Large pharmacy chains in the United States send sensitive medical records to the police without a warrant – and some do so even without consulting a legal professional, according to a parliamentary investigation.
Serious Concerns About Medical Privacy
This revelation raises serious concerns about medical privacy, especially in the post-Dobbs era where many states are criminalizing reproductive healthcare. Even if individuals in restrictive states cross state lines for care, pharmacists at large chains like CVS can access records across borders.
Requirements for Medical Record Releases
Lawmakers noted pharmacy policies regarding the release of medical records in a letter dated Tuesday to Health and Human Services (HHS) Secretary Xavier Becerra. The letter – signed by Senator Ron Wyden (D-Oregon), Representative Pramila Jayapal (D-Washington), and Representative Sara Jacobs (D-California) – stated that their investigation extracted information from briefings with eight major drug suppliers acting as pharmacies.
Pharmacy Policies on Medical Record Releases
These include the seven largest pharmacies in the country: CVS Health, Walgreens Boots Alliance, Cigna, Optum Rx, Walmart Stores, The Kroger Company, and Rite Aid Corporation. Lawmakers also spoke with Amazon Pharmacy.
The eight pharmacies stated that they do not require police to obtain a warrant prior to sharing sensitive medical records, which may include the medications a person uses and their medical condition. Instead, all pharmacies provide such information with nothing but a subpoena, which can be issued by government entities and does not require review or approval from a judge.
Pressure on Pharmacies
CVS Health, The Kroger Company, and Rite Aid Corporation told lawmakers that they do not even require pharmacy staff to consult with legal professionals before responding to police requests at pharmacies. According to lawmakers, CVS, Kroger, and Rite Aid stated that “pharmacy staff face intense pressure to immediately respond to police demands, and as such, companies direct their staff to process those requests in-store.”
Other Pharmacies
The remaining pharmacies – Amazon, Cigna, Optum Rx, Walmart, and Walgreens Boots Alliance – require at least a review of police requests by legal professionals before pharmacists respond. However, only Amazon stated that it has a policy to inform customers about police requests for pharmacy records unless there are legal restrictions preventing it, such as a gag order.
Health Privacy and Transparency Law
Lawmakers noted that pharmacies do not violate regulations under the Health Insurance Portability and Accountability Act (HIPAA). Pharmacies pointed to the language in HIPAA regulations that allows healthcare providers, including pharmacists, to provide medical records if required by law, with subpoenas being sufficient legal processes for such requests. However, lawmakers observe that the Department of Health and Human Services has discretion in establishing the legal standard here – that is, it has the authority to enhance regulation to require a warrant, which should be done according to the lawmakers’ opinion.
Call for Improvement from Pharmacies
Lawmakers urged pharmacies to make better efforts and encouraged them to follow the lead of tech companies. They stated, “Pharmacies can and should insist on a warrant, and law enforcement agencies that insist on requesting patient records under a subpoena should go to court to enforce that request. The warrant requirement is exactly the approach that tech companies take to protect customer privacy.” The trio noted that Google, Microsoft, and Yahoo have required law enforcement to have a warrant to obtain customer emails since 2010.
Encouragement
Transparency
In addition to noting technological leadership, lawmakers urged pharmacies to publish annual transparency reports. During the investigation, CVS Health only stated that it plans to do so.
Patient Rights and Awareness
HIPAA regulations grant patients the right to know who accesses their health records. However, patients must specifically request that information – and very few people do that. “Last year, CVS Health, the largest pharmacy chain in the country by total prescription revenue, received only a handful of requests from consumers,” lawmakers noted.
Lawmakers stated, “It is likely that the average American is unaware that this is even an issue.”
Source: Ars Technica
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