UC Says Blue Shield Seeked ‘Expansive’ Data In State COVID Contract


Blue Shield of California initially sought an “expansive” amount of medical data from the University of California health system in exchange for vaccine doses under the state’s renewed allocation plan that gives the insurance giant broad powers, a move that has raised objections from UC and alarm from patient privacy advocates.

UC Health spokeswoman Heather Harper said UC system representatives contacted Blue Shield and the contract was revised to “limit access only to immunization records and only by federal and state agencies and their contractors.” . The university health system declined to give details on what kind of patient data Blue Shield requested.

“We made the third party administrator aware of their concerns about a seemingly expansive scope of access to patient data,” Harper said of discussions with Blue Shield about the original contract. “… We were able to solve the problem.”

UC finally signed the contract on Thursday.

Patient privacy concerns provide a glimpse into questions posed by health care and local government officials about the extent of Blue Shield’s role as the independent monitor of California’s COVID-19 vaccine provider network, which slows down the implementation of the program that Governor Gavin Newsom unveiled several weeks ago. The counties contacted by The Times said they were still reviewing the contract and declined to comment. Other vaccine providers raised issues with the original contract but declined to speak publicly, citing concerns that doing so could affect future vaccine allocations.

On Friday, the California Department of Public Health released a template for the revised contract. A Blue Shield spokesperson denied that the company sought access to patient data, saying the contract provision was standard record retention language intended to ensure that there is adequate access to records in the event of an audit.

Blue Shield President Paul Markovich said “it would be completely inappropriate” for the insurance provider to use the data obtained from administering the vaccine program for its own commercial purposes.

“It’s just not going to happen and it’s contractually prohibited,” Markovich said Friday.

The Times obtained a copy of an earlier contract sent to some vaccine providers, but it is unclear if the provisions are the same as the initial contract sent to the UC health system. The contract reviewed by The Times stated that a vaccine supplier would have to provide Blue Shield with access to “accurate medical, vaccination, financial and other records and reports” for at least three years after the contract expires. The revised contract released by the state on Friday specified that the data Blue Shield would have access to for three years is “vaccination, financial and other records and reports.”

The state has final approval of the contract drawn up by Blue Shield, based on California’s agreement with the insurance company. Markovich said more than 30 vaccine suppliers have signed contracts so far.

“This language is not now, and never has been, a three-year data request,” said Don Campbell, vice president of corporate communications for Blue Shield. “It is a request not to destroy records for three years on the provider’s performance of its vaccine network contract.”

Health care privacy advocates say there is reason for increased scrutiny of how much data is shared with Blue Shield through the state’s new vaccine network.

“The state should step in, not perpetuate the exploitation of Californians seeking information, services and vaccines during a global pandemic,” said Samantha Corbin, an advocate for privacy and technology.

Data plays a critical role in the healthcare industry, enabling health 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 foundation of healthcare and not only supports patient care, it also supports the business of providing care,” said Jennifer Kent, who was named director of the state’s Department of Health Care Services during the administration. of former Governor Jerry Brown in 2015 before resigning in 2019. “Whoever controls the data controls it all.”

Blue Shield began taking over the administration of the state’s vaccine program on February 15 and is tasked with deciding who should administer doses in California and how many vaccines each provider should receive from the limited supply available.

But some local government officials have complained that the vaccine distribution process has become more complex.

Blue Shield was scheduled to begin work Monday in 10 counties located primarily in or near the Central Valley, along with Riverside. State officials say the changes were delayed a week and will begin Monday.

“Nothing has changed yet,” said Fresno County Supervisor Ernest “Buddy” Mendes.

Newsom said Friday that the state’s contract with Blue Shield will allow all 58 California counties to operate on a single platform that will provide “transparency, more accountability.” Blue Shield will rely on the analysis to determine where doses are most needed, while monitoring and incentivizing providers who administer the vaccine efficiently, he said.

“Next week, that process begins on a whole new scale,” Newsom said Friday.

In its contract with the state, Blue Shield set a goal of administering 3 million injections per week by March 1. Government Operations Agency Secretary Yolanda Richardson said California is on track to meet that goal anticipating that supplies entering the state will increase. .

“Through April, we expect the network to grow further with the capacity to deliver 4 million doses per week,” Richardson said Friday.

In January, Newsom came under immense pressure to improve the launch of the vaccine in the state, which was hampered by fewer doses than expected, complex rules dictating who qualified for citations and data errors. The state was initially ranked among the worst in the country for administering the doses of vaccines it received, but has improved that ranking in recent weeks.

County health officials have said the improvement was largely the result of correcting state data problems, leading some to question the need for a new system under Blue Shield.

San Joaquin County Public Health Officer Dr. Maggie Park said during a meeting of the board of supervisors Tuesday that timelines and information continue to change under the Blue Shield contract, making planning difficult. Park said county health officials across the state have been frustrated with the timing of changes in the state’s vaccine distribution, which she says have come about even though officials “feel like we’re really increasing our capacity. “.

Tom Patti, chairman of the San Joaquin County Board of Supervisors, requested Tuesday that the county attorney explore options for opting out of the “tremendous bureaucratic system” under Blue Shield and see if other counties would join the effort.

Before the state signed the Blue Shield deal, Ventura County officials had asked the state to exclude the option from the deal, arguing that insufficient supply, not poor oversight, was hurting distribution.

A separate vaccine contract was signed with Kaiser Permanente on Tuesday, which Newsom announced at the same time as its agreement with Blue Shield. Kaiser Permanente, which serves more than 9 million Californians, will run a separate vaccination program for its members, manage two mass vaccination sites, and create clinics in vulnerable and disproportionately affected communities, under the contract.

The state’s decision to hire Blue Shield has raised questions about how the Oakland-based company, which is a Newsom donor and has considerable political influence in state politics, got the contract and what it can win. Blue Shield has agreed 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 states that the company cannot bill more than $ 15 million. during the contract term for out-of-pocket costs.

Blue Shield is expected to assume full responsibility for the administration of vaccines in the state by March 31. The terms of the contract will run until December 31.

“What I said to the counties first and what I say to all of you is give us a chance to make this work,” Markovich said. “I think there has been a lot of speculation about all the things that could go wrong and it is our job to make this work and work for everyone.”

Times staff writer John Myers contributed to this report.



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