Re: Fwd: HMO Line on Privacy

[Dynalysis of Princeton <mail@dynalysis.com>]

Dear Peter & Med-Privacy

I  recently learned that my physician has given much of his practice over to a
nurse practioner that is his assistant. Instead of him, I see her  and  since the
info below makes reference  to this  I thought it confirms what  I thought -- HMO
pressures..  I suppose this solves some of the privacy concerns for my  physician
-- now he won't be writing in my chart and his license won't be on the line  when
privacy is violated.  I wonder why the HMO's feel to confident that they will not
be held accountable for invasion of privacy?.

METRA1001@aol.com wrote:

> Peter & Med-Pri-
>
> Received this from a physician (who for some reason wishes to remain
> anonymous); thought it might be of interest:
>
>  >> Yesterday I was hit with a "surprise" chart audit by your local friendly
> HMO.
>  3 weeks ago they called and said they were coming into audit charts using
> HEDIS
>  criteria so they could get their NCQA approval. We were told what patients
> would be
>  audited and what they expected to be on each chart. (Some surprise) Any way,
> I found the reviewer going through parts of the chart that had nothing to do
> with this HMO. When I confronted him on this issue, he informed me that the
> patient had NO privacy rights  since the contract they singed to get the
> insurance allowed them to nose around where  ever they wanted. He was reading
> a 10 year old operative report to find out why I had done a hysterectomy on
> her.
>
>   Finally he told me there were 2 options. If the patient didn't like the
>  intrusion, she could drop her insurance. My option was to forbid him the
> chart access he requested or drop out of the HMO.  He also told me that within
> a few months, the information  taken from charts by one HMO would soon be on
> the internet!!!!! (encrypted he claims). The idea is to be able to share info
> with all insurance companies. He feels the danger of patient info getting out
> is not important. I told him doctors would put a stop to it. He laughed and
> said Doctors are irrelevant and are only needed as a middleman to do the work.
> Hopefully they would be replaced by nurses with an MD supervisor.
>
>   He also started to discuss the upcoming DNA mapping on all patients and the
>  impact  that would have. He said that the HMO's require cholesterol testing,
> tetanus
>  shots,  immunizations, PAP smears and next genetic mapping would be required.
>
>   Today I was informed that I would not be able to treat a child with a
>  hemangioma with a laser until I biopsied it and got the results back. Are we
> all going nuts in this world. Guess it depends on what the meaning of the word
> "is" is. I want to win megabucks and move to an island in the Pacific.
>   >>
>
>   ------------------------------------------------------------------------
>
> Subject: HMO Line on Privacy
> Date: Sun, 28 Feb 1999 02:34:16 EST
> From: RuthCliff@aol.com
> To: cac@quiknet.com, prc@privacyrights.org, JWilli4906@aol.com,
>      METRA1001@aol.com, cscsw@pacbell.net, VKockelman@aol.com, CAPA@jps.net,
>      LisaRod@aol.com
>
> >From a physician on another list:
>
> >From a physician on another list:
>
>  Yesterday I was hit with a "surprise" chart audit by your local friendly HMO.
> 3 weeks
>  ago they called and said they were coming into audit charts using HEDIS
> criteria so
>  they could get their NCQA approval. We were told what patients would be
> audited and
>  what they expected to be on each chart. (Some surprise) Any way, I found the
> reviewer
>  going through parts of the chart that had nothing to do with this HMO. When I
>  confronted him on this issue, he informed me that the patient had NO privacy
> rights
>  since the contract they singed to get the insurance allowed them to nose
> around where
>  ever they wanted. He was reading a 10 year old operative report to find out
> why I had
>  done a hysterectomy on her.
>
>  Finally he told me there were 2 option. If the patient didn't like the
> intrusion, she
>  could drop her insurance. My option was to forbid him the chart access he
> requested
>  or drop out of the HMO.  He also told me that within a few months, the
> information
>  taken from charts by one HMO would soon be on the internet!!!!! (encrypted he
>  claims). The idea is to be able to share info with all insurance companies.
> He feels
>  the danger of patient info getting out is not important. I told him doctors
> would put
>  a stop to it. He laughed and said Doctors are irrelevant and are only needed
> as a
>  middleman to do the work. Hopefully they would be replaced by nurses with an
> MD
>  supervisor.
>
>  He also started to discuss the upcoming DNA mapping on all patients and the
> impact
>  that would have. He said that the HMO's require cholesterol testing, tetanus
> shots,
>  immunizations, PAP smears and next genetic mapping would be required.
>
>  Today I was informed that I would not be able to treat a child with a
> hemangioma with
>  a laser until I biopsied it and got the results back. Are we all going nuts
> in this
>  world. Guess it depends on what the meaning of the word "is" is. I want to
> win
>  megabucks and move to an island in the Pacific.