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FALL 2006 |
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Online
Only H
E A L T H A D M I N I S T R A T I O N
The new form of
MCP
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NLMA Photo |
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The need to confirm
eligibility is understandable. But why would a government agency need consent to
perform one of its basic functions?
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By Ed Brown |
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Most households have received an
MCP
re-registration form
(PDF)
and the accompanying “encouragement” to submit the information in a
timely fashion. Terms and conditions are less than prominently
included on the back of the form, consenting to the collection of
information by MCP and the release of any information by the care
provider for “payment, eligibility confirmation and audit
verification purposes”.
The need to confirm eligibility is
understandable, especially since the re-numbering effort is ostensibly
for “tightening controls” and weeding out more than 80,000 invalid
subscriptions. But why would a government agency need consent to perform
one of its basic functions?
Part of the answer is the
Access to
Information and Protection of Privacy Act, which limits how
government handles information. An “identifying number… assigned to an
individual” is included as personal information, which generally
requires consent. On the other hand, the
MCP Act requires everyone to
register (although perhaps not to re-register. The "original"
registration form has no such consent notice!). The authority for MCP to
undertake these activities without consent (or to require consent) is
not entirely clear, especially given the broad scope requested to
“conduct any investigation and obtain information from any person…
to determine and verify eligibility”. Added to the mix is the request
for the beneficiary’s Social Insurance Number identification (another
identifying number), signaling the kind of investigation MCP might
consider appropriate for such determination/verification.
Putting aside the patient’s perspective,
let’s consider the health care provider. If you think there’s patient
information not relevant for billing purposes, you’re going to have a
difficult time denying access now that MCP has written consent from the
patient. There might not be many circumstances where this creates an
issue (e.g., chart entries MCP actually wants), but it does echo a
particular tone — effectively placing the insurance agency within the
confidence of the patient-doctor relationship. This contrasts
significantly with the efforts in U.S. legislation to keep private
insurers out of this relationship.
The form first came to my attention when
my wife asked for my SIN. Like most people (I suspect), she saw another
government-mandated chore. With my usual professional skepticism I
wondered if we should sign off. In response to “what should I do?”, I
gave her an answer worthy of a lawyer working without retainer: “I'd
have to give that some thought.” So, in the manner of all practical
spouses, she signed the form and sent it in.
Since there is only one signature line for
the entire family, I didn’t actually consent to anything. I guess I’ll
find out if that matters when the new cards show up!
Ed Brown is a faculty member in the
Computer Science Department of Memorial University and a member of the
Bar of Newfoundland and Labrador. He has interests in both law and
technology related to privacy.
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