Health Net violated patient confidentiality for 12,000 members being treated for depression and anxiety by accidentally sending their names to the wrong doctors, a spokesman for the state's third-largest health insurer acknowledged yesterday.

Health Net, a Southern California company that insures almost 2.2 million Californians, blamed the mid-December e-mail mistake on a computer programming error that failed to match patient names with the correct doctor.

Health insurers regularly send information to physicians, flagging patients who may benefit from specific treatment, drugs or preventive care programs.

While the practice is promoted as a way to improve patient care, some doctors and privacy experts say it can too easily breach patient rights.

"This does highlight the inherent danger when insurance companies have centralized copies of very personal information," said Stan Dorn, project director of Health Consumer Alliance, an Oakland legal service group. "Although this private information was disclosed to doctors, it's not your doctors who got the information.

"It could be a doctor who goes to your church or synagogue. It could be a family friend," Dorn said. "Consumers should be able to trust that private information will stay private."

When Health Net discovered that 4,992 doctors had received incorrect patient lists, the company sent a Dec. 14 follow-up letter asking physicians to destroy the list and "provide us with your acknowledgement that you have done so."

Health Net spokesman Brad Kieffer said that an "overwhelming majority" of doctors had returned the acknowledgement form enclosed with the letter.

"Most physicians are going to be respectful, but the reality is that this shouldn't have happened," said Mill Valley psychiatrist Mary De May, who received the Dec. 14 correction letter. "As a physician, if I got a list of patients that supposedly were mine, but weren't, I would know something that I shouldn't know."

De May said that she no longer contracts with Health Net, so her patients were not affected by the error and she did not receive a list of patients being treated by another doctor. Nevertheless, she said she was "horrified" by the error, particularly because the mailing related to patients with mental health issues.

"In an ideal world, we wouldn't discriminate against people receiving psychiatric treatment. But the reality is we do discriminate," she said.

Future Health Net mailings will be "reviewed more vigorously to ensure that the correct information goes out," said Kieffer.

Health insurers categorize patients and send specific lists of names mostly as a convenience for physicians, who are barraged with information about treatment options.

"Doctors, like all people, are more apt to respond with more specific recommendations," said Peter Lee, president and CEO of Pacific Business Group on Health, a San Francisco coalition that purchases health care for 45 major companies in California. "This is a way to enable doctors to do the right thing."

It is unclear how the insurance industry's practice of categorizing patients and treatment information to physicians will be impacted by President Clinton's sweeping health care privacy regulations.

The 1,500-page Health Insurance Portability and Accountability Act, issued Thursday, sets federal standards requiring doctors, hospitals and health insurers to gain consent from patients before disclosing health information.

"It is quite possible that a number of what are very good health care practices may be negatively impacted by the regulations. But I hope not," said Lee.

"It is one of the real advantages of managed care to have an organized system to give a heads-up to a doctor to think about whether a patient should get a beta blocker for a heart attack, for example, when the doctor hadn't thought about it."

SF Gate

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