QUICK ANSWER
A prescription history report is a record of an individual’s prescription medication history compiled from pharmacy and insurance data. These reports are typically compiled and reported by Milliman IntelliScript (a specialty consumer reporting agency) and may be used by insurance companies, pharmacy benefit managers, and other authorized parties to assess risk, verify information, and make coverage decisions.
What Information Is Included in a Prescription History Report?
A prescription history report typically contains:
- Patient details
- Information about medications
- Drug names
- Dosage amounts
- Prescribing physicians
- Pharmacies used
- Dates prescriptions were dispensed
- Information about refills
- Insurance claims associated with prescription purchases
While these reports contain medication-related information, they generally do not include complete medical records or detailed treatment notes from healthcare providers.
How Prescription History Reports Are Created and Used
Prescription history reports are created by collecting prescription data from pharmacies, pharmacy benefit managers, and insurance providers. Companies compile this information into reports that may be used for underwriting, risk assessment, and eligibility determinations.
These reports help organizations verify prescription information, but they can also contain outdated or inaccurate data if records are not properly maintained.
Who Can Access Your Prescription History Report?
Access to prescription history reports is generally limited to authorized parties with a permissible purpose. This may include insurance companies evaluating applications, and consumers requesting their own reports.
Federal and state privacy laws restrict how prescription information can be shared, helping protect sensitive healthcare data from unauthorized access.
How Insurance Companies and Employers Use Prescription Data
Insurance companies may review prescription history reports when evaluating applications for certain types of coverage (i.e. life insurance). Employers generally have limited access to prescription information and must comply with applicable privacy and employment laws. In many cases, employers cannot freely access an individual’s prescription history without authorization.
How Prescription History Reports Can Affect Your Insurance Coverage
Information contained in a prescription history report may influence underwriting decisions for insurance products. Insurers may review prescription records to identify medical conditions, evaluate risk factors, or verify application information.
If a report contains untrue information, it could potentially affect eligibility, premiums, or coverage decisions.
Common Errors Found in Prescription History Reports
Like other consumer reports, prescription history reports can contain mistakes. Common errors include:
- Prescriptions belonging to another person
- Incorrect medication information
- Duplicate entries
- Outdated records
- Inaccurate identifying information
These errors can occur because of data entry mistakes, reporting issues, or mixed consumer files.
Your Rights Under the Fair Credit Reporting Act (FCRA)
Prescription history reports that are used to make insurance coverage and other decisions, like a Milliman IntelliScript report, are regulated by the Fair Credit Reporting Act (FCRA). Prescription history reports simply maintained for the purposes of keeping a thorough medical record, such as within a healthcare network, likely are not.
The FCRA gives you the right to:
- Provide consent
- Have accutate reports
- Access your reports
- Dispute false information
- Ask for corrections when errors are found
- Seek help from an attorney
How to Request and Review Your Prescription History Report
Consumers can request a copy of their prescription history report from the company that maintains the records.
Once received, carefully review the report for inaccurate details including: medications, personal information, duplicate records, and prescriptions.
Reviewing your report regularly can help identify errors before they affect insurance decisions or other matters involving your prescription information.
How to Dispute Errors in a Prescription History Report
If you discover an error, submit a dispute to the company that prepared the report (in writing through certified mail). Clearly explain the incorrect information and Include supporting documentation. The reporting company must investigate the dispute and correct or remove information that cannot be verified.
What to Do If Your Prescription Data Is Misused
If your prescription information has been improperly accessed, shared, or used, take steps to protect your rights:
- Document the suspected misuse
- Request copies of relevant records
- Notify the appropriate organizations involved
Depending on the circumstances, privacy laws and consumer protection laws may provide remedies for unauthorized access or misuse.
When to Contact a Consumer Protection Lawyer About Prescription Reports
A consumer protection lawyer may be able to help if prescription information containing errors - has affected your insurance coverage, employment opportunities, or other important decisions. An attorney can evaluate whether reporting companies complied with applicable laws and explain your legal options.
Legal guidance may be especially valuable when disputes remain unresolved.
Frequently Asked Questions
What is a prescription history report used for?
Prescription history reports are commonly used for insurance underwriting, risk assessment, fraud prevention, and verification of prescription information.
Is a prescription history report the same as a medical record?
No. A prescription history report focuses on prescription medication data and generally does not contain complete medical records or treatment notes.
Who can legally access my prescription history?
Access is generally limited to authorized parties with a permissible purpose, such as insurers and consumers requesting their own reports.
Can a prescription history report affect my insurance rates or coverage?
Yes. Insurers may use prescription information when evaluating eligibility, premiums, or coverage decisions.
How do I get a copy of my prescription history report?
You can request a copy directly from the company that maintains the prescription history report.
What should I do if my prescription report has an error?
Review the report carefully and submit a dispute with supporting documentation to the reporting company.
Are prescription history reports covered by the FCRA?
Yes. In certain circumstances, prescription history reports may be subject to protections provided by the Fair Credit Reporting Act.
Can employers see my prescription history?
Generally, employers have limited access to prescription information and must comply with privacy and employment laws.
How long does information stay on a prescription history report?
The length of time may vary depending on the reporting company and the type of prescription information being maintained.
When should I contact a lawyer about a prescription report issue?
Consider speaking with a lawyer if incorrect or misused prescription information has caused harm or affected important decisions.
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