FEHBP database raises privacy concerns

A new Office of Personnel Management database designed to track federal employee health benefit plans could put at risk the personal information of participants, according to privacy advocates.

OPM last week announced plans for a database tool to track and evaluate the quality and cost of services provided through the Federal Employees Health Benefits Program. According to an Oct. 5 notice in the Federal Register, the health claims data warehouse will centralize information about FEHBP; the National Pre-Existing Condition Insurance Program, which provides coverage to those denied insurance because of a medical condition; and the Multi-State Option Plan.

The tool will collect information such as the enrollee's name, Social Security number, employment details and information about health care providers, medical diagnoses and insurance coverage. OPM will look at demographic, health and pricing trends across the programs to find ways to reduce costs, the notice said.

Privacy advocates expressed concern the database could violate patient privacy. The notice does not provide details about how the information will be stored securely, nor does it explain how the data will be stripped of identification information before being released for research purposes, said Dr. Deborah Peel, founder of the nonprofit Patient Privacy Rights.

OPM doesn't need a centralized tool to analyze FEHBP information because that data already exists with the plan providers, said Deven McGraw, director of the Health Privacy Project at the nonprofit Center for Democracy and Technology, adding the database presents another opportunity for outsiders to access sensitive information.

"OPM is proposing to create one big, centralized database rather than asking the plans to run analyses and give them the answers," McGraw said. "Records that used to be in one place are now in two."

She suggested OPM require health plans to provide aggregated information rather than the raw data the warehouse tool will collect.

"This could be a condition of participation in FEHBP," McGraw said. "There's no reason why they can't get plans to give them this data ... they have the authority to have queries run by plans without moving data into the middle, thereby exposing the data to risk."

According to the notice, the information could be used in law enforcement proceedings, congressional inquiries or OPM workforce studies. In some cases, individuals could be identified through the data selected, OPM said. Researchers and analysts outside government also could gain access to the information to examine health insurance trends, the notice added. McGraw and Peel both expressed concern that individuals claiming to do research could access sensitive patient data without rules or constraints.

"We do not see adequate safeguards to ensure that the aggregated records are made secure from thieves and are not used as fodder for the health data mining industry," Peel said. "This proposal is irresponsible because those in the database cannot trust that their information is secure and they have no ability to consent to research uses of their data."

OPM did not respond to requests for comment.