Tell Us Everything
The physicians have never seen anything like it, according to the Los Angeles Times. A letter crossed the desks of California doctors that's led to outrage among the state's health care providers.
Help us out, asks the letter (warning: PDF) from Blue Cross of California. Tell us which of your patients hasn't told the whole story about their medical conditions, BlueCross asks. You're on the frontlines, and we're just trying to clean up a few discrepancies, the letter implores. "Within the first 2 years of membership, Blue Cross has the right to cancel the member's policy back to its effective date for failure to disclose material medical history," the letter says.
The discrepancies can be cleared up, according to Blue Cross, if physicians just pass along some information about pre-existing conditions. That health history form that patients fill out in the waiting room? Send that. Oh, and be sure to let us know about "pre-existing pregnancies." The list goes on, and includes seven pieces of information that Blue Cross says should be passed along from physicians to the insurance giant.
California doctors are less than thrilled with the letter, according to the Times. "We're outraged that they are asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality," said the president of the California Medical Association., Dr. Richard Frankenstein.
Frankenstein went on to express worries that patients would stop telling doctors pertinent information for fear of being dropped or denied by insurance companies.
WellPoint Inc., which operates Blue Cross of California, pointed to the letters as a way to hold down costs. If applicants' "true condition[s]" aren't known, utilization insurance services will be increased, and all members of that insurance company will suffer. "Blue Cross feels it is our responsibility to assure all records are accurate and up to date for HMO providers," said a spokeswoman for WellPoint. "We send these letters to identify members early on in the process who may not have been honest in their application."
The spokeswoman said that doctors don't have to provide the information to Blue Cross, but they can volunteer the information to the insurance company. Insurers, including Blue Cross, recently came under scrutiny for hastily issuing policies and then canceling coverage after individuals incur major medical costs, according to an AP article. Insurers say that cancellations are important for fraud prevention and keeping costs down, and the insurers insist that cancellations aren't frequently used.
WellPoint also said that the practice of asking doctors for the scoop on patients has been around for "several years." Don Crane, executive director of the California Association of Physician Groups, said he never heard of such a thing. The California Medical Association shot off a letter to state regulators asking that they order Blue Cross to stop asking doctors to volunteer patient information, according to the Times, and the association said the request is "deeply disturbing, unlawful and interferes with the physician-patient relationship."
Is this genuinely an innocent attempt to keep costs down? Do you think the letter is clear that the information doesn't have to be disclosed, but that it can be given on a volunteer basis? Would you be less likely to share details with your doctor because of something like this? Does a request like this violate doctor-patient confidentiality?
Personally, this letter doesn't surprise me. I do wonder how many doctors volunteer the information, and I wonder how much my own insurance company knows about me and my health (I don't live in California, but I would be surprised if something similar was going on in my state, especially since this has been going on for years, according to the woman from WellPoint).
What are your thoughts? Does this letter go too far? What can be done to ensure doctor-patient confidentiality?
UPDATE: At around 6 p.m. last night (Feb. 12), Blue Cross of California announced that it would stop the practice of asking physicians to tell the insurance company certain information. Dr. Frankenstein praised the move, but expressed concern. "This letter was part of Blue Cross' pattern of unfairly canceling policies when people need coverage most," he said, according to the Times. "We're relieved that Blue Cross is ending this particular tactic but continue to have serious concerns about this company's practices looking forward."