how does that not violate HIPAA ? I see it talking about "you can proactively opt out with hipaa" but everything I've ever seen about HIPAA is that all "opting in" needs to be explicitly granted by the patient.

If you want life insurance then you are required to give permission to view this data about you. If you don't want to give permission, then you don't get life insurance.

https://www.rxhistories.com/irix/medical-data/

>How It Works

>1 Applicants sign a HIPAA-compliant authorization, enabling insurers to retrieve their medical information

>2 Insurers electronically query Milliman IntelliScript in real-time

>3 Milliman instantly gathers information from multiple data sources

>4 Irix interprets the data and generates automated decisions based on the insurer's guidelines

But I never gave Milliman permission to hold this data, so didn't they already violate HIPAA?

I think you misunderstand HIPAA. As long as they have a business associate agreement with the pharmacies and serve some vaguely care-adjacent purpose, the pharmacy can share your data with them without your knowledge or consent.

I can't tell if you're being cynical or serious, but if the latter I can't see how this is correct.

From "Pharmacy privacy Requirements here [1], I don't think "business associate agreement [with] some vaguely care-adjacent purpose" meets the standards for information-sharing. Rather the information must be being shared as part of specific treatment for a patient (discussing actual care) or payment.

[1] https://www.uspharmacist.com/article/hipaa-privacy-security-...

GP comment is being deadly serious and not at all cynical or sarcastic.

HIPAA is a fig leaf. Cardboard covers on clipboards to inconvenience the nurses and receptionists, but a unencumbered infobahn for anyone who touches the money to drive straight through.

For decades, every visit, test, procedure, and medication you've ever had paid for by a health insurer in the US got dumped straight into MIB, where any insurer could look at it. HIPAA functionally changed this not a whit.

> HIPAA has a rule that permits disclosure of PHI for health care operations, treatment, and payment.

I think this is what the GP was referring to. It's not just for care but for payment and operations too. A few operational examples, in the case of pharmacies, they must make sure that a patient doesn't fill the same prescription twice. Health insurance companies receive clinical data from health care providers for the purposes of HEDIS reporting.

Don't forget, the second P in HIPPA is portability.

Sounds like they have hooks into the back end systems to query multiple insurance companies and pharmacies on the fly. - "Milliman instantly gathers information from multiple data sources"

Likely deep within the terms and conditions you agreed to with your private health insurance company, you did indeed give permission.

I imagine somewhere in their quoting algorithm they have a conditional like `if potential_customer.opted_out_of_hipaa then quote = max_possible_quote, msg = 'you can lower your quote by sharing your data with us'".

Unlikely

I'm guessing you opt-in when you request a quote.

It still sounds sketchy since it sounds like your data is maintained at a 3rd party for a purpose that is not intended (unrelated to your care) on the idea that you may one day opt-in to the unintended use.

We are all most likely explicitly authorizing this activity in the reams of fine print you sign without reading or otherwise accept by agreeing to service by your local hospital group or pharmacy combine.

> First, the very act of requesting your data is in a way confirming and verifying the accuracy of the data.

Could you explain what you mean by that? And also hypothesize some implications of 'confirming and verifying the accuracy of the data'?

It's obviously contributing more data with a high probability of being all signal and zero noise. Some government IDs even include social security #s, but you're adding a photograph.

In the sense of confirming the data, it seems likely to at least attest to the identity being a genuine one associated with that data. Rather than something like a burner phone setup with a bunch of random stuff. Of course people can also have a fake photo ID, but it seems unlikely someone using a totally fabricated existence would be querying for this information and exposing them potentially to closer scrutiny.

For example, checking if you ever had an account at companies mentioned in your data takeout - to spot if someone does shit while using your name/personal information, or some incompetent/malicious clerk mixed up data.

That doesn't verify any data though. At most, it implies a likelihood of having an account, but nothing about the specific data.

If they're uncertain of your middle name for instance, uploading your ID just confirms that they had it right or wrong.

And the history of every life insurance application an individual filled is collected and shared through a company called MiB[0] to help mitigate fraud.

[0]. mib.com

> Two points: First, the very act of requesting your data is in a way confirming and verifying the accuracy of the data.

Same dilemma as hitting the "unsubscribe" link on spam: when doing so you confirm them you have a valid email address. It's a pure act of faith, you hope that they will comply and not take advantage of you even more.

How is that even legal? Isn't patient data specially protected?

Your healthcare providers, pharmacies included, can sign BAAs with other firms that allow them to share the data. Your consent is not required.