Insurer wants doctors' own medical files

Hawaii's largest health plan says it wants to protect patients, but physicians say it's violating doctors' privacy.

By Andis Robeznieks, AMNews staff. March 25, 2002.

Is there trouble in paradise? Several physicians in the nation's 50th state seem to think so.

Controversy has erupted between physicians and the state's largest health plan, the Blue Cross Blue Shield-affiliated Hawaii Medical Service Assn., over a portion of the company's new recredentialing form that calls for authorization to look into a physician's personal medical records.

"We've been told they want to protect the public and check on doctors to make sure they're competent to practice," said Kauai psychiatrist Gerald McKenna, MD, president of the Hawaii Medical Assn. "If that's their reason, they're not going to find anything in a doctor's medical records. It just gives them a fishing license to look for whatever they want to look for."

Because HMSA covers more than 70% of Hawaii's insured residents, HMA Director Paula Arcena said doctors would have difficulty staying in business without working with it.

"If you don't contract with HMSA, you don't have patients," she said.

HMSA first asked for authorization to inspect personal records last fall. When that came under criticism, the authorization form was revised and turned into a two-step process.

Doctors must first give general consent to let HMSA inspect personal and professional information. If the company feels it needs more data, the physician is asked to sign another form requesting records regarding their physical or mental conditions. If they refuse to sign either form, HMSA will terminate their contracts.

The AMA opposes any contract to provide care that requires access to a physician's own medical records. [...]