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Texas Pharmacies Files Lawsuit Against CVS–Privacy Misuse Cited With Patient Information Relating to Marketing Via RX Revi

Posted Oct 03 2010 11:17pm

The data bases created by pharmacy chains have been an issue for quite a while and there has been some effort made on protecting privacy, image but it has not gone far.  The information gathered originally was for use by pharma sales reps and has been around for years.  As time evolved, the medication record use has now become a portion of medical records, and PHRs with having the ability to import, so now as what is occurring all around us today, the data has a different meaning and use and with fewer pharma reps there is less use in that area and more interest with companies being able to sell this data. 

Prescription records are bought from insurers for underwriting purposes and firms make money at this and this appears to be one of the challenges with the pharmacies in Texas, and not a bad one at that. 

“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.”

You can read the statement from Milliman about Intelliscript here .

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“Does this process make it more difficult for consumers to get insurance?
No.  There is nothing new about consumers authorizing the release of their medical records, including prescriptions, to insurers.  This standard process has been in place for decades, helping insurers make good decisions about rates and insurability.”

You can read more about Ingenix MedPoint here.

There’s also a flash presentation where you can view the process here.

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“By increasing understanding of potential disease conditions and relative risk, MedPoint enables underwriters to more accurately project future claims costs on a case-by-case basis.”

Pharmacy companies are in possession of a lot more data these days too and we are seeing some partnerships in marketing that we have not seen before.  One thing to keep in mind too is all the mergers and acquisitions we are seeing today and this means sharing and analyzing data together as one company could be violating laws or rules with certain activities but another subsidiary in a related business could without violating laws.  Sometimes some wellness programs are vital partners in marketing efforts as well as performing reminders and care information for patients and sometimes keeping track of what both sides are doing is a challenge and where the data trails lead to who’s making money through algorithmic formulas on transactions selling this information, so yes you are for sale with your medication records kept by pharmacies and pharmacy benefit managers. This appears to be the direction of this lawsuit.  Hopefully the White House will be exploring some of these practices as well.

Caremark is not the only chain into marketing today as other big chains have their marketing plans and everyone is collecting and combining data on you the patient today.  This does make it difficult too for the smaller pharmacies to compete in some areas and who knows perhaps we might see a return of the small pharmacies based on trust and not being mass marketed one day.  Once a company like  Ingenix as an example has paid for your medical information, who knows which other data bases it could be combine with and whether it is for marketing or better care, it gets a little gray out there today as subsidiaries are working to increase their data intelligence from every angle.  From what I read here this appears to be part of what the pharmacies in Texas are contesting and as patients there’s good reason we should also question some of the business practices we see today if you want privacy.  BD  

A group of Texas pharmacies has filed a lawsuit against CVS Caremark, the nation’s largest pharmacy health care provider, saying it violates racketeering and privacy laws.

“The practice of CVS Caremark in violating the privacy of patients and unfairly competing with its rivals is well-documented,” the lawsuit alleges.

The Texas lawsuit accuses CVS Caremark of gaining too much control over patient information, including files from the independent pharmacies that have to hand over patient information for insurance disputes.

CVS Caremark had nearly $100 billion sales in 2009 and is the nation’s 18th largest corporation, according to the 2010 Fortune 100. It grew out of a $26 billion merger of a pharmacy chain and a pharmacy benefits company in 2007. The company has already disclosed it is under investigation by the Federal Trade Commission and more than 20 states.

The lawsuit also says CVS uses that information for direct marketing to patients and doctors at the behest of pharmaceutical companies. That program is called Rx Review.

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