As I have written about before, the C.U.R.E.S. database was created and is maintained by the California Department of Justice to track the prescriptions of Californians. The purpose of this database is ostensibly to detect patient prescription drug abuse and over-prescribing by physicians. However, C.U.R.E.S. is a huge medical information database that is unprotected from unchecked government intrusion and abuse. Over the past several years, C.U.R.E.S. has been employed as an investigative tool by the Medical Board of California and others to glimpse into the medical histories and medication use of individuals via their prescription records.
A case currently pending on appeal, Lewis v. Superior Court, raises troubling issues. In that case, at administrative hearing, a Medical Board investigator testified that the Board routinely accesses C.U.R.E.S. records for all patients of a physician subject to an investigation, even patients who are not part of the investigation. For attorneys who handle health care defense matters, this disclosure is not surprising. However, the public may be shocked to learn that without providing any waiver of confidentiality, these records are easily and routinely accessed. The California Medical Association has filed a brief with the Court of Appeal that clearly addresses these concerns.
Health care board investigators can access C.U.R.E.S. to check on the personal prescriptions of licensees, license applicants or indeed anyone, without a subpoena, warrant or HIPAA confidentiality release. These practices and the potential for abuse raise troubling questions not unlike those surrounding the NSA revelations from former contractor Edward Snowden. Therefore, we counsel any client who is under investigation or subject to discipline to expect that investigators will pry into their personal prescription records, possibly finding highly personal or embarrassing information.
We hope that Dr. Lewis and his legal team will persuade the Court of Appeals to place important checks on the limitless power of Board investigators to pry into patient medication records. In the meantime, health care licensees, license applicants and patients should be aware that prescription records are not private or protected as they should be in California.