Mom says mail-order pharmacy goes overboard with privacy rules

Keith Alvarez takes several medications to treat Tourette's Syndrome and attention-deficit disorder, but when his mother wanted to refill his prescriptions by phone, Express Scripts, the mail-order pharmacy, wouldn't give her a list of his medications.

"Although I'm the legal guardian, they will not speak to me about my son's medications over the phone," Gretchen Alvarez said.

Whenever she asked to speak with an Express Scripts supervisor, they would ask to speak with Keith for his authorization, Alvarez said.

"I did remind him that he was a minor, and he explained that that was OK," she said, adding that she asked what would happen if her son had been a baby. "He said, 'Well, if your son couldn't speak, then of course we'd speak to you.'"

Express Scripts spokesman Thom Gross said the company "zealously safeguards" the privacy of every patient, but he couldn't cite a specific policy about the release of medical information for children.

Federal patient privacy guidelines are stringent, and Express Scripts employees are routinely coached on how to correctly apply the rules, Gross said.

Under patient privacy rules in the Health Insurance Portability and Accountability Act, also known as HIPAA, parents are treated as personal representatives of patients under age 18. A medical provider can withhold information from a parent if abuse or neglect is suspected, however.

After weeks of battling with Express Scripts, Alvarez said, the company now will discuss her son's medications with her over the phone as long as she identifies them herself. She cannot ask for a list from the company.

"We have acknowledged our errors, apologized to (the Alvarezes) and detailed steps we have taken to remedy the situation," Gross said.

Alvarez said she still feels the company isn't treating her right. "One thing slips my mind, and I feel my rights as a parent have been taken away," she said.