Trump Administration Requests Federal Workers' Medical Records from Insurers

The Office of Personnel Management is requesting 65 insurance companies to provide monthly reports with identifiable medical records, pharmacy claims, and encounter data for more than 8 million federal employees, retirees including former members of Congress, and their families, without instructing insurers to redact identifying information. CVS Health executive Melissa Schulman argues the request raises substantial HIPAA compliance issues and that insurers would be breaking federal law by providing personal health information for vague purposes, while the Office of Personnel Management claims the data will ensure competitive and affordable plans. Privacy advocates warn the Trump administration could use the medical data for political retaliation against non-cooperating employees, particularly concerning abortion or transgender treatment records, given that dozens of federal workers report being targeted politically and the administration has tested legal bounds on sharing sensitive information for immigration enforcement. The Office of Personnel Management previously suffered a 2015 data breach affecting 22 million Americans and made a similar proposal in 2010 that prompted HIPAA concerns, but has not responded to requests for comment since closing public comments in March.

OPM's Request for Identifiable Medical Records

• ▪The Office of Personnel Management notice requests service use and cost data including medical claims, pharmacy claims, encounter data, and provider data
• ▪The Office of Personnel Management notice does not instruct insurers to redact identifying information from the medical records
• ▪The Office of Personnel Management regulation would require 65 insurance companies to provide monthly reports with identifiable health data on their members
• ▪The Office of Personnel Management posted a notice in December requesting medical records from insurers covering federal workers
• ▪The Office of Personnel Management request would affect more than 8 million Americans including federal workers, retired members of Congress, mail carriers, and their immediate family members
• ▪The Office of Personnel Management notice states the data will ensure insurers provide competitive, quality, and affordable plans

Privacy and Legal Concerns Under HIPAA

• ▪Melissa Schulman argued that federal law allows the Office of Personnel Management to examine records but not to collect data
• ▪The Office of Personnel Management made a similar proposal in 2010 that prompted HIPAA concerns
• ▪The Health Insurance Portability and Accountability Act of 1996 requires certain organizations that maintain identifiable health information to protect it from being disclosed without patient consent
• ▪The Office of Personnel Management announced in 2015 that personal records of roughly 22 million Americans had been stolen from the agency in a data breach blamed on the Chinese government
• ▪The Association of Federal Health Organizations submitted a 122-page comment opposing the Office of Personnel Management notice
• ▪CVS Health executive Melissa Schulman wrote that the Office of Personnel Management request raises substantial HIPAA compliance issues
• ▪Melissa Schulman stated that insurers would be breaking the law by providing personal health information for the Office of Personnel Management's vague and broad general purposes

Potential Political Misuse of Health Data

• ▪Sharona Hoffman stated that the Office of Personnel Management could use detailed medical data to discipline or target people who are not cooperating politically

Insurer and Expert Opposition to the Proposal

• ▪The Office of Personnel Management has not provided any update since closing comments in March
• ▪The Office of Personnel Management spokespeople did not respond to repeated requests for comment
• ▪Jonathan Foley worked at the Office of Personnel Management advising on the Federal Employees Health Benefits program during the Obama and Biden administrations
• ▪Blue Cross Blue Shield Association, Kaiser Permanente, and UnitedHealthcare declined to comment on their plans to comply with the Office of Personnel Management notice
• ▪CVS Health executive Melissa Schulman urged the Office of Personnel Management to reconsider its proposal in March
• ▪Michael Martinez filed a public comment opposing the Office of Personnel Management proposal in February through Democracy Forward

Perspective of Federal workers and retirees

• ▪Michael Martinez filed a public comment opposing the Office of Personnel Management proposal in February through Democracy Forward