? For smartest ladies I know (Trish U listening?)

What is the name of the central database that collects information on all patients and is parsed out to insurance companies? More specifically, it's the information on RX that were assigned by physicians and then filled by pharmacies. It's kind of like a "wrap" sheet on insurance incurrances. It's available to all health care professionals, and pretty much anyone who asks for it..EXCEPT THE PATIENT. I know this is completely off topic (seemingly), but it seems that we have some sisters with endo who are having a hard time getting pain medication because of inaccuracies, and perhaps misuse of this database (luckily, it ain't me, I'm pain free at the moment!), but I'm just trying to help them out, and also gather information. Any help is appreciated.
[Edited by Adrite on 12-19-2000]

Thanks, Angie, but I'm not smart enough for this one. I don't have a lot of time right now either to dig much. I was aware that they're pushing for such a thing, but I think the efforts are still relatively regional, so one would probably have to know where one was looking. (ARGH!!! This stuff is so :evil: ).

There seem to be three large efforts along this line, CANIS (Community Architectures for Network Information Systems) developed at the University of Illinois at Urbana-Champaign, a database in the VA system, and Meta-Script Systems, a commercial operation. The Meta-Script one seems to be directed at HMOs and prescriptions, but I couldn't find much on it at first glance. Maybe this can give you some places to search?

But the Association of Physicians and Surgeons is concerned about privacy issues too, so patients aren't the only ones feeling paranoid.

I knew you'd know where to start looking...

Here's the deal (when you get time) if you want to know how cloak and dagger some of this stuff is...

This person has had 5 surgeries and two major accidents in four years...they have been declared "disabled"...but now no doctors will give this person pain medication of any kind, when they pressed to see why, one frustrated doctor pulled out a copy of the letter from CareMark (drug company) that went back eleven years. The letter listed ALL doctors the person had seen, ALL medications that were paid for by insurance, ALL medications that were NOT paid for by insurance but prescribed, WHERE they had been filled and this letter was sent to EVERY one of these doctors (whethere anything was prescribed or not), ALL hospitals involved AND pharmacies that went back ELEVEN years with the words "Possible Narcotics Abuser" plastered all through it. The doctor said that she, and "anyone who asked for it" could get a copy PDQ. She also went on to say that this person would have a tough time finding pain medication outside of a pain clinic that was approved by insurance due to the "stigma" attached to them now.

Now, I AM a .dot commer so to speak. I work on massive warehouse systems that can track theft, fraud, etc...but this is what I've most feared in my career. Hounds like CareMark taking data and removing the faces, circumstances, diagnosis, and using it to SMEAR a person. This doesn't seem to be an isolated incident. It's down right scary.

I'm searching for more info...I intend to call my congress-person and make some noise! If anyone out there has a similar story...contact me. AS a sufferer of chronic, dibilitating pain for almost 20 years...oh, how I feel for this person and many like them. Luckily, I'm not in that shape anymore...but one day...we all will be (after all, death comes to all of us...but if CareMark has their way...we'll all die painful deaths).
[Edited by Adrite on 12-19-2000]

THIS does not surprise me at all. I heard about this a year ago at a seminar. The guy speaking was really really downing the FDA and its strong armed tactics. Whether the FDA is behind this invasion or not, I don't know. It doesn't surprise me either because I see an invasion on a different scale when dealing with those ******* third party insurances. They will come down on a pharmacy in a minute.

Can you tell me more about what you mean by "coming down" on a pharmacy? Do they refuse to pay, threaten to report you to FDA/DEA? I've heard stories, but never directly from a pharmacists re: "anonymous" reports going out by 3rd party insurance companies that result in "investigations" of dr's offices and pharmacies...a sort of "gustapo" measure sanctioned by the federal government that lends a hand to 3rd party carriers (intentional or not). Please email me directly if you don't feel comfortable discussing this subject here.
[Edited by Adrite on 12-22-2000]

Seems that the Prez is pushing for legislation that would enable patients to sue over mis-use of medical information by insurance companies, etc. Current legislation doesn't provide for that...MAKE SOME NOISE...tell them your fears...imagine your next door neighbor going through you medical records, picking and choosing facts, and concocting a "pattern" behavior by eliminating diagnosis and circumstances...in some cases even DATES of service and smearing your name. And if that didn't work...by calling the FDA or DEA and telling them that dr's this and that, and pharmacists such and such are peddling drugs to you...and a six week investigation follows....ladies it seems this kind of thing is happening right under our noses. And ya know what...there's nothing you can do about it. Not only that...your CREDITORS have every right to access your health information....how bout them apples. You don't pay a bill, you're health records are used against you. What about custody cases? What about bankruptcy issues? What about employment? What about just pi**ing the wrong person off? It seems this is currently a hot topic...now would be the time to write and voice your concerns. Check out:

http://www.whitehouse.gov and click on privacy legislation. READ IT...it helps SOME, but you still have NO RIGHTS to sue or prohibit the use of your information that's already been collected.

This blurb came to me yesterday--

"President Clinton issued the first federal rules to protect the privacy of patients, hoping to keep health plans and other groups from selling private medical records for profit."

Selling? Selling? That's the problem to me. What a sleazy way to make money. Feeding off others. Moochers.

The blurb goes on to say that patients will have to sign to release this information to doctors before the doctors can divulge your history to the insurance company or health plan. This new rule will take two years before can go into effect.

Adrite, I do want to discuss things with you. Let me gather facts.

Gathering facts that is. Apparently, after reading the legislationg (whew...it's long winded) it essentially does nothing to protect privacy. If you sign to have your doctor divuldge your records to the insurance companies (which you will HAVE to do in order to get a claim paid) they still can do what ever they want with it. Talk about loop holes, this legislation looks like swiss cheese! It's simply a pacifier for the public to make the politicians "look" like they've actually done something while leaving the insurance companies enough room to do whatever they **** well please. I have a few folks on the "scout" for these illusive "warning letters" I talked about above. I'll fax you a copy once I get it.

haven't dropped this Lauren...just so you know the Dr's office is giving this person the run-around now and using the holidays, schedule, and everything else to dawdle (in hopes this person will drop it and forget about the letter)...nothing doing...I've lit a fire under them and waiting for the thing to appear...when it does I'll let you know.

Has anyone else out there had a similar experience?

This Wednesday a fellow is coming to talk with me about some program for pharmacists that allows him to talk with the third party insurance companies. I don't plan to sign up for anything because I imagine he is not on the pharmacies' side. Most likely the 3rd party folks are putting him up to this. I will grill him on the privacy issue and see what he has to say about it.