News & Events News Insurers Using Health "Credit Report" to Assess Consumers
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Insurers Using Health "Credit Report" to Assess Consumers |
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Patient prescription drug records are now being used by insurers to develop health "credit reports." This new tool allows insurance companies to determine an applicant's risk much quicker than traditional means -- by gathering medical records from doctors. Privacy and consumer groups have expressed their concern with the new practice. Information services companies charge insurers $15 per patient report; the reports contain detailed prescribing information (including dosages and doctor information) for typically the previous five years. The report includes a "pharmacy risk score" which enables the insurer to determine which patients are expected to have the highest medical bills. The data is retrieved by the companies from pharmacy benefit managers; these entities are not governed under the Health Insurance Portability and Accountability Act (HIPAA) thus they cannot be regulated by the Department of Health and Human Services. While patients do sign consent forms prior to companies analyzing their risk score, insurers often won't consider the consumer for health insurance if they do not authorize the report. |
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