HIT Privacy in Massachusetts

By Greg Scandlen

A friend forwarded this announcement from Aetna in Massachusetts:

Massachusetts recently passed laws requiring that insurance carriers, HMOs, third-party administrators and self-funded plans report certain data on Massachusetts residents covered under Massachusetts contracts to a new All-Payer Claims Database (APCD). The APCD was created and is maintained by the Massachusetts Division of Health Care Finance and Policy (the Division).

All carriers must start submitting member/claims data to the APCD for calendar years 2008 through 2010 by January 31, 2011. Carriers then need to submit data each month, starting in February 2011. We are working with the Division to report this information for you. You do not need to take action for this reporting.

Content of data and its intended use

The data to be reported to the APCD includes, but is not limited to: subscriber and member identifiers; member demographics; race, ethnicity and language information; plan type; benefits codes; enrollment start and end dates; behavioral and mental health, substance abuse and chemical dependency, and prescription drug benefits indicators; and claims-line detail for all health care services provided to Massachusetts residents covered under Massachusetts contracts.

Massachusetts intends the APCD to serve as a reliable clearinghouse for health care cost and quality information for consumers, employers and governments, so they can make health care purchasing decisions. The APCD also will serve as the central repository for all health care claims data for Massachusetts state agencies. The Division will provide the required APCD data extracts to other Massachusetts government agencies. Massachusetts recently passed laws requiring that insurance carriers, HMOs, third-party administrators and self-funded plans report certain data on Massachusetts residents covered under Massachusetts contracts to a new All-Payer Claims Database (APCD). The APCD was created and is maintained by the Massachusetts Division of Health Care Finance and Policy (the Division).

All carriers must start submitting member/claims data to the APCD for calendar years 2008 through 2010 by January 31, 2011. Carriers then need to submit data each month, starting in February 2011. We are working with the Division to report this information for you. You do not need to take action for this reporting.

Content of data and its intended use

The data to be reported to the APCD includes, but is not limited to: subscriber and member identifiers; member demographics; race, ethnicity and language information; plan type; benefits codes; enrollment start and end dates; behavioral and mental health, substance abuse and chemical dependency, and prescription drug benefits indicators; and claims-line detail for all health care services provided to Massachusetts residents covered under Massachusetts contracts.

Massachusetts intends the APCD to serve as a reliable clearinghouse for health care cost and quality information for consumers, employers and governments, so they can make health care purchasing decisions. The APCD also will serve as the central repository for all health care claims data for Massachusetts state agencies. The Division will provide the required APCD data extracts to other Massachusetts government agencies.

So all of the assurance about privacy are out the window. Your most personal detailed information will be collected along with your personal identifiers

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One Response

  1. Already done in Colorado. A bunch of private foundations are paying for it. Providers who do not comply are in big trouble.

    And with data mining techniques, it doesn’t matter whether personal identifying info is redacted or not. They know where you live, your age, height, weight, family structure, and disease history. ID is simple.

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