23 Aug 2014
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Pa. Pill Tracker Could Breach Patient Privacy

Doctors say a proposed prescription tracker plan would violate patient confidentiality in Pennsylvania.

Pa. Pill Tracker Could Breach Patient Privacy

By Melissa Daniels | PA Independent

HARRISBURG — A plan to keep “pill shoppers” from scamming multiple narcotic prescriptions in Pennsylvania is on hold due to medical community concerns that it jeopardizes patient privacy.

House Bill 1694 would track prescriptions issued by doctors and filled by pharmacists through the Pennsylvania Accountability Monitoring Program. Law enforcement would be able to access information if they had an active investigation involving drug abuse,  which previously raised concerns of privacy advocates at the American Civil Liberties Union of Pennsylvania.

A recent amendment introduced by Rep. Matt Baker, R-Tioga, would require that any irregular prescription patterns be flagged and immediately sent to the state attorney general’s office. Local district attorneys and law enforcement could also have access to that data.

In a letter to House members, the Pennsylvania Medical Society called the amendment “a huge step backward for patient privacy.” The association, along withPennsylvania Psychiatric Society, said they would withdraw their longtime support if the Baker amendment goes through.

The bill was pulled from the voting calendar after the groups voiced their concerns.

C. Richard Schott, president of Pennsylvania Medical Society, said potential violations of doctor-patient confidentiality are the main concerns. Immediate flagging could lead to false positives, and potential Health Insurance Portability and Accountability Act violations, he said.

“How are they going to know there are a lot of people that clinically need high doses of narcotics for legitimate pain management without diving into their medical history?” Schott said.

Schott said patients might not want to come forward to doctors with health concerns for fear of being put in the database.

“The more people that can get their finger into this kind of data, the more potential for leaks,” he said.

Steve Miskin, spokesman for the House Republican caucus, said the caucus put the bill on hold pending a compromise between medical and law enforcement communities. He said the goal is to reach an agreement by the week of Oct. 15, when lawmakers return from session.

Baker and Rep. Gene DiGirolamo, R-Bucks, are leading the efforts for the legislation. Plans to develop a prescription database have been around for at least three sessions, Miskin said.

“We believe those two will be able to get that balance,” Miskin said. “It’s an issue that is very important to both of them.”

Rep. Bryan Cutler, R-Lancaster, has introduced amendments that would require law enforcement to obtain a search warrant before getting access to the prescription database. PMS supports this plan, as does the ACLU of Pennsylvania, said director of government affairs Andy Hoover.

Hoover said search warrants are a “basic principle” of the law enforcement system, whereas automatic notification allows private data to land in the hands of law enforcement without any probable cause determination.

“Automatic notification to the Attorney General’s office completely undermines the stated purpose of the legislation,” Hoover wrote to lawmakers this week. “The previous primary sponsor of this legislation has stated repeatedly that this bill is about saving lives and has said that his intent is not increased incarceration.”

The Pennsylvania Medical Society, despite its recent concerns, has long supported the concept of a prescription tracking database.

Schott said every state that borders Pennsylvania has one, making the state a target for pill shoppers.

“A lot of those concerns occur in situations where there is not a deep relationship with the patients, such as the emergency room,” Schott said. “Pill shoppers know how to go from doctor to doctor.”

If a doctor could check a database to find out if the patient has a history of pill shopping, it could be helpful and appropriate, Schott said. The best case scenario would be if checking the database was optional. Otherwise, it could be burdensome to doctors who already have relationships with their patients.

“We don’t want people out there selling drugs,” Schott said. “We understand the need to stay on top of that. But I think that taking normal prescribing by a physician and having it in a database including sensitive patient information is way over the limit of what government should be doing with our private information."

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