, the bill also requires hospitals to provide emergency services to 'any person who presents at the hospital or is brought to the hospital by emergency medical services.' Slater said this provision stems from the federal government's unwillingness to enforce the Emergency Medical Treatment and Labor Act, or EMTALA, given the Justice Department's decision to drop its case challenging Idaho's abortion ban and refusal to abide by EMTALA.
Slater said the existing prohibition on law enforcement cooperating with out-of-state or federal investigations should be extended to all state and local agencies.
Campbell's office also needs 'explicit authority' to enforce the shield law, Slater said.
'The 2022 shield law was silent, in particular respect, with the attorney general's enforcement mechanisms, with respect to certain provisions, ' Slater said. 'I think our office's recommendation would be to create explicit in the statute the fact that the attorney general could enforce certain mechanisms and certain protections, so that anytime the shield law was invoked, we would be notified and we would be in a position to defend and work with the providers or the patients that were subject to the shield law.'
Gavi Wolfe, legislative director at the ACLU of Massachusetts, urged senators to impose new limits on the Massachusetts Prescription Monitoring Program. To raise awareness among prescribers, the system tracks drugs that come with a risk of abuse or potential for psychological or physiological dependence.
In Texas, Attorney General Ken Paxton has used information from the state's monitoring program to sue physicians for prescribing gender-identity medications, Wolfe said.
'Let's make sure that our state Prescription Monitoring Program can't be used by the feds to go after reproductive or gender-affirming care,' Wolfe said. 'The Prescription Monitoring Program was established to prevent abuse of prescription drugs, especially opioids, but there's no reason that medications related to reproductive health and gender-affirming care need to be included in its vast database and made vulnerable to prying eyes.'
Aiming to curtail access to another trove of information, providers and advocates urged lawmakers to improve privacy protections around sensitive electronic medical records.
With most Massachusetts hospital systems using the same platform, called Epic, people's medical histories can be easily accessed. That information could become potentially harmful in the wrong hands, said Dr. Megan Evans, an OB-GYN representing the Massachusetts Section of the American College of Obstetricians and Gynecologists.
'Although this is helpful in accessing prior notes and labs to add to a patient's history or better understand their disease, it can also detail a patient's abortion procedure, IVF, or gender-affirming care, even if received in another state,' Evans said. 'When seeking care, patients may unknowingly provide consent for access to this information, or providers with malintent may say a patient provided consent for medical records when they may not have or may not have fully understood what they were consenting to.'
Senate Minority Leader Bruce Tarr, who pointed to past efforts to develop a streamlined, common platform like Epic, asked how the system could be adapted to address mounting privacy concerns.
Evans said providers could make certain records 'protected,' which would require future providers to secure 'specific consent' from their patients before they can access the information. Medical records dealing with behavioral health care, HIV testing and genetic testing already require 'explicit consent' from patients before they can be released, added Dr. Chloe Zera, a Boston-based maternal fetal medicine physician.
'I'm not too concerned that it can be done technologically,' Friedman told Tarr. 'I would worry how it's done, because as we know, electronic health records have been both a good thing and a bad thing, and we don't want to add to the confusion. But you raise a really good point.'
Ahead of the hearing, practicing and studying obstetricians and gynecologists pressed for stronger abortion protections and access to care, and shared support for Friedman's bill.
The Senate referred Friedman's bill to the Health Care Financing Committee, which Friedman chairs, on April 14. The House non-concurred with that action Tuesday and sent the bill to the Judiciary Committee. On Thursday, the Senate receded with its referral and also sent the bill to the Judiciary Committee.
Senate members of the Committee on Advanced Information Technology, the Internet and Cybersecurity earlier this month favorably reported out Sen. Cindy Creem's location shield law (S 197). The bill would also tighten abortion protections by blocking the sale of location data to third parties.
Friedman said Creem's bill is part of the 'whole package' of abortion protections.
'If people are selling your data, if they're tracking you, if we don't have any privacy, then we're just adding burdens to people who are providing legally protected care and getting legally protected care,' Friedman told the News Service.
Physicians and students also advocated for the location shield bill, which in the House is sponsored by Reps. Lipper-Garabedian and David Vieira (H 86). Lipper-Garabedian said that in 2023, more than 171,000 women traveled out of state to seek reproductive health care, with many getting care in Massachusetts.
'We know this in part because a federal investigation last year revealed that a data brokerage firm tracked interstate travel visits to Planned Parenthood clinics in 48 states, including here in Massachusetts, and then sold that data to the largest anti-abortion campaign in the country,' said Lipper-Garabedian (D-Melrose).
'Patients deserve privacy and dignity in making deeply personal health care decisions,' she added. 'Providers like you, who dedicate your lives to delivering life saving care, deserve to do so without fear and interference.'
[Ella Adams contributed reporting.]
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