Throughout the past year, the healthcare and life science industries experienced a proliferation of digital health innovation that challenged traditional notions of healthcare delivery and payment, as well as product research, development and commercialization, for long-standing and new stakeholders alike. Lawmakers and regulators made meaningful progress towards modernizing the existing legal framework to both protect patients and consumers and encourage continued innovation, but these efforts still lag behind the pace of digital health innovation. As a result, some obstacles, misalignment and ambiguity remain, and 2020 will likely be another year of significant legal and regulatory change.
The California Consumer Privacy Act (CCPA) is not yet one month old, but movement has already started on a new California privacy law. In November 2019, the advocacy group Californians for Consumer Privacy, led by Alastair Mactaggart, the architect of CCPA, submitted a proposed California ballot initiative to the Office of the California Attorney General that would build upon the consumer privacy protections and requirements established by CCPA. In December 2019, as required under state law, California Attorney General Xavier Becerra released a title for and summary of the proposed ballot initiative, which will be known as the California Privacy Rights Act (CPRA).
Key Provisions of the CPRA
CPRA seeks to give California consumers additional control over and protection of their personal information in five core ways.
On January 1, 2020, the California Consumer Privacy Act of 2018 (CCPA) went into effect. The CCPA applies to a wide range of companies and broadly governs the collection, use and sale of personal information of California residents (i.e., consumers and certain other individuals) and households.
The CCPA provides that consumers may seek statutory damages of between $100 and $750, or actual damages if greater, against a company in the event of a data breach of nonredacted and nonencrypted personal information that results from the company’s failure to implement reasonable security. The amount of the statutory damages depends on factors such as the nature and seriousness of the company’s misconduct, the number of violations, the persistence of the company’s misconduct, the length of time over which the misconduct occurred, and the company’s assets, liabilities and net worth. To defend against these consumer actions, a company must show that it has implemented and maintains reasonable security procedures and practices appropriate to the nature of the personal information it is processing.
This CCPA private right of action promises to shake up the data breach class action landscape in which such actions have generally been settled for small amounts or dismissed due to lack of injury. With the CCPA, companies now face potentially staggering damages in relation to a breach. To provide some context, a data breach affecting the personal information of 1,000 California consumers may result in statutory damages ranging from $100,000 to $750,000, and a data breach affecting the personal information of one million California consumers may result in statutory damages ranging from $100 million to $750 million. These potential statutory damages dwarf almost every previous large data breach settlement in the United States.
To mitigate the risk of this increased exposure, companies need to take key steps to ensure they have implemented reasonable security procedures and practices.
As businesses have scrambled to obtain compliance with the California Consumer Privacy Act (CCPA) in recent months, questions surrounding its constitutionality have arisen. As a broad, sometimes unclear state law that imposes significant obligations on businesses around the country, CCPA may be ripe for legal challenge. The strongest bases for such challenges appear to be: (1) that CCPA violates the “Dormant Commerce Clause”; and (2) that CCPA is impermissibly vague.
Dormant Commerce Clause
The burden that CCPA imposes on out-of-state economic activity may place it in violation of the Dormant Commerce Clause, a legal doctrine created out of the Commerce Clause of the US Constitution. The Commerce Clause allows the US Congress to regulate interstate commerce; from this grant of power, courts have inferred a limitation on the authority of states to regulate interstate commerce, a doctrine coined the Dormant Commerce Clause. On this basis, courts will strike down state laws that explicitly discriminate against out-of-state actors or that regulate activity that occurs entirely outside of the state. In addition, the Dormant Commerce Clause prohibits laws that do not explicitly discriminate against out-of-state economic interests if the effect of a law is to unduly burden interstate commerce. If a state law does unduly burden out-of-state interests, a court will typically balance the burdens imposed on interstate commerce against the benefits the law creates for the state to determine whether or not the law should be upheld.
On October 10, 2019, the Attorney General issued his Proposed Text of Regulations, along with a Notice of Proposed Rulemaking Action and Initial Statement of Reasons. According to the Attorney General, the regulations will “benefit the welfare of California residents because they will facilitate the implementation of many components of the CCPA” and “provid[e] clear direction to businesses on how to inform consumers of their rights and how to handle their requests.” See Notice of Proposed Rulemaking, page 10.
The deadline to submit public comments on the proposed regulations was December 6, 2019. The Office of the Attorney General (OAG) reported receiving about 1,700 pages of written comments from almost 200 parties. Despite this, the Attorney General stated in a news briefing that he does not expect the final regulations to include significant changes.
The proposed regulations should give everyone a sense of how the Attorney General will interpret the CCPA. The Attorney General is required to issue final regulations and a final Statement of Reasons at some point before July 1, 2020, which is the first day that the Attorney General can enforce the law.
Investing in Enforcement
California has invested in enforcement resources. The Attorney General stated that the CCPA will cost the state about $4.7 million for FY 2019-2020, and $4.5 million for FYI 2020-2021, which reflects the cost of hiring an additional 23 full-time positions and expert consultants to enforce and defend the CCPA. See Notice of Proposed Rulemaking, page 10. Despite this additional funding, the OAG is still an agency with limited resources. Many expect that the OAG will only be able to pursue a limited number of CCPA enforcement actions, particularly if it takes large on and well-funded companies.
On January 6, 2020, the California State Senate’s Health Committee unanimously approved California AB 713, a bill that would amend the California Consumer Privacy Act (CCPA) to except from CCPA requirements additional categories of health information, including data de-identified in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), medical research data, personal information used for public health and safety activities, and patient information that is maintained by HIPAA business associates in the same manner as HIPAA protected health information (PHI). If enacted, the bill would simplify CCPA compliance strategies for many HIPAA-regulated entities, life sciences companies, research institutions and health data aggregators.
Exemption for HIPAA Business Associates
Presently, the CCPA does not regulate PHI that is collected by either a HIPAA covered entity or business associate.
The CCPA also exempts covered entities to the extent that they maintain patient information in the same manner as PHI subject to HIPAA. The CCPA does not, however, currently include a similar entity-based exemption for business associates.
AB 713 would add an exemption for business associates to the extent that they maintain, use and disclose patient information consistent with HIPAA requirements applicable to PHI. For example, if a business associate maintains consumer-generated health information that is not PHI, but processes the information in accordance with HIPAA requirements for PHI, then the information would not be regulated by the CCPA. While the practical import of the new exemption may be limited because business associates may not want to apply HIPAA requirements to consumer-generated health information, AB 713 offers business associates another potential exception to CCPA requirements for patient information about California consumers.
Exception for De-Identified Health Information
AB 713 would except from CCPA requirements de-identified health information when each of the following three conditions are met:
The information is de-identified in accordance with a HIPAA de-identification method (i.e., the safe harbor or expert determination method) at 45 CFR § 164.514(b).
The information is derived from PHI or “individually identifiable health information” under HIPAA, “medical information” as defined by the California Confidentiality of Medical Information Act (CMIA), or “identifiable private information” subject to the Common Rule.
The business (or its business associate) does not actually, or attempt to, re-identify the information.
The California Consumer Privacy Act (CCPA) requires businesses who engage in sales of personal information, to offer consumers the right to opt out of such sales through a “Do Not Sell My Personal Information” link or button on their websites. These “Do Not Sell” obligations present a particularly thorny question for businesses that participate in a digital ad exchange or otherwise use advertising tracking technologies on their websites. Because data elements such as IP address, cookie ID, device identifier and browsing history are considered “personal information” for purposes of the CCPA, the question is: does sharing that information with third-party ad tech providers constitute a “sale” of data?
The answer, so far, is a resounding “maybe.” In what follows, we expand on the issue and survey different approaches to this hotly contested question.
Why the Debate?
The CCPA defines a “sale” as “selling, renting, releasing, disclosing, disseminating, making available, transferring, or otherwise communicating orally, in writing, or by electronic or other means, a consumer’s personal information by the business to another business or a third party for monetary or other valuable consideration.” The Network Advertising Initiative (NAI) broke this definition down into three main elements that, when satisfied, might make the case that digital advertising involves a “sale.”
The digital advertising must involve “personal information.” We know that it does because serving digital ads requires, at the very least, access to IP address and browsing history.
The digital advertising must involve the movement of personal information from a business to another business or third party. This is often true for digital advertising relationships, as ad tech intermediaries and other participants in the ad exchange often use the personal information they have received from businesses for their own purposes, thus taking many ad tech entities outside of CCPA’s “service provider” safe harbor.
The digital advertising must involve the exchange of monetary or other valuable consideration for the personal information. This is a fact-specific inquiry that will vary across contractual arrangements. For that reason, the NAI analysis states it would be difficult to broadly categorize all digital advertising activities as “sales.” However, the NAI cautions that if the recipients of personal information can retain the information “for profiling or segmenting purposes” (e.g., the ability to monetize the data independently), that could be evidence of a “sale” of data.