OPM in October 2010 announced plans for a database tool to track and evaluate the quality and cost of services provided through the Federal Employees Health Benefits Program. The agency earlier this month issued revised notices addressing concerns that the database -- which would store information such as the enrollee's name, Social Security number, employment details, health care providers, medical diagnoses and insurance coverage -- could violate patient privacy.
Harley Geiger, policy counsel at the nonprofit Center for Democracy and Technology, said the updated notices show improved transparency, privacy and security, as well as stricter limits on the amount of health information OPM will make available. The original notice stated that information could be used in law enforcement proceedings, congressional inquiries or OPM workforce studies, as well as made available to researchers and analysts outside government examining health insurance trends. In some cases, individuals could be identified through the data selected, the notice said.
Information still would be accessible for law enforcement and fraud detection, but OPM would create a clear division between the data used for research and analysis and that used for audits. The agency also would prohibit congressional inquiries, mask identities in data released to researchers and eliminate data collection from the Multistate Option Plan and the National Pre-Existing Condition Insurance Program, which provides coverage to those denied insurance because of a medical condition. Privacy experts note fundamental change still is needed, however.
"It's unclear why OPM needs identifiable data for its purposes," Geiger said. "We had suggested they move toward a decentralized database model, where it leaves the data with health plans rather than collect a copy of the data so it's not in one giant pot."
OPM's revisions still fall short of strong privacy standards, said Dr. Deborah Peel, founder of the nonprofit Patient Privacy Rights, noting the agency needs strict monitoring and oversight of contractors performing fraud audits and a clear process for protecting identities. Instead of releasing health information for research purposes, OPM could conduct inquiries internally and release only the results, she said.
"The lack of patient control over personal health data has a chilling effect on the willingness to seek treatment and to share information," Peel said in an email. "The more the public learns about data releases for research without consent, the more they will oppose electronic health systems and research . . . Federal employees' claims and health data should be used only as specified by contract, and penalties, oversight and enforcement are essential for trust in the FEHBP."
National Treasury Employees Union President Colleen Kelley applauded the changes, noting stricter security measures and a narrower scope of data to be collected will better protect FEHBP enrollees' information.
"Taken together, these changes are a substantive improvement in the earlier proposal in that the information can still be put to effective use while the need to recognize and respect employee privacy rights is being addressed," Kelley said.
OPM Director John Berry in March said the database will be up and running this year, adding that the tool will help the agency better understand factors driving health care costs.