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To charge higher rates, or reject applicants, insurance companies rely on the Medical Information Bureau Inc. (MIB) to divulge personal information about health status and pre-existing conditions. According to an AHIP press release (2007),

The Medical Information Bureau Inc. (MIB) is a cooperative data exchange formed by the North American insurance industry more than 100 years ago. Today, the MIB operates the most extensive database of medical information on individuals who have previously applied for health, life, disability income, critical illness and long-term care insurance.

Not all of the information collected by the MIB is medical; some MIB report codes indicate previous criminal activity or evidence of a dangerous lifestyle, including, "adverse driving records, hazardous sports, aviation activity, or homosexual behavior." In 1995, the Federal Trade Commission ordered the MIB to comply with the Fair Credit Reporting Act (FCRA) and provide annual disclosure of medical report files to consumers.

Essentially, the Medical Information Bureau Inc. (MIB) helps make sure that if one life insurance company rejects a person on medical grounds, then other life insurance companies will be made aware of the ailment and reject that person. MIB is thus the official insurance agency gossip columnist.

Never heard of The Medical Information Bureau Inc. (MIB)? Here is what Meg Brown, Chief Underwriter for American Republic and World Insurance says about the MIB information service,

"We already have an admirably low rescission rate, and we think MIB will allow us to improve performance even further. Frankly, as use of MIB becomes more widespread among health insurers, we want to be sure we have access to the same data our competitors have."

The sales of personal medical information are indeed rising, says Douglas M. Mertz, Vice President for MIB Solutions Inc.,

"Companies and health plans selling individual medical expense insurance are increasingly seeking new tools to give them a better understanding of their applicants’ medical profiles up front. Information provided by the MIB is the fastest, most cost-effective way to help determine if medical statements on applications are accurate and complete."

According to the Federal Trade Commission press release, MIB member corporations account for 99 percent of the individual life insurance policies and 80 percent of all health and disability policies issued in the United States and Canada. Thus, "medical reports" sold to insurers by the Medical Information bureau are like credit reports for your health.  The Washington Post reported that these insurance industry databases contain file records on more than 200 million Americans.

In fact, just as Experian, Equifax, and TransUnion, keep "credit reports" for all consumers, and are required to provide annual credit reports, there are actually three insurance reporting agencies that collect and sell medical reports.  In addition to the MIB, the Federal Trade Commission has identified Ingenix, Inc. (a Division of UnitedHealthcare Inc.) and Milliman, Inc. as nationwide specialty consumer reporting agencies under the Fair Credit Reporting Act (FCRA). From the FTC complaint against Ingenix, Inc.,

"the medical profile generated by Ingenix Inc.'s MedPoint product includes, but is not limited to, prescription drugs, including dosage and number of refills filled by the insurance applicant for the previous five years. It also includes for each drug, the name and address of the dispensing pharmacy, as well as the name and address of the prescribing doctor, including specialty medical practice."

Based on the information in your personal medical report file, insurance companies can reject your application, charge you higher prices, or cancel your existing policy. For example, a BusinessWeek report reveals that filling certain prescriptions can hurt your chances of affordable health insurance in the future. At the very least, consumers should be aware that medical reports, sold to insurers by the MIB, Ingenix, Inc., and Milliman, Inc. enable health and life insurance corporations to charge higher premiums and rescind coverage.  

Checking your medical report for errors and accuracy is the simplest way to reduce out-of-pocket costs for insurance. And, for any person who thinks they may have a "pre-existing condition" that could cost them more or exclude them from coverage, checking their medical report disclosure file is essential before appling for insurance.

Originally posted to B Dizzle on Fri Mar 26, 2010 at 07:50 AM PDT.

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Comment Preferences

  •  Tip Jar (9+ / 0-)

    Orville and Wilbur Wright never needed a pilot's license...

    by B Dizzle on Fri Mar 26, 2010 at 07:50:56 AM PDT

  •  And the database is managed by the twins (4+ / 0-)
    Recommended by:
    otto, buddabelly, pantherq, Siri

    wwywywywyw and Bob.  :)

    Hurley - "Bucky, the mice will agree with anything. You guys are all idiots, right?" Mice - "Right!"

    by Dingodude on Fri Mar 26, 2010 at 07:54:08 AM PDT

  •  They will provide you a free report (3+ / 0-)
    Recommended by:
    lalo456987, pantherq, Siri

    if you call them.

    •  social security number by telephone (4+ / 0-)
      Recommended by:
      lalo456987, Dartagnan, pantherq, Siri

      yep... you can call them directly.  be prepared to leave your personal information on a voicemail machine. you'll need: name, address, social security number, DOB, previous addresses, and previous names/aliases.  according to the voicemail machine message, you "may be prosecuted to the fullest extent of the law if you provide any false information."

      Orville and Wilbur Wright never needed a pilot's license...

      by B Dizzle on Fri Mar 26, 2010 at 08:10:50 AM PDT

      [ Parent ]

    •  I'd rather cut off a limb... (3+ / 0-)
      Recommended by:
      Dartagnan, pantherq, Siri

      than ask them to send me a copy of something that ought to be illegal for them to have and/or disseminate without my permission.

      I appreciate your pointing out the link, tho.  :-)

      Where are the "better" Democrats?

      by lalo456987 on Fri Mar 26, 2010 at 08:14:19 AM PDT

      [ Parent ]

      •  Fine, but It Could Cost You (1+ / 0-)
        Recommended by:

        I certainly appreciate your point lalo.  But, that's like refusing to look at your credit report because the bankers are crooks. Its a principled stand, but it could cost extra money!

        Even if you dont know whats in your MIB file, the insurers do. So, checking your medical report is just as important as checking your credit report if you plan to apply for insurance, or intend to keep the insurance you have.  Its important to ensure there are no coding errors on the MIB reports that could disqualify a healthy person from finding affordable coverage.

        Consumer Reports Health’s Cover America Tour realized the impact of the Medical Information Bureau (MIB) when they visited Sheila (above) in Gulfport, Miss., the day after her 50th birthday.

        When she attempted to apply for health insurance, Sheila was surprised when she was rejected for an individual health insurance policy by three different companies. She was even more shocked when she learned why: Her record with MIB listed her as having a history of Chronic Obstructive Pulmonary Disease (COPD). Sheila does suffer from asthma, but COPD is supposed to be used to indicate more severe diseases of the lungs, such as emphysema or severe bronchitis. No company would insure her with this damaging mark on her record.

        Sheila eventually traced the problem to a coding disparity at her doctor’s office. But, there was no quick fix...

        Orville and Wilbur Wright never needed a pilot's license...

        by B Dizzle on Fri Mar 26, 2010 at 08:44:50 AM PDT

        [ Parent ]

  •  Doesn't this violate HIPPA laws? (5+ / 0-)

    I honestly don't know and would like to find out how they get around that. I don't believe I ever ok'd my personal medical info. to go to any such organization.

    •  Really (3+ / 0-)
      Recommended by:
      lalo456987, buddabelly, Siri

      Isn't this private information that should only be in your doctors records?

      •  All Your Doctors Records are Belong to Insurers (2+ / 0-)
        Recommended by:
        pantherq, Siri

        Well, the information is definitely in your doctors records, and your pharmacy records, and your employer benefit manager records, and your credit card records... Think of all the transaction data that is generated when you visit the doctor, get a prescription, pick it up at the pharmacy, and bill your insurance company for reimbursement.  At each of these points, your personal data loses its privacy.

        And, would it surprise you that the American Medical Association is actually selling data directly out of the doctor's files!!  You should read about the AMA Physician Masterfile Database.

        For the past 60 years, the American Medical Association has made the AMA Physician Masterfile available for sale to corporations and other medical entities. Currently, purchasers of the AMA Physician Masterfile database include pharmaceutical companies, consultants, market research firms, insurance companies, hospitals, medical schools, medical equipment and supply companies, health data brokers, and commercial organizations.

        AS A PATIENT, information about your medical care is included in the American Medical Association’s collection of physicians’ practice-level data. All doctors are automatically enrolled to have their practice-level information recorded, UNLESS the doctor affirmatively acts to opt-out. It is NOT the choice of the patient, but the choice of the doctor as to whether the patient’s information will be sold.

        According to an AMA spokesman, here is how the pharmaceutical companies utilize the AMA’s Physician Masterfile database:

        "[Pharmaceutical corporations] take our data as well as [data from] several dozen other databases and combine them together with information that they receive from pharmacies, and they put together a picture of physicians’ prescribing habits — by zip code, by specialty, by individual physician — and they use it for their planning and marketing purposes... It benefits physicians in that they receive targeted visits from pharmaceutical reps as opposed to broad visits, so that physicians don’t receive visits concerning therapeutics that they might or might not be interested in. This is not really a patient issue, from our perspective, but I would ask how it would hurt patients if it’s designed to provide physicians with information about therapeutics."

        Orville and Wilbur Wright never needed a pilot's license...

        by B Dizzle on Fri Mar 26, 2010 at 08:32:00 AM PDT

        [ Parent ]

        •  Hippa (2+ / 0-)

          Hi- jacking
          Prefer to be

          •  HIPAA (1+ / 0-)
            Recommended by:

            The Health Insurance Portability and Accountability Act (HIPAA), enacted by the U.S. Congress in 1996 and signed by President Clinton, was originally co-sponsored by Sen. Edward Kennedy (D-Mass.) and Sen. Nancy Kassebaum (R-Kan.).

            Orville and Wilbur Wright never needed a pilot's license...

            by B Dizzle on Fri Mar 26, 2010 at 08:48:34 AM PDT

            [ Parent ]

        •  Pharmacy prescription info by physician (2+ / 0-)
          Recommended by:
          B Dizzle, MKSinSA

          is also collected.  We heard it first from our own pharmacist.  Used by insurers, state medical boards and of course pHarma.

          No honor among thieves.  

          "Never, desist till we ... extinguish this bloody traffic, of which our posterity, will scarce believe that it suffered a disgrace and dishonor to this country.

          by Regina in a Sears Kit House on Fri Mar 26, 2010 at 10:34:47 AM PDT

          [ Parent ]

          •  AMA Physician Masterfile Database (2+ / 0-)

            Really? I'm surprised to hear a pharmacist talking about such things! The AMA makes about $40 million per year in licensing fees to sell "patient and prescriber-level data" contained in its Physician Masterfile Database.

            The American Medical Association closely tracks the activities of physicians from medical school to death. In its Physician Masterfile, the AMA merges all of the information it has ever collected about physicians and the medical care they provide. The AMA began compiling physician data in 1906— the Physician Masterfile is now more than a century old and includes records for approximately 900,000 physicians, about two thirds of whom are not AMA members. Physician records are never removed from the AMA Physician Masterfile, even in the case of a physician’s death.

            Shockingly, the results of a Kaiser Family Foundation research studyshowed that only 60% of physicians were aware that the American Medical Association is selling their information through the AMA Physician Masterfile Database, but 74% of physicians were opposed to the practice once they were so informed. A spokesman for the AMA said "this is not really a patient issue, from our perspective."  

            But, members of theAmerican Medical Student Association (AMSA) are protesting the "sales" of these data for pharmaceutical marketing purposes.

            (In July 2007, protests at the American Medical Association (AMA) annual meeting in Chicago brought to the forefront the fact that the AMA has begun disclosing information in its Physician Masterfile, or physician database, to pharmaceutical companies.)

            In defense, the AMA calls the financial arrangement "licensure" and notes that physicians have the right to opt-out of sharing their personal information (although not its collection.) However, the AMA opt-out options do not limit the AMA’s ability to store this medical data indefinitely into the future; physician information collected by the AMA is never deleted from the Masterfile, even after the physician’s death. Since the AMA began compiling physician data in 1906, the Masterfile is now more than a century old and includes approximately 900,000 physicians, about two thirds of whom are not AMA members.

            Orville and Wilbur Wright never needed a pilot's license...

            by B Dizzle on Fri Mar 26, 2010 at 12:00:52 PM PDT

            [ Parent ]

            •  Thanks, it's good to get even more (2+ / 0-)
              Recommended by:
              B Dizzle, MKSinSA


              I keep seeing percentage of doctors belonging to the AMA is only 20 - 25%.

              I do know from research, that AMA members staff the state medical boards.  Through that bureaucracy they can control all docs in any state.

              But the idea that they pass on prescribing information added onto being told by insurance clerks what is or is not ok to do for patients, must be a horrible way to have a day at the office.

              "Never, desist till we ... extinguish this bloody traffic, of which our posterity, will scarce believe that it suffered a disgrace and dishonor to this country.

              by Regina in a Sears Kit House on Fri Mar 26, 2010 at 12:22:35 PM PDT

              [ Parent ]

    •  No Violation of HIPAA (4+ / 0-)
      Recommended by:
      bara, wilderness voice, sanglug, Siri

      Interesting question Siri... In fact, the HIPAA provisions don't apply to these nationwide consumer reporting agencies.  

      First, HIPAA covers only "individually identifiable health information" and the MIB, Ingenix, and Milliman actually exchange "coded" medical information. (In much the same way, your credit report has "codes" of your financial activity but not all the specific details of every transaction.)

      Secondly, when applying for insurance with a company that is a member of the MIB, each consumer gives explicit consent to divulge and exchange their personal information through the MIB. If you have individual insurance (or are on a group plan) pull out your original application for insurance and closely review the terms!  If your policy is held by a larger insurance corporation, the chances are good you consented to allow MIB to collect and share your information.

      Orville and Wilbur Wright never needed a pilot's license...

      by B Dizzle on Fri Mar 26, 2010 at 08:18:24 AM PDT

      [ Parent ]

      •  this is depressing... (1+ / 0-)
        Recommended by:

        The elimination of health insurance rescission won't really end this practice the MIB as a business or would it?

        Where are the "better" Democrats?

        by lalo456987 on Fri Mar 26, 2010 at 08:28:58 AM PDT

        [ Parent ]

        •  MIB was founded in 1900 and is here to stay (2+ / 0-)
          Recommended by:
          lalo456987, Siri

          Currently, there is much debate about how the new health care law actually affects rescission and pre-existing conditions in adults and children... But, until 2015 at the earliest, these health insurance practices are here to stay. And, even if you aren't actually sick, a coding error in your MIB report can disqualify you for coverage.

          The MIB will remain critically important for insurance executives to set policy rates and boost profitability before the 2010 cut-off.  Its already happening, "Coverage For Sick Kids Under Question In New Law"

          There is no doubt that for children who are enrolled in insurance plans, the new law bars insurers from excluding coverage of any pre-existing conditions...But, one thing is clear: The law does nothing to stop insurers from charging higher rates for children with pre-existing illnesses until 2014 when insurers can no longer use health status in setting premiums.

          Finally, the MIB data exchange is vital to other areas of insurance, including life, disability, critical illness, and long-term care. So, the MIB is probably here to stay.

          Orville and Wilbur Wright never needed a pilot's license...

          by B Dizzle on Fri Mar 26, 2010 at 08:39:04 AM PDT

          [ Parent ]

      •  That's simply staggering (2+ / 0-)

        I always thought you had to give express permission to have your medical information shared in any instance.  I think having a pharmacy attach my name to my prescription history and share it with an outside source would be a violation but if it's done through the insurance company and the language is hidden in the contract I don't suppose there's anything anyone could do.

        This does clearly illustrate why the HCR law (YAY no longer just a bill) is necessary to protect people from insurance company cherry picking.

        Thanks for you answer!

        •  Best thing to do is request a consumer disclosure (2+ / 0-)

          Depending on the type of information, and who's collecting it, different laws apply.  With insurance, you do give your express permission to have your information shared.  It's just that most people don't realize exactly what they are consenting to share when they apply or sign the insurance contract!

          Also, for example, when you purchase a prescription at CVS/Rite Aid/Walgreens, you consent to share that transaction data with the store, your credit card company/bank (unless you pay cash) and, if you file it as an insurance claim, your insurer and pharmacy benefit manager (PBM).  So, there are many instances where seemingly "private" data is being expressly shared.

          If you have a chance to review the fine print of your own health insurance policy, you'll probably find the words "Medical Information Bureau" or "MIB".  Here is one example of an MIB notice of consent in an insurance application (from the book "Database Nation"):

          "I AUTHORIZE any physician, medical practitioner, hospital, clinic, other medical or medically-related facility, the Medical Information Bureau (MIB, Inc.), consumer reporting agency, insurance or reinsurance, employer having certain information about me or my dependents to give John Alden Life Insurance Company or its legal representative any information. The nature of the information to be disclosed includes information about: (1) physical condition(s), (2) health history(ies), (3) avocation(s), (4) age(s), (5) occupation(s), and (6) personal characteristics..  This authorization includes information about: (1) drugs, (2) alcoholism, (3) or (4) communicable diseases.

             I UNDERSTAND the information obtained by use of the Authorization be used by JOHN ALDEN LIFE INSURANCE COMPANY to determine eligibility for benefits.  I ALSO AUTHORIZE JOHN ALDEN LIFE INSURANCE COMPANY to release any information obtained to reinsuring companies, Medical Information Bureau, Inc., or other persons or organizations performing business or legal services in connection with my application, claim, or as may be otherwise lawfully required, or as I may further advocate."

          The book author says "I asked my wife if she knew what the Medical Information Bureau was. She said she didn’t. I then showed her John Alden medical insurance application she had filled out nearly two years before. It included the two paragraphs above.  Her signature was at the bottom."

          Orville and Wilbur Wright never needed a pilot's license...

          by B Dizzle on Fri Mar 26, 2010 at 09:04:49 AM PDT

          [ Parent ]

  •  Privacy and security are two of our most (0+ / 0-)

    cherished illusions.  And now with all the cameras out there in the world we live in, watch where you scratch yourself.

  •  Forget Big Brother! (1+ / 0-)
    Recommended by:
    B Dizzle

    It's never going to be Big Brother that finally gets you, but all of his cousins (as in henchmen).  Remember, the Don never pulls the trigger!

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