A few weeks back, Caoimhin wrote a fantastic diary expressing concerns over proposed implementation of 2005's legislation creating the Vermont Prescription Monitoring System. At the time, he wrote:
The Department of Health is in the process of seeking legislative approval of administrative rules the Department drafted to govern VPMS. The proposed rules will monitor your physician's provision, and your access to, hundreds of treatments for thousands of conditions. The purpose of the law is intended to identify substance abusers and to facilitate their treatment -- nothing inherently wrong with that and in fact it is a laudable goal. However, the proposed regulations by the Department of Health do not accomplish the goal set out by the legislature, violate the laws governing the VPMS and present too many dangers for disclosure, misuse, mishandling of sensitive patient medical information.
As CL stated, the law mandates collecting the minimum necessary information to achieve it's stated goals.
But instead of the Department of Health, we apparently needed to be watching out for the State Police.
GMD has learned that State Police representatives are going to Vermont Pharmacies and demanding complete dumps of all information about patients with Schedule II prescriptions (the class of medications that include prescription drugs with street value). After talking to a few pharmacists, I found one in Franklin County that confirmed they had been approached, and had been advised by the state that they did, indeed need to comply with the request. Needless to say, he wasn't too happy about it.
What's even more disturbing? When I asked if he knew of any other pharmacies that were being mined for data in this way, he responded that it was his understanding that this was a process that was to take place across the state.
Sounds to me like the State Police is actively putting together a medical records database of Vermonters across the state for the purpose of, as this pharmacist opined, "fishing expeditions."
And if you think something of this magnitude wasn't signed off on by the Governor's office, you're kidding yourself.
The pharmacist I spoke to was understandably concerned about the implications to their responsibilities under the federal law which regulates electronic medical records and privacy, as such a warrantless, mass-data capturing adventure would seem to run afoul of this federal regime. However, HIPAA (The Health Insurance Portability and Accountability Act) also requires pharmacists to cooperate with local, duly empowered law enforcement, so he was advised to comply.
When I expressed shock, the pharmacist merely suggested I look at "who's in the White House."
(a) It is hereby made the duty of the department of public safety, its officers, agents, inspectors, and representatives, and pursuant to its specific authorization any other peace officer within the state, and of all state's attorneys, to enforce all provisions of this chapter and of the rules and regulations of the board of health adopted under this chapter, except those otherwise specifically delegated, and to cooperate with all agencies charged with the enforcement of the federal drug laws, this chapter, and the laws of other states relating to regulated drugs.
(b) Such authorities and their specifically authorized agents shall have, at all times, access to all orders, prescriptions, and records kept or maintained under this chapter, as provided herein.
(c) A person who gives information to law enforcement officers, the drug rehabilitation commission, or professional boards as defined in section 4201 of this title and their specifically authorized agents, concerning the use of regulated drugs or the misuse by other persons of regulated drugs, shall not be subject to any civil, criminal, or administrative liability or penalty for giving such information.
Can't get much broader than that.
This is a bad law, and now we're seeing exactly why.
I'll post more information soon. In the meantime, it's time for some letters to the editor (and some calls to legislators).
UPDATE: In State of Vermont v. Judy Welch, the Vermont Supreme Court - unbelievably - has upheld the power of law enforcement to seize pharmacy records without a warrant as far back as 1992, stating "there is no patient's privilege available for pharmaceutical records." Here's a link (MAJOR hat tip to CL for all the help, here)
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