U.S. Customs and Border Protection (CBP) seized a psychiatric nurse practitioner's phone filled with confidential patient information at Washington Dulles International Airport last week, according to a new lawsuit. Muhammad Numaan Imam alleges that CBP agents told him that they could take his electronics the "easy way or the hard way" and refused to let him talk to his lawyer because "we are the authorities at the border."

The lawsuit by the American-Arab Anti-Discrimination Committee (ADC) may be the first time CBP is taken to court over seizing people's medical records. ADC is also helping Palestinian-American lawyer Jay Shehadeh and Jewish-American journalist Max Blumenthal sue over their devices being seized.

"We're seeing a pattern where officers use their border-search authority not to advance any legitimate border-related purpose, but to punish individuals for refusing to provide access to their personal electronic devices and for having expressed views the government didn't approve of," ADC president and legal director Jenin Younes wrote in a statement emailed to journalists.

While Shehadeh and Blumenthal claim that CBP is retaliating for their political views, Imam argues that he faced threats and retaliation with the simple act of asserting privacy rights. Both Imam and Shehadeh were considered "trusted travelers" under the Global Entry program, which allows American citizens who undergo a background check to pass through an automated fast track at airports and borders.

Asked by Reason, a CBP spokesperson did not address any specifics of the case, giving only a generic statement about how "CBP's ability to lawfully inspect electronic devices crossing the border is integral to keeping America safe in an increasingly digital world."

The border exemption to the Fourth Amendment gives U.S. authorities the power to look for "contraband" crossing into the country without a warrant. There is a mess of contradictory court rulings on whether that power includes searching travelers' electronic data, but in practice, CBP can simply seize the physical devices that the data live on.

And the agency often lies outright to travelers whose data that it wants to search, as documents recently released in the case of Atlanta protester Samuel Tunick show. CBP agents gave Tunick a false reason for detaining him and falsely promised that he would be allowed to leave with his phone if he cooperated, even though they were under orders to seize his devices no matter what. Tunick is now on trial for allegedly tricking the CBP agents into deleting his data to avoid a search.

"It's happening to a lot of people, and it's being used in this coercive, inappropriate way," Younes tells Reason.

The problems for Imam, who lives in Virginia, actually began at another border. He was heading to Istanbul on Saturday for a family vacation with his Pakistani wife, Khadijah Mansoor, and their 1-year-old child. Turkish authorities demanded to see Mansoor's U.S. green card, which she had forgotten at home, and wouldn't let her enter on her Pakistani passport alone. The family had to board the next flight back to Washington. On their arrival, CBP naturally wanted to know why they had been turned away and why Mansoor didn't have her green card.

But things took a weirder turn after agents told Imam he had been "flagged" for undisclosed reasons, pulled him into a separate room, and began questioning him about his social media use and group chats, according to the lawsuit. (Imam tells Reason that they asked about group chats in general, not any specific group chat.) When agents asked for the password to Imam's phone, he told them that he uses the phone to communicate with and manage cases for patients at the rehab facility where he works. The Health Insurance Portability and Accountability Act (HIPAA) strictly prevents doctors and other medical staff from sharing patient data without consent, so Imam asked to speak to a lawyer.

"Your lawyer cannot do anything. We are the authorities at the border," Imam recalls one agent saying. A supervisor then told the couple that CBP could take all of their electronics the "easy way or the hard way," and that the devices could take months to get back, Imam and Mansoor claim.

CBP's own internal policy says that devices should "ordinarily" be held for less than five days. The same policy includes vague guidelines for dealing with medical information: "Possibly sensitive information, such as medical records and work-related information carried by journalists, shall be handled in accordance with any applicable federal law and CBP policy." Imam says that the CBP agents claimed to have software for filtering out HIPAA-protected data.

After four hours in detention, CBP took the family's phones and laptops and let them go. The next day, Imam got an email stating, "We regret to inform you that your membership in Global Entry has been revoked for the following reason(s): You do not meet the Trusted Traveler standard." In addition to both Imam and Mansoor losing valuable work data, the lawsuit argues, Imam is now unable to prescribe certain psychiatric medications to his patients, because of federal regulations that require phone verification.

The lawsuit demands the return of the devices and data under Rule 41(g) of federal criminal procedures, which requires the government to hand back property that is no longer necessary for a criminal investigation. ADC has also filed these motions in Shehadeh and Blumenthal's cases. (CBP gave back Blumenthal and Shehadeh's phones almost immediately afterward, but ADC is continuing to press for records of what they did to those phones in custody.) Younes filed a brief on Blumenthal's behalf in support of an upcoming Supreme Court case over whether CBP can continue these electronic searches.

"The devices are neither contraband nor subject to forfeiture, and, to Plaintiffs' knowledge, there is no pending criminal investigation, criminal prosecution, or warrant authorizing their continued seizure or search," Imam's lawsuit states. "The Fourth Amendment does not permit the border-search exception to become a means of coercing compliance through the threatened or actual confiscation of travelers' personal property."

The post Border Cops Seize Nurse's Phone Filled With Psychiatric Patient Information appeared first on Reason Magazine.

Like most of American healthcare, kidney care has for decades been plagued by red tape. The Trump administration says it wants to change that. On Tuesday, Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. announced his department's Kidney Care National Plan, which promises to introduce more competition, reduce regulatory barriers, expand patient choice, and overhaul America's kidney transplant system.

Much of the plan focuses on barriers to entry in dialysis care, which treats nearly 558,000 Americans. While dialysis can be performed at home, most patients receive treatment at specialized facilities, which must comply with federal certification requirements governing equipment, staffing, water quality, and patient safety in order to participate in Medicare.

Kennedy argues that regulatory barriers have discouraged competition and innovation, leaving patients with fewer dialysis treatment options. "Dialysis technology is an extraordinary technology," said Kennedy at the press conference, but "because of monopolies in the system and the barriers to new entrants, we have not seen any real improvements in that technology."

Of course, the existence of large or even monopolistic companies is not in itself evidence of a problem, but government regulation can often entrench those companies' positions in the market. "I like the fact that they're recognizing that a lot of regulatory…barriers are contributing to the problem, and that's refreshing to hear," says Jeffrey Singer, a practicing general surgeon and senior fellow at Reason Foundation, the nonprofit that publishes Reason. Singer says that removing barriers that prevent new companies from competing with established providers could not only increase choice but also drive down prices.

HHS says that two companies, DaVita and Fresenius Medical Care, control approximately 74 percent of the American dialysis market. As of 2019, roughly a third of Americans lived in areas where the only available dialysis provider was one of those two companies, according to the agency. The administration argues that government regulation has helped entrench this dominance by making it difficult for new providers to enter the market.

To address this, the Kidney Care National Plan suggests a number of reforms, including simplifying certification requirements. HHS also plans to investigate whether dominant dialysis providers have used payment arrangements and legal strategies to secure higher reimbursements without delivering better care.

The 17-page report calls for a review of existing requirements, but it does not specify which regulations will be repealed, nor does it establish a timeline for doing so. It also does not propose any significant reduction in the government's role in financing the distorted market. Instead, the plan largely seeks to make existing government-financed systems such as Medicare more competitive and efficient.

Kennedy has also correctly identified the need for reform regarding kidney donations. Nearly 90,000 people are waiting for a kidney transplant at any given time in America, and 11 people die every day waiting for a kidney. The transplant process is currently managed by Organ Procurement Organizations (OPOs), which are federally certified nonprofits responsible for recovering organs from donors and coordinating their transfer. There are currently just 55 federally designated OPOs operating in the United States, and HHS argues that they behave as "regional monopolies." Since no new OPOs have been approved in the last year, the Kidney Care National Plan suggests fast-tracking certification.

The plan also seeks to make living kidney donation easier by reducing financial barriers. Following the passage of the Honor Our Living Donors Act in February, HHS revised federal reimbursement rules so that a donor's eligibility for financial assistance is no longer determined by the transplant recipient's income. Eligible donors can receive up to $6,000 to cover expenses, including travel, lost wages, and childcare.

However, the reforms proposed stop short of allowing kidney donors to receive direct compensation for the organs themselves, which remains prohibited under federal law. "I can sell my blood. Why can't I sell my kidney?" Singer asks.

Peter Jaworski, director of the Georgetown Blood and Plasma Research Group, feels similarly, arguing that financial incentives are available to nearly everyone involved in kidney transplantation except the donors themselves. "According to this plan, it's OK to use incentives to encourage them to be more productive, to actually do a better job," Jaworski tells Reason, referring to transplant surgeons, hospitals, and organ procurement organizations. "The only exception, once again, is the donor who is offering a kidney."

Better solutions exist, according to Jaworski, who points to the proposed End Kidney Deaths Act. The bill, which was introduced by Rep. Nicole Malliotakis (R–N.Y.) last year, would offer living kidney donors a $50,000 refundable tax credit, distributed over five years. "We have those systems in order to make sure that we can treat patients. That's the point of blood donation. That's the point of plasma donation. That's the point of kidney donation too."

America's plasma market is an excellent example of financial incentives encouraging donation. Unlike many other countries, the U.S. allows plasma donors to be compensated, and despite accounting for just over 4 percent of the world's population, it supplies approximately 68 percent of the plasma collected globally for manufacturing medicines.

"Why do you think America does it? Is it because in America there's way more altruism than in France or Italy or Belgium? No, it's because in the United States you can be paid to donate plasma," argues Jaworski.

The Trump administration appears to recognize that government overreach has stifled competition and restricted patient choice. It also recognizes that living adults donating kidneys will be part of the solution to the long, deadly waiting lists. But its plan leaves the government's outsize role in kidney care largely untouched. For patients facing years on dialysis or waiting for a lifesaving transplant, recognizing the problem is not enough.

The post RFK Jr. Wants To Cut Red Tape in Kidney Care. He Should Go Further. appeared first on Reason Magazine.

Ohio State University (OSU) is disputing allegations from the Department of Justice (DOJ) that it is discriminating in the admissions process for its medical school.   The DOJ sent a letter Wednesday to the OSU College of Medicine alleging the school intentionally discriminated against applicants on the basis of race, particularly Asian applicants, to the benefit of Black…

Ohio State University (OSU) is disputing allegations from the Department of Justice (DOJ) that it is discriminating in the admissions process for its medical school.   The DOJ sent a letter Wednesday to the OSU College of Medicine alleging the school intentionally discriminated against applicants on the basis of race, particularly Asian applicants, to the benefit of Black…