AnnualMedicalReport.com

Consumer Reports Health’s Cover America Tour realized the impact of the Medical Information Bureau (MIB) when they visited Sheila (above) in Gulfport, Miss., the day after her 50th birthday.

When she attempted to apply for health insurance, Sheila was surprised when she was rejected for an individual health insurance policy by three different companies. She was even more shocked when she learned why: Her record with MIB listed her as having a history of Chronic Obstructive Pulmonary Disease (COPD). Sheila does suffer from asthma, but COPD is supposed to be used to indicate more severe diseases of the lungs, such as emphysema or severe bronchitis. No company would insure her with this damaging mark on her record.

Sheila eventually traced the problem to a coding disparity at her doctor’s office. She says letters and phone calls to both her doctor and MIB have been to no avail, and the problem remains uncorrected on her record, effectively blocking her from obtaining individual health coverage. Unable to obtain health insurance coverage because of this medical coding error on her MIB report, Sheila has been forced to exhaust her 401(k) savings to pay out of pocket for healthcare costs.

Watch Sheila’s story and, before you apply for insurance or pay another monthly premium, make sure you request a copy of your medical report file from the Medical Information Bureau (MIB).

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Medical report files, sold to insurers by the nationwide specialty consumer reporting agencies Medical Information Bureau, Inc. (MIB), Ingenix, Inc., and Milliman, Inc. enable health and life insurance corporations to charge higher premiums and deny coverage to policyholders.  Although consumers dislike these consumer reporting agencies, insurance corporations rely on such companies to provide them with your private data in order to execute underwriting decisions.

What do paid corporate subscribers say about the technology products and services the MIB, Inc. provides to it corporation membership? The MIB, Inc. marketing materials offer the following description:

“WHAT MEMBER COMPANIES SAY ABOUT MIB

“I cannot do business without MIB –  it is an irreplaceable source of anti-selection criteria.” VP, Life Underwriting

“MIB always finds something that hasn’t been disclosed.” VP, Individual Medical Underwriting

“We save $58 for every dollar we spend on MIB.” Assistant VP, Underwriting (more…)

The Medical Information Bureau Inc. (a/k/a, MIB, MIB Group Inc.) maintains a consumer “medical report” file for every consumer of life and health insurance.  The MIB Group Inc. provides its membership with a multi-million dollar computer infrastructure to instaneously access the personal information of insurance applicants and policyholders.

These are a few of the technology and web-based information products that the Medical Information Bureau (MIB) offers to its member insurance and health care corporations:

• “MIB Codes Portal: WEB 2.0” – In June 2008, the Medical Information Bureau (MIB) introduced a new, web-based version of the MIB Coding Manual that provides underwriters a user-friendly interface and effortless navigation.  More than just an electronic book, the “MIB Codes Portal” uses a WEB 2.0 approach that allows the Medical Information Bureau (MIB) to continually enhance the “portal” to offer underwriters easy access to information well beyond traditional coding reference information. (more…)

The Washington Post reports that Milliman, Inc. and Ingenix Inc. compile individual “medical report” profiles on insurance consumers. Amid growing privacy concerns, the Washington Post calls these reports, “health “credit reports” drawn from databases containing prescription drug records on more than 200 million Americans.”

How does it this technology work?

“When an insurer makes an online query about an applicant, Ingenix or Milliman’s servers scour the data and within minutes or less return reports to a central server at the company. The server aggregates the information going back as far as five years, including the drugs and dosages prescribed, dates filled and refilled, the therapeutic class and the name and address of the prescribing doctor.”

Then comes the analysis. The MedPoint data tool, sold by Ingenix Inc., provides insurers a “pharmacy risk score,” or a number that represents an “expected risk” for a group of people. Of course, higher scores imply higher medical costs. Likewise, Milliman Inc.‘s IntelliScript codes pharmaceutical drugs for classification, according to the insurer’s instructions. So called “high-risk” codes could include AIDS cocktail drugs and cancer medications (both Ingenix and Milliman refuse to release their coding standards).

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Health and genetic information is regarded as the most private of information. People desire to keep their medical and health care records private for many reasons, including personal privacy, avoiding stigmas associated with certain diseases or conditions, and preventing job and economic discrimination.

When the New York Times reported on pharmacy marketing and advertising databases for sale, the Internet was generally outraged.  However, there seems to be less or concern (or a general unawareness), regarding the prescription analytics that corporations are now utilizing to construct massive medical and prescription databases.

According to a BusinessWeek Special Report from 2008, health care providers and insurers work with medical data brokers to compile records of your prescription activity.  Based on this data, insurers and health care providers charge consumers more for coverage, deny pay-outs, or rescind coverage altogether.

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The Medical Information Bureau Inc. (MIB Inc.) (a/k/a, MIB Group, Inc., a/k/a, MIB, Inc., a/k/a, MIB Solutions, Inc.) has been the subject of ongoing controversy since the 1970′s, when its existence first became generally known. Even today, the Medical Information is an unknown entity; most consumers, doctors, and even politicians, remain unaware of its existence.

The Medical Information Bureau has a penchant for secrecy. For many years, insurance agencies consulted MIB without telling applicants about the files. MIB even had an unlisted phone number. Today, the secret continues, if to a lesser extent: MIB won’t publish its list of corporate members or release the list of codes it uses. More importantly, the MIB refuses to provide a centralized, secure, online source for consumers to request, review, and dispute their medical report files.

The following article, “Nobody Knows the MIB” by, Simson Garfinkel is excerpted from Database Nation: The Death of Privacy in the 21st Century (2000):

“… As part of his Ph.D. thesis at Harvard Business School on privacy policies in corporate America, Jeff Smith surveyed more than a thousand people on a variety of privacy issues, and conducted in-depth interviews with several dozen. One of the key questions he asked was whether people had ever heard of a company called the Medical Information Bureau (MIB). What he found wasn’t terribly surprising: they hadn’t… I asked my wife if she knew what the Medical Information Bureau was. She said she didn’t. (more…)

The Medical Information Bureau (a/k/a, MIB Group, Inc., a/k/a, MIB, Inc., a/k/a, MIB Solutions, Inc.) is the nation’s largest insurance reporting agency. Under Federal law, every consumer is entitled to a free annual copy of their medical report file.

MIB’s basic purpose was (and continues to be) to detect and deter fraud and misrepresentation in connection with the underwriting of life and health insurance and claims. MIB helps “keep the cost of insurance down for insurance companies and for consumers by preventing losses that would occur due to fraud or omissions,” says Neil Day, MIB’s president.

For many years, insurance agencies consulted MIB without telling applicants about the files. MIB even had an unlisted phone number. Today, the secret continues, if to a lesser extent: MIB won’t establish a secure website for consumers to request, review, and dispute their MIB medical reports.

In the past the Medical Information Bureau (MIB) reported codes in consumers’ files for such non-medical information as “sexual deviance” and “sloppy appearance.” MIB, Inc. President Neil Day disagrees, but since the Medical Information Bureau (MIB) won’t release the list of conditions for which it has created codes, there is really no way to know for sure. There have also been disagreements over the accuracy of MIB’s files.

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In July 2007, protests at the American Medical Association (AMA) annual meeting in Chicago brought to the forefront the fact that the AMA has begun disclosing information in its Physician Masterfile, or physician database, to pharmaceutical companies. The American Medical Student Association (AMSA) are protesting the “sales” of these data for pharmaceutical marketing purposes.

In defense, the AMA calls the financial arrangement “licensure” and notes that physicians have the right to opt-out of sharing their personal information (although not its collection.) Likewise, the AMA opt-out options do not limit the AMA’s ability to store this medical data indefinitely into the future; physician information collected by the AMA is never deleted from the Masterfile, even after the physician’s death. Since the AMA began compiling physician data in 1906, the Masterfile is now more than a century old and includes approximately 900,000 physicians, about two thirds of whom are not AMA members.

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