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Feds move toward health claims database despite privacy fears

Jaikumar Vijayan, Computerworld | June 16, 2011
Despite lingering privacy concerns, the U.S. Office of Personnel Management is plowing ahead with plans to build a massive centralized database containing detailed healthcare information on millions of federal workers and their families.

The inspector general's office, meanwhile, will use the claims database for audit and investigative purposes to detect fraud and waste, according to one notice.

The OPM's revised plan differs substantially from the one it proposed last year in some key areas.

Originally, for instance, the OPM data warehouse would have pulled in data from two other sources as well: the National Pre-Existing Condition Insurance Program and the Multi-State Option Plan.

As it stands, the system will now use only data from the FEHBP, although OPM left the door open for including the Multi-State Option Plan, Geiger said.

The narrower scope is important because a significantly smaller number of people will now be part of the database, he said.

Another change involves greater transparency about privacy protections, Geiger said. The revised notice offers more detail on the privacy laws OPM will follow, and spells out who has access to fully identifiable data and who has access only to anonymized data.

"They have also made it clear that some of the information sharing they had reserved for their use under the previous SORN is no longer in place," he said. And when the OPM does share information externally, it will be only be fully anonymized data.

The main issue is about the need for such a centralized data repository in the first place, Geiger said. The OPM could achieve its goals just as well simply by accessing the FEHBP data here it is now, rather than pulling it into a separate database.

The need for the OPM to have fully identifiable data is also unclear, he said, arguing that the analyses OPM envisions can be achieved by using hashed, anonymized data.

In most cases, enrollees in the federal health employment benefit plan won't know that claims information is going to OPM and they won't know what information is used and why, he said.

Officials at the OPM could not be reached immediately for comment.

 

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