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Cumulus spying on employee's prescriptions

My understanding is that no company official, be it CEO or HR, can access employee medical records without your written consent. What they can access is how many employees take advantage of the group plan, what services they are taking advantage of i.e.: mental health, physical therapy, wellness, etc, how many are taking prescription medications but not what they are taking it for. HIPAA laws are quite clear on this.

For example, I had my an emergency appendectomy earlier this year and I told my company because I was going to be missing work. They referred me to the insurance carrier and the Short-Term Dishabille company to handle everything. My company never saw anything related to my illness, hospital stay, pain meds or anything else. When I returned I had to have a note stating I was healthy enough to return, it was never listed why I was out, though they obviously knew.

Dickey and Cumulus are trying to reduce costs, which there is nothing wrong with doing that. What else is any company supposed to do when we have for profit health care in this country?
 
I had a "front row seat" to all of these issues at one time. Back in the 70s Congress passed the ERISA Act which made it possible for employers to establish a trust fund, put the money that would have been their health insurance premiums into that fund, and pay the claims as a "self insured mechanism".

Many employers chose to hire an insurance carrier to process the claims. An industry of "Third Party Administrators" developed for those who wanted to stay clear of insurance companies.

The company where I was working decided to do "self administration" and I was tagged with the task.

That probably wouldn't work today. Back then claims were paid on a "Reasonable and Customary" basis in determining what fees would be paid and when we would balk at paying. Today you need the brute-force negotiation power of a big, big insurance company bullying the hospital and doctors for the best possible rate. One little company with 4400 employees would have the bargaining power of a South Georgia Gnat.

Here's my point: It was a personal burden to know as much about my fellow employees and their families as I did. I had to get on the phone and discuss billings with hospitals and doctors. I knew the whole story. And I always had this nagging fear that my employer might someday demand a list of who was costing them the most money in claims. They didn't ask for it. And I certainly didn't offer it. (Do you want your boss to know WHY your wife is going to the doctor?)

In all of the political wrangling over how we will handle health insurance in this country, this privacy issue doesn't come in for a lot of discussion. I hope it doesn't come home to bite us you-know-where. (With HIPPA in place, maybe there is nothing more to discuss?)

If indeed Cumulus starts pressuring or dismissing employees over prescription claims, I see interest court cases in their future.
 
a text seen from john dickey a few months back...to a manager of cumulus...."who the F cares we are the Dickies" upon hearing of a law suit against them for a wrongful firing of a employee.....
 
he's using wellnet. http://www.wellnethealthcare.com

i went to their website, and i'll be dammed if i can figure out what their software does.

Using prescription drug data, WellNet turns information into actionable strategies, enabling employers to understand where their risks are before they surface. By providing the lowest net cost on prescription drugs, we then analyze and interpret Rx data to determine cost saving methods that will improve member health and overall plan performance.
Click to expand...

ok so i'm not the sharpest razor blade in the production room, but what does that mean? generics?

-amos
 
This is a lot of over-reaction to a very simple process. Employers are trying to deal with rising health care costs. It's all over the news. Everryone, even the President, is trying to keep costs down. The Congress is fighting over ways to control rising costs, while the medical and insurance companies are getting richer. Either Dickey controls costs this way, or he passes any cost increases to the employees. Which do you prefer?

He is NOT personally looking into employee health records. It's all perfectly legal, and no one is being fired for their use of certain drugs or the cost of their health care. But if a doctor prescribes an expensive drug, and a cheaper one is available, the patient is made aware of it.

But if you think rising health care costs is some fiction on TV, you're wrong.
 
TheBigA said:
He is NOT personally looking into employee health records. It's all perfectly legal, and no one is being fired for their use of certain drugs or the cost of their health care. But if a doctor prescribes an expensive drug, and a cheaper one is available, the patient is made aware of it.
Click to expand...

This thread has become a classic example of how we sometimes screw up debate in our society. Let me start by pointing out what I have done in this thread that was wrong. Some of us, including me, JUMPED TO THE CONCLUSION that Mr. Dickey was getting access to which employees, by name, where running up his insurance costs in the area of prescriptions. I assume that if he were told, by name, which employees were using specific prescriptions, that would be in violation of Federal Medical Privacy laws. (The writer of the original story wrote carelessly and we can't tell what information and what detail he receives.

If on the other hand the vendor doing the analysis tells him that "You have 132 employees who have prescription costs exceeding $500 per month" and no names of employees are included, yes, that would be reasonable information for management to review. In the past I have collected and delivered such information. We used it annually to set rates for our trust fund for the coming year.

If we will be patient and let the situation develop, we may someday know whether Mr. Dickey is receiving healthy permissible information, or if he is received sensitive non-permissible information. I have to believe the company providing him with information would not create a business model of selling contraband information.

Here is a side-note, a political side-note that has nothing to do with this discussion of what Mr. Dickey and his company are doing. One of the loudest messages given by those who are against the proposed health-care reform legislation is the "we don't want a system where some government bureaucrat is making our personal health care decisions for us." How many times have you heard that one. These same people start staring at the ceiling and then their shoelaces when you point out that we already have a system like that. We currently have INSURANCE bureaucrats deciding what medicine you can and cannot take, forcing you to accept a generic often times even after your doctor certifies that this patient has reactions to the generic, but tolerates the brand name product well. We dealt with that problem in our household this week.
 
Goat Rodeo Cowboy said:
Some of us, including me, JUMPED TO THE CONCLUSION that Mr. Dickey was getting access to which employees, by name, where running up his insurance costs in the area of prescriptions.
Click to expand...

He doesn't care WHO they are...just that there are some people who are running up the costs. That's why he's engaged the services of an intermediary...so he keeps himself out of the process. The intermediary has medical knowledge, and can recognize waste, and then speak in medical language back through the proper chain of command. All Dickey sees is results and a bill for their services. People keep trying to turn this into something personal, and it's not. It's all about money. This is a huge expense for employers, and a huge bureaucratic pain in the ass. A lot of companies would rather outsource the whole thing to some outside company, and trust them to come up with a solution. But it's way worse for smaller mom & pop companies, who can't get the discounts given to bigger companies. I know a guy who runs a small company with ten employees, and employee insurance costs him more than rent. After payroll, it's his biggest expense.


The rest of the story here is if you don't want your employer involved in your health care, pay for it yourself. That's the one sure way of knowing you're getting what you want, and not what fits into a budget. And don't assume the government will be any more benevolent if they get involved in the process. If the goal is to cut costs, and you have an expensive treatment, they will seek the cheapest way to get it done. The best advice is this: Don't get sick.
 
Next, Cumulus will probably require their salespeople to where helmet cams, so that they can monitor where they are throughout the day.

This company is the poster child of micromanaging everyone and everything it can, so its really no surprise. It you work there, leave or just get out of the business all together, they don't want good people working for them anyways.
 
Does it seem logical that the Dickies would review what every employee is going through? No. They are far too busy to care to know about what is happening with a traffic person in East Bumblast.
Do I see them looking at the costs for Insurance premiums and saying " Holy MOTHER OF GOD!" - I sure do. As anyone would do, you would ask why is this so much? Well let's see, you had:

10 cancer
2 MS
4 parkinsons
2 ALS
200 Pregnancies
800 broken bones
2500 misc surgeries
etc
etc
etc.

This is quite common and a matter of fact. Health care costs need to be managed and if your Carrier is not providing, then you cut them off. How would you know to do this without asking some questions like why so much and how can I reduce it?
 
Fenway Frank said:
Does it seem logical that the Dickies would review what every employee is going through? No. They are far too busy to care to know about what is happening with a traffic person in East Bumblast.
Do I see them looking at the costs for Insurance premiums and saying " Holy MOTHER OF GOD!" - I sure do. As anyone would do, you would ask why is this so much? Well let's see, you had:

10 cancer
2 MS
4 parkinsons
2 ALS
200 Pregnancies
800 broken bones
2500 misc surgeries
etc
etc
etc.

This is quite common and a matter of fact. Health care costs need to be managed and if your Carrier is not providing, then you cut them off. How would you know to do this without asking some questions like why so much and how can I reduce it?
Click to expand...
Franky,

I don't think insurance works that way. The ins carrier can't even give out those details. As it was explained to me by someone in HR, all the employer will receive is a summary of the services used. 600 PCP visits, 350 OB-GYN visits, 500 Specialists, etc. This is to protect the individual. Your boss or HR can't say, "Hey Frank, what's with all the Zoloft, Propecia and Podophyllin you've been taking?"

As I mentioned in an earlier post, the Dickey's, like every other company, are looking at a way to get a cheaper price on the prescriptions their employees are taking. They are not trying to monitor their employees.

Note to those who care, I discuss the health care issue on my blog, (http://puregibberish.wordpress.com/), you should all bookmark it and visit it daily. ;)
 
Look...I worked for Cumulus... here's the deal... if you work for them about the best you can expect is a week to week situation. No matter what type of job you have from management to on air part time. Even if you have a contract it's a wash... you are just a number. I'm very lucky to work for two different groups now and both are fantastic places to work that treat they folks very well and care about the people that work for them. I never had that feeling at cumulus. I was even told once that a monkey could do my job. Made me feel real motivated to try harder... No thanks.. God bless the Dickey brothers and I wish them well... but want no part of "Cume For Less"
 
Skipper! said:
Look...I worked for Cumulus... here's the deal... if you work for them about the best you can expect is a week to week situation. No matter what type of job you have from management to on air part time. Even if you have a contract it's a wash... you are just a number. I'm very lucky to work for two different groups now and both are fantastic places to work that treat they folks very well and care about the people that work for them. I never had that feeling at cumulus. I was even told once that a monkey could do my job. Made me feel real motivated to try harder... No thanks.. God bless the Dickey brothers and I wish them well... but want no part of "Cume For Less"
Click to expand...

Are the Dickey Brothers at Cumulus the same people who own 680 WCNN a Dickey Brothers station? If so I hope they are treating Christopher Rude who is battling cancer better than this posting would have you to believe.
 
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