In a scenario that bears more than a passing resemblance to the David and Goliath story, Shrager took on patient privacy the largest mental health care carveout in the patient privacy. He refused to stand by and take it when a subsidiary, patient privacy Health Services, de-credentialed him from its provider network.
Managed care problem arose when patient privacy, which owns patient privacy and manages mental Patient Privacy Monitoring health care for people insured by Highmark, told him to call and schedule a site review of his practice. As part of that review, company representatives would assess such factors as record-keeping procedures and other office-related issues, for example. The patient-record review is a company practice for high-volume providers.
The psychiatrist wrote back to patient privacy, emphasizing that he was not about to share patient records with the company without first obtaining his patients’ consent. He told the company that his concern stemmed from a possible diminution in the strength of the relationship he had with patients if they were always aware that the substance of therapy could end up in the hands of insurance company employees.
What he did receive was a notice that he had been decredentialed, which meant that his patients could no longer expect insurance coverage if they continued treatment with him. It also meant that Protecting Patient Privacy his income was likely to take a serious hit.
The company wrote letters to each of patient privacy informing them by phone and letter that he was no longer a member of their provider networks, but gave no explanation as to why his status with patient privacy had changed.
patient privacy motion was based on two premises–that he was decredentialed without due legal process and that violated Pennsylvania law when it insisted it had the right to review his patients’ psychiatric records during the course of a site review.
The judge did not, however respond to one of the two crucial issues addressed in his motion for injunctive relief. The judge based his ruling on the psychiatrist’s failure to receive due process in the decredentialing procedure, but he did not comment on whether state law does in fact prohibit insurers from demanding to review patients’ records.
The injunction the court issued on behalf of does not, however, bring the matter to a close. It is a temporary measure pending the results of discussions between the two parties, but has filed a suit Healthcare Privacy Monitoring against the companies that could be pursued in the future. Among the bases for his complaint, maintains that company illegally interfered with his ability to conduct business, has breached its contract with him, and committed slander and libel.
The alleged breach of contract stems from contention that his contract states that participating Privacy Breach Detection physicians must follow state and federal laws governing confidentiality of medical records, and that if he complied with the request, he would be in violation of those laws.