"Utilization Review"

[Black Unicorn]

I listened with horror this evening to a radio program which 
discussed the state of medical record privacy today.

In one segment a doctor (psychologist) described an experience 
she had after a session which was covered by the patient's 
insurance plan.

The doctor in question received a phone message with a 1-800 
number and the request to return the call.  On returning it she 
was connected with a very polite representative of the insurance 
company (who apparently had some experience in mental health, but 
not a M.D.) who proceeded to ask the most sensitive questions 
about the patient's session in order to conduct a "utilization 
review to determine medical necessity."  Most alarmingly, the 
representative could be heard typing on a computer during the 
entire review.

The program went on to indicate that among the provisions in the 
most recent health insurance reform bill there was a provision 
for information sharing among insurance companies to facilitate 
the transfer of insurance policies when the insured switches 
jobs.  Among the more alarming suggestions in the legislation is 
the use of a "unique medical identifier."  Many of you will see 
this coming.  One of the currently proposed "identifiers" is the 
Social Security Number.

Members of the list might also wish to consider that companies 
which self insure their employees for health benefits are 
entitled to all their medical records directly.

The prospect of cradle to grave medical files as an everyday 
reality in the United States is but around the corner.

In my view it is time for the foundation of an offshore insurance 
company which recognizes the basic tenant that client medical 
records are the property of the client, used in a license 
capacity at the pleasure of the insured, and not an entitlement 
to which the company is automatically privy.


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