Proposal to Identify Mental Health Patients Barred From Owning Firearms Moves Forward

January 08, 2014 04:45 pm News Staff

A proposal that would ease restrictions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to ensure firearms are kept out of the hands of patients with mental illness is inching its way toward a final rule.

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At issue is a proposed rule from the Obama administration that would create permission within the HIPAA privacy rules to allow states to report the identities of individuals who are barred from buying or owning firearms because of a mental illness to the National Instant Criminal Background Check System (NICS). The administration issued a notice of advanced proposed rulemaking last April, and now is moving to a notice of proposed rulemaking(

Currently, HIPAA privacy regulations create federal protections to ensure the privacy and security of certain health information. The proposed rule would modify those regulations "to expressly permit certain HIPAA covered entities to disclose to the NICS the identities of individuals who are subject to a federal 'mental health prohibitor' that disqualifies them from shipping, transporting, possessing or receiving a firearm."

These individuals are "ineligible to purchase a firearm because they have been 'committed to a mental institution' or 'adjudicated a mental defective.' (U.S. Department of Justice) regulations define these categories to include persons who have been involuntarily committed to a mental institution for reasons such as mental illness or drug use; have been found incompetent to stand trial or not guilty by reason of insanity; or otherwise have been adjudicated by a court, board, commission, or other lawful authority to be a danger to themselves or others or unable to manage their own affairs, as a result of marked subnormal intelligence, or mental illness, incompetency, condition, or disease."

The proposed rule calls for only minimal information, including the names of the individuals, certain demographic data, and codes identifying the reporting entity and the relevant mental health prohibitor.

When the proposed rule was issued last April, the AAFP joined five other organizations in writing a letter of support for the proposal. "As a step toward reducing gun violence, we support creating a permission within HIPAA privacy rules to allow states to report the identities of individuals subject to the mental health prohibitor to the NICS," said the letter. "We appreciate that HHS seeks ways to address the HIPAA barrier to NICS reporting without discouraging individuals from seeking needed mental health services."