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Marketing: Company Takes HHS to Court Over Not Being Able to Get Medicare Claim Information to Resell and Market

Posted Jan 11 2010 7:30pm

I had to read this one through a couple times here to make sure I was reading it correctly.  We certainly a market driven world today but this is almost beyond belief when they actually went to court in pursuit of both the physician and claim information from HHS.  Gee, are they losing money because they can’t market medical treatments, diagnosis and the physicians who performed them. 

We know we are all data crazy today and want every stick and inch we can get our hands on, especially the insurers to use with business intelligence scoring for risk assessments.  The original judgment said it was ok, until the AMA and Department of Justice intervened.  This is some of what I mean when I say read everything as businesses right now appear to be aligned to doing what they can get away with rather than perhaps abiding by the laws or using common sense in what they pursue for that matter.  This case is still on going and for the efforts here, she must see a huge gold mine in being able to sell this data.  You know it may be somewhat like the huge dollars Milleman and Ingenix make selling our medication data from pharmacy benefit managers.  The Senate is trying to make headway on one of those items, we can still be sold, but not marketed, well I kind of though 2 and 2 go together in issues like this. 

Data Mining Marketing Amendment on Senate Health Bill – So Our Medication Records Can Still Be Sold Just not Marketed, Huh?

Pharmacy Benefit managers make a lot of money too.

Medco Health Solutions $14.8 Billion 3rd Quarter Profit – Automation Is Part of Their Solution

“HIPAA does not give the Department of Health and Human Services the ability to directly investigate or hold accountable entities, such as pharmacy benefit managers or companies such as Ingenix and Milliman, who are not covered by HIPAA.”

These 2 companies make a ton of money from selling and marketing our medication information.  They sell it back to underwriters.  You can click on the images to find out more.  Again, after reading this post about the lawsuit and the diligent effort being used for the number of years it covers, the company must figure the information is going to be goldmine to riches, like the selling of our medication files goes.  



We talk privacy but it appears folks who are money driven only will go to court, create algorithmic formulas with software and who knows what else to keep the profits rolling in to make money off of healthcare.  BD 

Washington -- A federal appeals court cited an injunctive order from three decades ago when it said a private company does not have a right to sell physicians' Medicare claims data to hospitals. The decision is the latest in a series of court actions protecting doctors' privacy against the release of such information for various purposes.

In a ruling on Dec. 18, 2009, the 11th U.S. Circuit Court of Appeals said the government was not required to turn over physician claims information to Real Time Medical Data. The firm, based in Birmingham, Ala., was incorporated in 2002 to provide hospitals, doctors' offices and other health care entities access to Medicare marketing data. At issue was whether the U.S. Dept. of Health and Human Services was obligated, under the Freedom of Information Act, to provide Medicare data to the company, including doctors' names, addresses and the types of procedures they performed.

amednews: Appeals court rejects effort to sell Medicare physician claims data :: Jan. 11, 2010 ... American Medical News

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