The Australian had a great yarn a day of so ago.
Insurers snooping in our health records
Revelations that the $44 billion life insurance industry still enjoys largely unfettered access to sensitive information comes amid rising consumer concern over the privacy of medical records, centred on the government’s My Health Record system. Picture: Supplied
Life insurers have trawled through the medical records of 150,000 Australians in an attempt to deny payouts in the 18 months since a parliamentary inquiry called for new restrictions on access to personal health data.
The government has not responded to the inquiry’s recommendations, which included real-time notifications alerting people to when insurers were accessing their records, while legal experts have sounded the alarm on the need for further consumer protections.
They have also warned that a new voluntary industry code of conduct will not stop insurers demanding full medical records under the threat of refusal to provide cover or stall the processing of a payout.
Revelations that the $44 billion life insurance industry still enjoys largely unfettered access to sensitive information comes amid rising consumer concern over the privacy of medical records, centred on the government’s My Health Record system. More than 2.5 million people opted out of the database after the government extended the deadline to January this year, but about 90 per cent of Australians’ records are now held on the system.
These records can still be accessed by life insurance companies, which ask medical practitioners to access the database on their behalf and pass on the information, providing customers have given their consent. Without full access to medical records, life insurance companies can threaten to refuse cover or not process insurance claims.
Based on claims data from the prudential regulator and the corporate watchdog, close to 150,000 claimants have had their medical records accessed by life insurers since the parliamentary committee reported in March last year, says Maurice Blackburn principal Josh Mennen.
“In my experience, because we administer hundreds of these claims each year, insurers routinely request open-ended medical authorities and essentially engage in a fishing expedition where they seek any evidence of a pre-existing medical condition to build an avoidance case (to knock back claims) based on medical disclosure,” Mr Mennen said.
He said My Heath Record was “a central source of all relevant medical information, which makes it all the more easy for insurers to conduct a broad trawl via a treating doctor”.
Insurance companies ask applicants, when they take out policies or lodge a claim, to sign over “full authority” to their medical records. Once that authority has been signed, doctors are obligated to provide the information.
Mr Mennen said this exposed the “laziness” of insurers, who preferred to trawl for information rather than make targeted requests. “It raises privacy concerns, but the thing that really concerns me is that it has incentivised consumers to withhold information from healthcare providers,” he said.
More here:
Needless to say the ADHA has out with a rebuttal.
Response to The Australian article ‘Insurers snooping in health records’
9 August, 2019 - 13:15
The article ‘Insurers snooping in health records’ published by The Australian on 9 August contains incorrect information relating to insurance companies’ access to information in My Health Record.
It is against the law for a life insurance company to access the My Health Record system for insurance purposes.
Further, medical practitioners cannot use information from a person’s My Health Record for these purposes to share with insurance companies, regardless of whether the patient has provided consent.
Criminal offence and civil penalties include up to five years in jail and/or up $315,000, for natural persons, and/or up to $1.5 million in fines for bodies corporate.
ENDS
Here is the link:
This led to a second article in the OZ.
Doctors risk jail over My Health insurance leaks
The Australian Digital Health Agency has warned doctors against passing on medical information gathered through the government’s My Health record database to life insurers under threat of large fines or jail.
The agency yesterday said new laws prevented My Health records being accessed by life insurance companies, and medical practitioners were banned from accessing the database to pass on the information, even if patients had given their consent.
Lawyers have raised concerns that doctors who have access to the records will not heed the laws, after The Australian reported warnings of the need for further consumer protections after the life insurance industry created a new voluntary code to regulate access to medical information.
Without full access to medical records, life insurance companies can threaten to refuse cover or not process insurance claims.
More here:
So what is actually the case?
What we know is that an insurance company can’t have direct access to the #myHR but an when insurer comes to a GP and requests all the information on a patient that the GP holds (including maybe #myHR data) and the patient has agreed to disclosure (consented) – on the basis of having been told that their claim will go nowhere unless they do – that all bets a probably off and the data can be passed to the insurer – especially if the information has been downloaded to the GP computer previously. Of course the ADHA is trying to scare people and make such activity a capital offence - no matter how vague the law is in some cases!
Even if not your doctor, or yourself, can print myHR data to a .pdf and hand it over. It really is a moot point just how illegal it would be for a doctor to give information to their patient and then the patient hand it over, potentially under duress of rejection of their claim. Equally what if you access your #myHR and give it to the insurer?
It really has to be some sort of fiction that a patient’s health information can be segmented to that that is sourced from the #myHR and that is not – given that by definition the #myHR is a secondary system holding only copies of data from other sources – except, of course, any user entered information. What the #myHR does – and badly on most occasions – is bring the data to one point. The ‘honey pot’ is what is exciting the insurers!
There are two issues I see here. One is having the insurers know of a source of information – Government created – that may, or may not, cause problems for an individual.
The second is the pressure for access to the #myHR its existence may create.
I am not sure how all this is resolved – for most it is not a problem as the record will not create insurance claim denial – but for some it may – just because some pre-existing condition was forgotten or overlooked when the insurance was taken out in good faith.
There is a seven minute podcast which discusses some of the issues. I don’t feel it is black and white at all.
Insurers Accessing MyHealth Records of Australians
Published: 09 August 2019 Written by 2CC Podcasts
Category: Podcasts
News today says that Insurance Companies are accessing the medical records of Australians to avoid making payments. Eddie Williams speaks with Former Howard Government Adviser and Cormorant Policy Adviser Terry Barnes about what it means for those who still have a My Health Record.
Use this link to access the podcast page:
What do others think?
David.
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