Blue Shield of California initially sought an “expansive” amount of medical data from the University of California’s health care system in exchange for doses of vaccine under the state’s redesigned allocation plan that grants broad powers to the insurance giant, a move that raised objections of the UC and alarm of the defenders of the privacy of the patient.
UC Health spokeswoman Heather Harper said UC system representatives contacted Blue Shield and the contract was revised to “limit access to vaccination records only and only by federal and state agencies and their contractors”. The university’s health care system declined to elaborate on the types of patient data requested by Blue Shield.
“We draw the attention of the outsourced administrator to concerns about an apparently broad scope of access to patient data,” said Harper of discussions with Blue Shield on the original contract. “… We managed to solve the problem.”
UC ended up signing the contract on Thursday.
Concerns about patient privacy offer a glimpse of the questions raised by health officials and local government about the scope of Blue Shield’s role as an independent supervisor of California’s COVID-19 vaccine supply chain, delaying implementation of the program that Governor Gavin Newsom revealed several weeks ago. The counties contacted by The Times said they were still reviewing the contract and declined to comment. Other vaccine suppliers raised questions about the original contract, but declined to speak publicly, citing concerns that doing so could affect future vaccine distribution.
A model of the revised contract was released on Friday by the California Department of Public Health. A Blue Shield spokesman denied that the company sought access to patient data, saying the contract clause was a standard record retention language designed to ensure proper 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 in administering the vaccine program for its own business purposes.
“This is simply not going to happen and is prohibited by contract,” said Markovich on Friday.
The Times obtained a copy of a previous contract sent to some vaccine suppliers, but it is not clear whether the clauses are the same as the initial contract sent to the UC health system. The revised contract 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 made public by the state on Friday specified that the data to which Blue Shield would have access for three years is “vaccine, financial and other records and reports”.
The state has final approval of the contract drawn up by Blue Shield, in accordance with the California agreement with the insurer. Markovich said more than 30 vaccine suppliers have signed contracts so far.
“This language is not now, and never has been, a three-year request for data,” said Don Campbell, vice president of corporate communications at Blue Shield. “It is a request not to destroy the records for three years on the performance of the provider of its vaccine network contract.”
Health privacy advocates say there is a reason for further scrutiny about the amount of data shared with Blue Shield through the state’s new vaccine network.
“The state should intervene, not perpetuate the exploitation of Californians in search of information, services and vaccines during a global pandemic,” said Samantha Corbin, a defender of privacy and technology.
Data plays a critical role in the healthcare industry, allowing healthcare plans to identify high-cost consumers, target geographic areas to expand and grow their market, meet regulatory and quality requirements, and adapt marketing to specific demographics.
“Data is the foundation of health and not only does it support patient care, it also supports the care business,” said Jennifer Kent, who was appointed director of the state’s Department of Health Services during the administration of the former. Governor Jerry Brown in 2015 before resigning in 2019. “Whoever controls the data controls everything.”
Blue Shield began taking over 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 stock 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 on Monday in 10 counties located mainly in or near Central Valley, along with Riverside. State officials say the changes took a week and will begin on Monday.
“Nothing has changed yet,” said Fresno County supervisor Ernest “Buddy” Mendes.
Newsom said on Friday that the state’s Blue Shield contract will allow all 58 California counties to operate on a single platform that will provide “transparency, more accountability”. Blue Shield will rely on analysis to determine where doses are most needed, while monitoring and encouraging suppliers who are administering the vaccine efficiently, he said.
“Next week, this process starts on a whole new scale,” Newsom said on Friday.
In its contract with the state, Blue Shield set a target to administer 3 million shots a week by March 1. Government Operations Agency secretary Yolanda Richardson said California is ready to meet that goal, predicting that supplies arriving in the state will increase.
“By April, we expect the chain to grow even further with the ability to deliver 4 million doses a week,” said Richardson on Friday.
In January, Newsom was under immense pressure to improve the distribution of the vaccine in the state, which was hampered by less than expected doses, complex rules that dictated who was qualified for consultations and data errors. The state was initially ranked among the worst in the country in administering the doses of the vaccine it received, but it has improved that rating in recent weeks.
County health officials 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.
Dr. Maggie Park, public health officer for San Joaquin County, said during a meeting of the board of supervisors on Tuesday that deadlines and information continue to change under the Blue Shield contract, making planning difficult. Park said county health officials across the state were frustrated by the timing of changes in the distribution of the vaccine in the state, which she said had occurred, although officials “think we are really increasing our capacity.”
Tom Patti, chairman of the San Joaquin County Board of Supervisors, on Tuesday asked the county council to explore options to opt out of the “tremendous bureaucratic system” under the Blue Shield and see if other counties would join the effort.
Before the state signed the agreement with Blue Shield, officials in Ventura County asked the state that the option to be excluded from the agreement, arguing that insufficient supply, not poor supervision, was hampering distribution.
A separate vaccine contract with Kaiser Permanente, announced by Newsom at the same time as the Blue Shield agreement, was signed on Tuesday. Kaiser Permanente, which provides services to more than 9 million Californians, will run a separate vaccination program for its members, administer two mass vaccination sites and set up clinics in vulnerable and disproportionately affected communities, under the contract.
The state’s decision to sign a contract with Blue Shield raised questions about how the Oakland-based company, which is a Newsom donor and has considerable political influence in state policy, got the contract and what it has to gain. Blue Shield has committed to running 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 over the term of the contract. pocket costs.
Blue Shield is expected to assume full responsibility for managing the vaccine in the state by March 31. The terms of the contract run through December 31.
“What I said to the counties first and what I tell all of you is to give us a chance to make this work,” said Markovich. “I think there has been a lot of speculation about all the things that could potentially go wrong and it is our job to make it work and work for everyone.”
The Times staff writer John Myers contributed to this report.