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Blue Shield of California initially sought a “considerable” amount of medical data from the University of California health care system in exchange for vaccine doses as part of the state’s overhauled allocation plan which grants sweeping powers. at the insurance giant, a move that has sparked objections from UC has alarmed patient privacy advocates.
UC Health spokeswoman Heather Harper said representatives of the UC system have contacted Blue Shield and the contract has been revised to “limit access only to immunization records and only by federal and state agencies and their subcontractors. ” The university health system declined to say what kind of patient data Blue Shield was requesting.
“We have brought to the attention of the third-party administrator concerns about a seemingly broad scope of access to patient data,” Harper said of discussions with Blue Shield regarding the original contract. “… We were able to solve the problem.”
UC finally signed the contract on Thursday.
Concerns about patient privacy offer insight into questions raised by health care officials and local governments about the scope of Blue Shield’s role as the independent supervisor of the California network of COVID-19 vaccine providers, slowing the implementation of the program that Governor Gavin Newsom unveiled several weeks ago. Counties contacted by The Times said they are still reviewing the contract and declined to comment. Other vaccine suppliers raised issues with the original contract, but declined to speak publicly, arguing that it could affect future vaccine allocations.
A revised contract template was released Friday by the California Department of Public Health. A spokesperson for Blue Shield denied that the company sought access to patient data, saying the contract provision was standard record keeping language intended to ensure proper access to records in the event of an audit.
Blue Shield chairman Paul Markovich said “it would be grossly inappropriate” for the insurer to use the data obtained through the administration of the vaccination program for its own business purposes.
“It just won’t happen and is contractually prohibited,” Markovich said on Friday.
The Times obtained a copy of an earlier contract sent to some vaccine vendors, but it is not known whether the terms are the same as the original contract sent to UC’s health system. The contract reviewed by The Times stipulated that a vaccine supplier should provide Blue Shield with access to “accurate medical, immunization, financial and other records and reports” for at least three years after the contract ends. The revised contract released by the state on Friday specified that the data Blue Shield would have access to for three years are “records and reports related to vaccines, finance and others.”
The state has definitively approved the contract drafted by Blue Shield, in accordance with California’s agreement with the insurance company. Markovich said more than 30 vaccine suppliers have signed contracts to date.
“This language is not now, and never has been, a three-year data request,” said Don Campbell, vice president of corporate communications at Blue Shield. “This is a request not to destroy records for three years on the supplier’s performance of its vaccine network contract.
Health care privacy advocates say there is a reason for an in-depth look at the amount of data shared with Blue Shield through the state’s new vaccine network.
“The state should step in, not perpetuate the exploitation of Californians for information, services and vaccines during a global pandemic,” said Samantha Corbin, privacy and technology advocate .
Data plays a critical role in the healthcare industry, enabling healthcare plans to identify high cost consumers, target geographic areas to expand and grow their market, meet regulatory and quality requirements, and ” tailor marketing to specific demographics.
“Data is the lifeblood of health care and it not only supports patient care, but it also supports the business of delivering care,” said Jennifer Kent, who has been appointed State Department Director of health services under the administration of former Governor Jerry. Brown in 2015 before stepping down in 2019. “Whoever controls the data controls everything.”
Blue Shield began taking over administration of the state’s immunization program on February 15 and is responsible for deciding who should administer doses in California and how many vaccines each supplier should receive from the limited supply available. .
But some local government officials have complained that the vaccine distribution process has only become more complex.
Blue Shield was scheduled to begin work Monday in 10 counties primarily located in or near the Central Valley, along with Riverside. State officials say changes have been delayed for a week and will begin on Monday.
“Nothing has changed yet,” said Ernest “Buddy” Mendes, Fresno County supervisor.
Newsom said on Friday that the state’s contract with Blue Shield will allow California’s 58 counties to operate on a single platform that will provide “transparency, more accountability.” Blue Shield will rely on scans to determine where doses are needed most, while monitoring and encouraging providers who deliver the vaccine effectively, he said.
“Next week this process begins on a whole new scale,” Newsom said on Friday.
In its contract with the state, Blue Shield set a goal of administering 3 million shots per week by March 1. Government Operations Agency Secretary Yolanda Richardson said California is on track to meet that target in anticipation of increased supplies in the state. .
“Until April, we expect the network to grow even further with the capacity to deliver 4 million doses per week,” Richardson said on Friday.
In January, Newsom was under immense pressure to improve vaccine deployment in the state, which was hampered by lower-than-expected doses, complex rules dictating who qualified for appointments, and data errors. The state was initially ranked among the worst in the country when it comes to administering the vaccine doses it has received, but has improved that ranking in recent weeks.
County health officials said the improvement was largely the result of fixing state data issues, prompting some to question the need for a new system under Blue Shield.
San Joaquin County public health official Dr Maggie Park told an oversight board meeting on Tuesday that timelines and information continue to change under the Blue Shield contract, making planning difficult. Park said county health officials across the state were frustrated with the timing of vaccine distribution changes in the state, which she said came despite officials “feeling that we are really increasing our efforts. capabilities.
Tom Patti, chairman of the San Joaquin County Oversight Board, on Tuesday called for the county council to explore options to get out of the “formidable bureaucratic system” under Blue Shield and to see if other counties join in. effort.
Before the state signed the deal with Blue Shield, Ventura County officials asked the state for the option of being excluded from the deal, arguing that insufficient supply, not one poor surveillance, interfered with distribution.
A separate vaccine deal with Kaiser Permanente, announced by Newsom along with its deal with Blue Shield, was signed on Tuesday. Kaiser Permanente, which provides services to more than 9 million Californians, will run a separate vaccination program for its members, run two mass vaccination sites and establish clinics in vulnerable and disproportionately affected communities, according to the contract.
The state’s decision to contract with Blue Shield has raised questions about how the Oakland-based company, which is a Newsom donor and holds considerable political influence in state policy, landed the contract and what she has to gain. Blue Shield has committed to run the distribution programs at or near cost and “will not make a profit,” according to a letter of intent, and its contract with the state says the company cannot. charge over $ 15 million over the term of the contract. – pocket costs.
Blue Shield is expected to assume full responsibility for vaccine management in the state by March 31. The terms of the contract run until December 31.
“What I first said to the counties and what I’m saying to all of you is give us a chance to do this job,” Markovich said. “I think there has been a lot of speculation about all of the things that could potentially go wrong and it’s our job to make it work and work for everyone.
Times editor John Myers contributed to this report.
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