Do patients have a right under HIPAA to access documentation on prior authorization denials, specifically license information for the insurance-side physician who denied the claim?
My daughter's health care was delayed and wellbeing jeopardized by a denied prior authorization which went against the prescribed treatment plan of her board certified subspecialist physician. I am wondering if I can get access to the license of the physician who made the denial determination as I would like to file a complaint with their licensing board. It was a PBM through the insurance company and given this pharmacist/physician acting under their license made determinations that altered my daughter's health care it seems like that should fall under HIPAA, at least logically, but I know that's not often synonymous with legally. These physicians abdicate their oaths and prostitute their licenses to protect insurance company profit margins solely by harming patients via delayed care and inferior care. I want to know why their board supports this. If this pathway exists, I think patients should DDOS the relevant boards with these complaints and reward these sellouts with the social and career consequence they've earned. Make the positions toxic to fill. Thanks in advance for any ideas or help
submitted by /u/Alarming_Ordinary_71
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