200 million Americans have a health credit report on clarkhoward.com

The Washington Post reports that health "credit reports" have been compiled on 200 million Americans. Ingenix and Milliman are 2 companies that make billions of dollars developing profiles based on your prescriptions. A "pharmacy risk score" tells insurers the risk level you pose to them as a potential customer.

Pharmacy benefits managers (PBMs) actually sell your information regarding prescriptions. PBMs are a popular option at companies because they offer cheaper prices when you get your drugs online or through the mail -- instead of at a retail pharmacy.

The info in your health "credit report" can be used by an insurer to charge you more or decline you coverage altogether.

For those of you who have asked how this plays out with HIPAA, The Washington Post reports the the following: "Ingenix and Milliman officials stress that they provide data only with the patient's consent, as required by the Health Insurance Portability and Accountability Act (HIPAA)...But HIPAA does not give the Department of Health and Human Services the ability to directly investigate or hold accountable entities, such as [PBMs] or companies such as Ingenix and Milliman, who are not covered by HIPAA." See the original report.

Another wrinkle in the story comes with "off-label" prescriptions. Off-label refers to using a prescription for an unintended use. For example, your doctor may be using a depression medication to treat your stomachache. But that off-label usage could redline you with insurers who don't want to see a history of depression medication -- even though you're not depressed.

Under new federal rules, you are allowed to see your health "credit report" from Ingenix and Milliman.

Clark believes the real problem is not the lack of privacy, but rather the way that insurers are allowed to redline you. We need insurance coverage based on community-rating standards -- that is to say, age and sex.

UPDATE: To obtain your Ingenix report, call MedPoint Compliance at 888-206-0335.

What others are saying

medical insurance bureaus and privacy
Does anyone know if the gov's medicaid/medicare patients are included in this ? Is their privacy protected while mine is not? Since I already pay for their care and then get held accountable and charged more for my own.Please keep this in the spotlight,it is another infringement on our rights.
By sandy @ 03/31/09 10:22:24 AMreport abuse
Health Credit Report
I am so glad to see this being exposed! There is another entity called the Medical Insurance Board (or Bureau?) that until recently was very secretive. There website is http://www.mib.com/html/about_mib_group.html. I encourage all consumers to check into this very disturbing group and understand the power they have over your ability to obtain insurance. My previous doctor wrote in multiple erroneous reports in my file (COPD, arthritis, high blood pressure, etc etc etc) in order to run expensive & unnecessary test. His report went to the MIB when I applied for anther insurance company and was denied any and all insurance. It took me months to get it straight, and only after I sought legal counsel. It is scary to think that there is indeed a "Big Brother" in the insurance industry, but there is. Keep up the good work, Clark. Let's expose those who try to intimidate and invade our right to privacy! Thank you.
By Courtney @ 12/12/08 02:41:26 PMreport abuse
Just called & left my info. Will see how long it takes to get this report
By msg @ 12/11/08 01:51:39 PMreport abuse
Health credit report
The insurance companies have too much power. When will we citizens start demanding our rights. Every corp. get what they want except the american citizen. When ever we need help, they don't think about us. Why are we always last when it comes to our health?
By Karen Terry @ 12/04/08 10:25:25 PMreport abuse
meds and insurance
My 21 year old healthy son applied for health ins and was rated high because a doctor gave him a med for headaches to try for 30 days and they tried to make us checkmark that he had seizures or epilepsy because the drug was used for this also. This is so wrong and unfair where are our politicians when we need them or the insurance commissioner
By Sherry @ 12/03/08 08:51:00 PMreport abuse
menopause
I had to make a comment because I had mood changes when I started menopause and I don't consider that depression even though I am on Prozac which is used for depression. I always get funny looks or questions as to why I am on it. Doesn't the medical profession know that menopause is treated with depression drugs.
By Trish @ 12/02/08 05:59:17 PMreport abuse
Medical Files
This is so unfair!!! What has happened to our privacy in this country. We should contact our Congressmen and put a stop this this!!!
By Louise @ 12/02/08 05:38:18 PMreport abuse
medpoint
who are the folks that they are asking for our social security number --or that they already have it...weird...No one answers and mailbox is full...no exceptions...
By judy @ 12/02/08 04:21:57 PMreport abuse
Med Point required info
Just called. The recording wants you to spell out your first/last name; date of birth;complete social security number; mailing address; and the source of how you learned about MedPoint. Mail box was full.
By Kevin @ 12/02/08 10:06:09 AMreport abuse
MED POINT INGENIX
I CALLED THE 888 #,MAIL BOX IS FULL.THESE FOLKS ARE SNEAKY AND DONT WANT THIS TO HIT THE MEDIA.GREAT JOB "CLARK"
By JIM @ 12/02/08 12:37:01 AMreport abuse
Health Credit Report
Did you know that it only takes 5-10 letters in a folder about a particular topic when you Legislative Rep will take notice and act on it?
This health credit report is a huge topic and speaks of business loopholes that strips us from coverage and large sums of money, while the insurers and logistics companies make huge sums of money that they distribute to their executive branch and golden parachutes. As a recipient of coverage with lots of riders (no coverage for my own chronic diseases and disabilities) and having to pay high premiums for coverage for one physician, I am sad and mad at the same time. I continue to learn-read-write and help others to see what is the truth but also to encourage others to help advocate for each other. There are a number of think-tanks and government officials that are working on some new health care plans as we speak to change the course that we are in right now. Check out the HealthLeaders and Thomas.gov websites for information on this subject as well as health care in general. Your eyes will be amazed...but it is worth the time and energy to get involved. After all, it only takes one!. Clark is helping so...don't be hesitant in calling and staying with it until you get a satisfactory answer. Thank you.
By The Nurse Part 3 @ 12/01/08 06:50:55 PMreport abuse
Health Credit Report
Our country's infrastructure for health care is broken and requires some drastic changes. That change will only take place if you and I speak up to our legislators, or President-elect and the new Congress. HIPAA was a nice idea on the table but turned out to be a nightmare in practice. The gov knows it. The only way is to go to Congress and change the law. If enough voice is put out there, things can and will change. It will take time. Writing letters, attending meetings with your legislators, signing up for community forum groups as representative of change is how it works. Complaining and not following it with action, is in a sense doing nothing. Persistence, opinions, and real-time facts to prove your situation is what draws their attention.
By The Nurse Part 2 @ 12/01/08 06:50:03 PMreport abuse
Insurance coverage
The focus in the insurance industry is to cover only those who will not be a liability to the insurer and the company that is paying for the services. If you have any type of chronic diseases requiring medications or physician management, coverage will not be granted. If one is employed without any lapse in insurance coverage, the coverage and benefits are there regardless of acute or chronic status. Once any lapse occurs, such as change in jobs and no insurance coverage is provided, you are put on the list for having a chronic disease and will not be covered. If you want coverage, your monthly dues are doubled, since you are now a risk for them, even if your past medical history shows no risk at all.
By The Nurse @ 12/01/08 06:47:51 PMreport abuse
Ingenix report
Just called and got right through, No problems at all. Now we will see whae we get the report
By FOURMOREMARINE @ 12/01/08 06:41:20 PMreport abuse
Health Credit Report
Recorded message tells you the 5 things that they need to process your request, then informs you that the mailbox is full. What's up???
c
By Cheryl Williams @ 12/01/08 06:03:42 PMreport abuse
VA Health Care
Lauren M . . . I have to agree with gs . . . in my personal (me) analytical (very) experience (many), VA health care, at least in southern California, has become excellent . . . maybe not 20 years ago, but it is now . . . and our veterans deserve no less than world class care for their collective sacrifices.

The quintessential definition of a Veteran is: "A Veteran is someone who, at one point in his/her life, wrote a blank check made payable to the United States of America, for any amount, up to and including his/her life." Author Unknown.
By W @ 12/01/08 06:01:29 PMreport abuse
Ingenix report
Called several time..mailbox is always full so you get disconnected..no report
By Phil Capps @ 12/01/08 05:58:24 PMreport abuse
Report
I just tried calling...their mailbox is full!
By Robert @ 12/01/08 05:30:11 PMreport abuse
Company Medical and HIPAA
We were given a letter stating that the medical company as part of agreeing to taking me on would divulge EVERY and ALL information as regards my health, any tests and outcomes.

Being a non American Citizen (but here legally!!) I was astounded, questioned it to be told take it or leave it, I have since been told "leaving it" is a quick way to being "let go"
By David @ 12/01/08 05:22:08 PMreport abuse
Must provide SS# for health report
It asked for information including SS# and then, even though I would not have provided the number, it disconnects you.
By Suz @ 12/01/08 05:12:34 PMreport abuse
Health "credit reports"
MedPoint Compliance won't receive my call requesting my Ingenix report.
By Bob Morehead @ 12/01/08 02:45:24 PMreport abuse
VA Health-care
I am a veteran who has went to the VA for 10 years now and I think every American should have that kind of medical care available to them. I was a small business owner and the medical community and insurance companies have a bull-eye on my back. High premiums and large deductibles, that's their game. There are millions of small owners out there that have been flushed into bankruptcy due to health-care. I read that it cost the VA approximately $ 1700 a year for my care and believe me I have seen many of my fellow veterans with major problems. Maybe your now paying $ 12,000 a year for your premiums, with a high deductable? You my friend you are being ripped off big-time, $ 10,300 a year by the Corporate machine and paper pushers! You have to make approximately $18,000 in gross wages to make the payment. gs
By gs @ 12/01/08 02:38:47 PMreport abuse
MedPoint Compliance
I just called MedPoint Compliance and their mailbox is full. Thanks to Clark's listeners
By Susan Parrish @ 12/01/08 02:28:54 PMreport abuse
Health 'dredit reports'
This is an interesting twist on insurance. I can see pro's and con's here:
On the Pro side, folks that are healthy (like me) probably will pay less; yet on the con side folks that have lots of issues may not be able to afford insurance. And being healthy may or may not be something I can control for lots of reasons.
I do see something positive here: I have seen countless folks that buy 'full coverage' insurance, and then believe anything that hurts or does not feel good is the doctor's and insurance co's problem... in other words no thought whatsoever about taking care of themselves... I personally do not want to finance the old age problems of someone that does not take care of their health, so in that respect I think this might be a good thing... however;
At the same time if my health took a turn for the worse, after a major claim I probably would be dropped and not be able to find coverage.
I am not sure there is a single shoe size here, we may need multiple ideas...
Personally, I only carry major coverage. The 'little things' (which are rare in my case) are out/pocket.
I full well realize not everyone is in the place I am; however I am also not interested in financing folks that do not at least try to take care of themselves.
By John @ 12/01/08 01:33:16 PMreport abuse
Health Credit Report
Just called MedPoint Compliance and they are not answering, just leave all the info on tape-really? Their mailbox is full, thanks to Clark's listeners!
By Judi @ 12/01/08 01:30:45 PMreport abuse
medpoint
I just called and the mailbox is full....now what
By cute22980 @ 12/01/08 01:28:59 PMreport abuse
MIB
More details about all this, including about the Medical Information Bureau (MIB) -- a central database of medical information shared by insurance companies -- and how you can obtain your MIB report free once a year:

http://www.privacyrights.org/fs/fs8-med.htm
By Danny @ 12/01/08 01:10:15 PMreport abuse
Health Credit Report
In order to get your personal health credit report from Ingenix, they REQUIRE you to give your social security number AND how you found out about being able to get a free report. "No exceptions" they say on their recording. It seems they realize they have been caught profiting from what SHOULD BE private information and are trying to figure out just how it happened. You go, Clark! Keep this story in the news until they plug this hole in the HIPAA law and keep our private health information private. Shame on the Pharmacy Benefit Managers for selling our information.
By Sandi Weld @ 11/28/08 10:07:53 AMreport abuse
Reply to Medical Vulture
Have you experienced the VA first hand? Unfortunately, I have often with my Dad. It is free, but wow...its HORRIBLE. We beg him to pay the medicare co-pays and get decent care. The VA is not exactly what you want to use as a "good option"
By Laurel M @ 11/25/08 10:02:54 PMreport abuse
Hi
By the way, see my post that I oppose national insurance.
By Nathan @ 11/25/08 03:04:25 PMreport abuse
Hi
I agree that a person should be covered if 1) we have national insurance or 2) if someone had insurance when they obtained the condition.
By Nathan @ 11/25/08 03:03:40 PMreport abuse
MEDICAL FRAUD
I see it each day..in the USA, the sick are excluded from medical care, and half the population has no coverage at all, the VA looks like the best system, no exclusions, bargains for drugs, and no dirty hustlers propositioning doctors for drug samples. But most people are not veterans.
By MEDICAL VULTURE @ 11/25/08 01:54:19 PMreport abuse
booming medical tourism
http://www.time.com/time/health/article/0,8599,1861919,00.html
By sks @ 11/25/08 10:10:26 AMreport abuse
The Last Straw
The insurance companies have weaseled out of HIPAA. I am now sold on socialized medicine.
By PJ @ 11/25/08 05:30:02 AMreport abuse
Keeping it private
Why weren't we told this before? Did I sign a release for this? Is this information shared even when you pay out of pocket instead of using medical insurance? It is like car insurance, use and get hit with higher rates... or denied.
By Amanda @ 11/24/08 08:54:22 PMreport abuse
Redlining by pharmacists
This is troubling indeed. Why wouldn't HIPAA cover this?
By Dawn @ 11/24/08 07:59:50 PMreport abuse

medical insurance bureaus and privacy

Does anyone know if the gov's medicaid/medicare patients are included in this ? Is their privacy protected while mine is not? Since I already pay for their care and then get held accountable and charged more for my own.Please keep this in the spotlight,it is another infringement on our rights.

By sandy @ 03/31/09 10:22:24 AMreport abuse

Health Credit Report

I am so glad to see this being exposed! There is another entity called the Medical Insurance Board (or Bureau?) that until recently was very secretive. There website is http://www.mib.com/html/about_mib_group.html. I encourage all consumers to check into this very disturbing group and understand the power they have over your ability to obtain insurance. My previous doctor wrote in multiple erroneous reports in my file (COPD, arthritis, high blood pressure, etc etc etc) in order to run expensive & unnecessary test. His report went to the MIB when I applied for anther insurance company and was denied any and all insurance. It took me months to get it straight, and only after I sought legal counsel. It is scary to think that there is indeed a "Big Brother" in the insurance industry, but there is. Keep up the good work, Clark. Let's expose those who try to intimidate and invade our right to privacy! Thank you.

By Courtney @ 12/12/08 02:41:26 PMreport abuse

Just called & left my info. Will see how long it takes to get this report

By msg @ 12/11/08 01:51:39 PMreport abuse

Health credit report

The insurance companies have too much power. When will we citizens start demanding our rights. Every corp. get what they want except the american citizen. When ever we need help, they don't think about us. Why are we always last when it comes to our health?

By Karen Terry @ 12/04/08 10:25:25 PMreport abuse

meds and insurance

My 21 year old healthy son applied for health ins and was rated high because a doctor gave him a med for headaches to try for 30 days and they tried to make us checkmark that he had seizures or epilepsy because the drug was used for this also. This is so wrong and unfair where are our politicians when we need them or the insurance commissioner

By Sherry @ 12/03/08 08:51:00 PMreport abuse

menopause

I had to make a comment because I had mood changes when I started menopause and I don't consider that depression even though I am on Prozac which is used for depression. I always get funny looks or questions as to why I am on it. Doesn't the medical profession know that menopause is treated with depression drugs.

By Trish @ 12/02/08 05:59:17 PMreport abuse

Medical Files

This is so unfair!!! What has happened to our privacy in this country. We should contact our Congressmen and put a stop this this!!!

By Louise @ 12/02/08 05:38:18 PMreport abuse

medpoint

who are the folks that they are asking for our social security number --or that they already have it...weird...No one answers and mailbox is full...no exceptions...

By judy @ 12/02/08 04:21:57 PMreport abuse

Med Point required info

Just called. The recording wants you to spell out your first/last name; date of birth;complete social security number; mailing address; and the source of how you learned about MedPoint. Mail box was full.

By Kevin @ 12/02/08 10:06:09 AMreport abuse

MED POINT INGENIX

I CALLED THE 888 #,MAIL BOX IS FULL.THESE FOLKS ARE SNEAKY AND DONT WANT THIS TO HIT THE MEDIA.GREAT JOB "CLARK"

By JIM @ 12/02/08 12:37:01 AMreport abuse

Did you know that it only takes 5-10 letters in a folder about a particular topic when you Legislative Rep will take notice and act on it?
This health credit report is a huge topic and speaks of business loopholes that strips us from coverage and large sums of money, while the insurers and logistics companies make huge sums of money that they distribute to their executive branch and golden parachutes. As a recipient of coverage with lots of riders (no coverage for my own chronic diseases and disabilities) and having to pay high premiums for coverage for one physician, I am sad and mad at the same time. I continue to learn-read-write and help others to see what is the truth but also to encourage others to help advocate for each other. There are a number of think-tanks and government officials that are working on some new health care plans as we speak to change the course that we are in right now. Check out the HealthLeaders and Thomas.gov websites for information on this subject as well as health care in general. Your eyes will be amazed...but it is worth the time and energy to get involved. After all, it only takes one!. Clark is helping so...don't be hesitant in calling and staying with it until you get a satisfactory answer. Thank you.

By The Nurse Part 3 @ 12/01/08 06:50:55 PMreport abuse

Our country's infrastructure for health care is broken and requires some drastic changes. That change will only take place if you and I speak up to our legislators, or President-elect and the new Congress. HIPAA was a nice idea on the table but turned out to be a nightmare in practice. The gov knows it. The only way is to go to Congress and change the law. If enough voice is put out there, things can and will change. It will take time. Writing letters, attending meetings with your legislators, signing up for community forum groups as representative of change is how it works. Complaining and not following it with action, is in a sense doing nothing. Persistence, opinions, and real-time facts to prove your situation is what draws their attention.

By The Nurse Part 2 @ 12/01/08 06:50:03 PMreport abuse

Insurance coverage

The focus in the insurance industry is to cover only those who will not be a liability to the insurer and the company that is paying for the services. If you have any type of chronic diseases requiring medications or physician management, coverage will not be granted. If one is employed without any lapse in insurance coverage, the coverage and benefits are there regardless of acute or chronic status. Once any lapse occurs, such as change in jobs and no insurance coverage is provided, you are put on the list for having a chronic disease and will not be covered. If you want coverage, your monthly dues are doubled, since you are now a risk for them, even if your past medical history shows no risk at all.

By The Nurse @ 12/01/08 06:47:51 PMreport abuse

Ingenix report

Just called and got right through, No problems at all. Now we will see whae we get the report

By FOURMOREMARINE @ 12/01/08 06:41:20 PMreport abuse

Recorded message tells you the 5 things that they need to process your request, then informs you that the mailbox is full. What's up???
c

By Cheryl Williams @ 12/01/08 06:03:42 PMreport abuse

VA Health Care

Lauren M . . . I have to agree with gs . . . in my personal (me) analytical (very) experience (many), VA health care, at least in southern California, has become excellent . . . maybe not 20 years ago, but it is now . . . and our veterans deserve no less than world class care for their collective sacrifices.

The quintessential definition of a Veteran is: "A Veteran is someone who, at one point in his/her life, wrote a blank check made payable to the United States of America, for any amount, up to and including his/her life." Author Unknown.

By W @ 12/01/08 06:01:29 PMreport abuse

Called several time..mailbox is always full so you get disconnected..no report

By Phil Capps @ 12/01/08 05:58:24 PMreport abuse

I just tried calling...their mailbox is full!

By Robert @ 12/01/08 05:30:11 PMreport abuse

Company Medical and HIPAA

We were given a letter stating that the medical company as part of agreeing to taking me on would divulge EVERY and ALL information as regards my health, any tests and outcomes.

Being a non American Citizen (but here legally!!) I was astounded, questioned it to be told take it or leave it, I have since been told "leaving it" is a quick way to being "let go"

By David @ 12/01/08 05:22:08 PMreport abuse

Must provide SS# for health report

It asked for information including SS# and then, even though I would not have provided the number, it disconnects you.

By Suz @ 12/01/08 05:12:34 PMreport abuse

Health "credit reports"

MedPoint Compliance won't receive my call requesting my Ingenix report.

By Bob Morehead @ 12/01/08 02:45:24 PMreport abuse

VA Health-care

I am a veteran who has went to the VA for 10 years now and I think every American should have that kind of medical care available to them. I was a small business owner and the medical community and insurance companies have a bull-eye on my back. High premiums and large deductibles, that's their game. There are millions of small owners out there that have been flushed into bankruptcy due to health-care. I read that it cost the VA approximately $ 1700 a year for my care and believe me I have seen many of my fellow veterans with major problems. Maybe your now paying $ 12,000 a year for your premiums, with a high deductable? You my friend you are being ripped off big-time, $ 10,300 a year by the Corporate machine and paper pushers! You have to make approximately $18,000 in gross wages to make the payment. gs

By gs @ 12/01/08 02:38:47 PMreport abuse

MedPoint Compliance

I just called MedPoint Compliance and their mailbox is full. Thanks to Clark's listeners

By Susan Parrish @ 12/01/08 02:28:54 PMreport abuse

Health 'dredit reports'

This is an interesting twist on insurance. I can see pro's and con's here:
On the Pro side, folks that are healthy (like me) probably will pay less; yet on the con side folks that have lots of issues may not be able to afford insurance. And being healthy may or may not be something I can control for lots of reasons.
I do see something positive here: I have seen countless folks that buy 'full coverage' insurance, and then believe anything that hurts or does not feel good is the doctor's and insurance co's problem... in other words no thought whatsoever about taking care of themselves... I personally do not want to finance the old age problems of someone that does not take care of their health, so in that respect I think this might be a good thing... however;
At the same time if my health took a turn for the worse, after a major claim I probably would be dropped and not be able to find coverage.
I am not sure there is a single shoe size here, we may need multiple ideas...
Personally, I only carry major coverage. The 'little things' (which are rare in my case) are out/pocket.
I full well realize not everyone is in the place I am; however I am also not interested in financing folks that do not at least try to take care of themselves.

By John @ 12/01/08 01:33:16 PMreport abuse

Just called MedPoint Compliance and they are not answering, just leave all the info on tape-really? Their mailbox is full, thanks to Clark's listeners!

By Judi @ 12/01/08 01:30:45 PMreport abuse

I just called and the mailbox is full....now what

By cute22980 @ 12/01/08 01:28:59 PMreport abuse

MIB

More details about all this, including about the Medical Information Bureau (MIB) -- a central database of medical information shared by insurance companies -- and how you can obtain your MIB report free once a year:

http://www.privacyrights.org/fs/fs8-med.htm

By Danny @ 12/01/08 01:10:15 PMreport abuse

In order to get your personal health credit report from Ingenix, they REQUIRE you to give your social security number AND how you found out about being able to get a free report. "No exceptions" they say on their recording. It seems they realize they have been caught profiting from what SHOULD BE private information and are trying to figure out just how it happened. You go, Clark! Keep this story in the news until they plug this hole in the HIPAA law and keep our private health information private. Shame on the Pharmacy Benefit Managers for selling our information.

By Sandi Weld @ 11/28/08 10:07:53 AMreport abuse

Reply to Medical Vulture

Have you experienced the VA first hand? Unfortunately, I have often with my Dad. It is free, but wow...its HORRIBLE. We beg him to pay the medicare co-pays and get decent care. The VA is not exactly what you want to use as a "good option"

By Laurel M @ 11/25/08 10:02:54 PMreport abuse

By the way, see my post that I oppose national insurance.

By Nathan @ 11/25/08 03:04:25 PMreport abuse

I agree that a person should be covered if 1) we have national insurance or 2) if someone had insurance when they obtained the condition.

By Nathan @ 11/25/08 03:03:40 PMreport abuse

MEDICAL FRAUD

I see it each day..in the USA, the sick are excluded from medical care, and half the population has no coverage at all, the VA looks like the best system, no exclusions, bargains for drugs, and no dirty hustlers propositioning doctors for drug samples. But most people are not veterans.

By MEDICAL VULTURE @ 11/25/08 01:54:19 PMreport abuse

booming medical tourism

http://www.time.com/time/health/article/0,8599,1861919,00.html

By sks @ 11/25/08 10:10:26 AMreport abuse

The Last Straw

The insurance companies have weaseled out of HIPAA. I am now sold on socialized medicine.

By PJ @ 11/25/08 05:30:02 AMreport abuse

Keeping it private

Why weren't we told this before? Did I sign a release for this? Is this information shared even when you pay out of pocket instead of using medical insurance? It is like car insurance, use and get hit with higher rates... or denied.

By Amanda @ 11/24/08 08:54:22 PMreport abuse

Redlining by pharmacists

This is troubling indeed. Why wouldn't HIPAA cover this?

By Dawn @ 11/24/08 07:59:50 PMreport abuse

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Nov 24, 2008 -- 200 million Americans have a health credit report

What others are saying