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Is there really privacy?
May 1, 2012

I have a good friend who runs an HR department ( 150 employees ). He told me that there really is no privacy and that an employer can find out conditions regardless of what plan type. He said that when an company goes out for bid all the prospective insurances companies want a list of the conditions and treatments the existing insurance company is paying. The information can transmit several ways including identified bills ( names of meds, labwork, and doctor visits ). This transmition can occur from insurance company to insurance company or through the employer or third party administrator. In other words, insurance company A does not say to insurance company B that Jane Doe is HIV positive, however, data related to conditions is released that can let one extrapolate who has what. Please advise.

Response from Mr. Chambers

When I saw your title, "Is there really privacy?", I was ready to agree with you. However, once you explained your reason for the question, I really don't believe privacy has been that badly eroded.

I worked for an insurance company well before HIPAA (the gold standard of medical confidentiality) was passed, and the company I worked for ran claims runs on every client. Even then, the claims information was bundled. There were no names, there were no diagnoses. Claims charges were grouped by type of service. The amount spent on prescriptions was lumped as one amount; it did not name the medications actually purchased nor by whom.

Working with many insurance companies since I became an advocate, I do not find them to be generous with information about medical information without the individual's written permission. HR departments have the same issues and operate under the same laws.

In fact, most large employers are very careful to NOT learn their employees' medical issues. They know that if there is a charge of discrimination or wrongful termination by an employee, they will probably lose their case if it can be shown that the employer had access to the medical information. The best way for them to prove they don't discriminate against people with medical conditions is to show they had no access to that information. This is true even for very large companies who self-fund their claims. They inevitably hire an outside administrator to actually pay the claims and arrange it so any claim data they receive from the administrator does not allow them to know who had what claim.

Does that mean your medical records are perfectly secure? No, humans are involved. If the owner of a small company plays golf with the insurance agent and wants to know why his health insurance is so expensive, it's not impossible for her to learn those details, but both she and the agent would be committing federal crimes to get that information. It is also highly doubtful that the agent would even be able to get access to the information, but maybe she plays golf with the head of claims at the insurance company too.

I agree that, thanks to the vast amount of information available and the apparent willingness of many people to put anything on line, there are times when it appears we have no privacy left. However, if there is one thing that is protected by federal and state law, by the caution insurance companies and medical providers must take to show they know and comply with the laws, your medical information is probably the most well protected information there is.

Just a few years ago, medical staff at UCLA decided to look through some of their more famous patients' files. They were promptly all fired or severely disciplined.

The reason most employers find out details of their employees' medical conditions is that the employee has confided the information in a coworker who promised not to say a word to anyone.

Jacques



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