All consumers are entitled by law to receive an annual copy of their IntelliScript pharmacy history report files kept by Milliman, Inc. Under an order from the Federal Trade Commission in 2008, Milliman, Inc. and all healthcare and insurance companies that utilize the IntelliScript prescription profiling technology, agreed to abide by the Fair Credit Reporting Act.
The prescription profiling technology product provided by Milliman, Inc. is called IntelliScript and is a service that enables underwriters to access prescription medical records through the Internet. Consumers should be aware that IntelliScript is a data aggregation service that provides individual medical profiles containing seven-year prescription drug purchase histories to insurance companies.
The IntelliScript pharmacy history report generated by Milliman, Inc. includes, but is not limited to: all prescription drugs, including dosage and number of refills filled by the insurance applicant for the previous five years. The IntelliScript pharmacy history report also includes, for each drug, the name and address of the dispensing pharmacy, as well as the name and address of the prescribing doctor, including medical specialty. The medical profile generated by IntelliScript analyzes the individual’s prescription drug history and provides a “map” of the risk levels associated with each drug, based on information provided by the insurer.” (Source, FTC complaint, February 2008).
How does the IntelliScript prescription profiling technology work? Milliman, Inc. creates the profiles by plumbing rich databases of prescription drug histories kept by pharmacy benefit managers (PBMs), which help insurers process drug claims. When an insurer makes an online query about an applicant, Milliman’s servers scour the data and within minutes or less return reports to a central server at the company. The Milliman server aggregates the information going back as far as seven 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. Milliman Inc.’s IntelliScript codes pharmaceutical drugs for classification, for instance red, yellow or green, according to the insurer’s instructions, with red signaling the greatest risk. Red codes could include the so-called AIDS cocktail drugs and cancer medications. Higher scores imply higher medical costs. (More information about Milliman, Inc. and the the IntelliScript prescription profiling database and software tools.)