This week’s story questions whether a druggist who believes that a patient is not taking their prescription should squeal on them directly to their doctor.

A couple of weeks ago, MrConsumer got an unexpected letter from his primary care physician (PCP). It said:

Say what? My mail order pharmacy, CVS/Caremark, wrote to my PCP to tell her I might not be taking my medications properly, urging her to be in touch with me (hence she sent the letter above).

Here is the fax they sent her:

Apparently, this is what happened. For years, I have been taking simvastatin to help lower cholesterol. I get 90-day prescriptions filled via mail order from Caremark, and the last time I ordered it was January 15th. Sometime shortly after April 15th, when I had not yet reordered it from them, CVS/Caremark took it upon themselves to notify my doctor. In turn, she sent me the above letter expressing concern.

No, MrConsumer is not having a problem taking the drug daily. He simply had several weeks of pills left over since prior prescriptions were received in advance of them actually being needed. We have all experienced the practice of pharmacies telling us way in advance that it is time for a refill when we still have plenty of pills left from the last one.

On one hand, maybe Caremark should be thanked for putting the patient’s health ahead of privacy concerns. But on the other hand, it feels like the company was overreaching, going behind the back of the patient to his PCP to tattle on him, without asking the patient first if he was having a problem. Of course, they did send me refill reminders.

A quick review of CVS/Caremark’s terms and conditions and privacy policy on its website did not reveal any specific disclosure that such contacts would be made. However, in its HIPAA policy, it made this broad disclosure:

*MOUSE PRINT:

Uses and Disclosures of Your PHI for Treatment, Payment and Health Care Operations

We may use and disclose your PHI for treatment, payment and health care operations without your written authorization.

PHI is information about you that we obtain to provide our services to you and that can be used to identify you. It includes your name and contact information, as well as information about your health, medical conditions and prescriptions. It may relate to your past, present or future physical or mental health or condition, the provision or health care products and services to you, or payment for such products or services. [Definition inserted to guide readers.]

The following categories describe and provide some examples of the different ways that may use and disclose your PHI for these purposes:

Treatment: We may use and disclose your PHI to provide and coordinate the treatment, medication and services you receive. For example, we may:

Use and disclose your PHI to provide and coordinate the treatment, medication and services you receive at CVS Health. Disclose your PHI to other third parties, such as pharmacies, doctors, hospitals, or other health care providers to assist them in providing care to you or for care coordination. In some instances, uses and disclosures of your PHI for these purposes may be made through a Health Information Exchange or similar shared system. Contact you to provide treatment-related services, such as refill reminders, adherence communications, or treatment alternatives (e.g., available generic products). [Emphasis added.]

This says that your personal health information, including your prescriptions, can be disclosed to third parties, such as doctors, to assist them in providing care to you. However, it says Caremark may contact YOU, the patient, with “adherence communications.” It doesn’t explicitly say, however, that they can contact your doctor with respect to your staying on your regimen.

Mouse Print* contacted CVS/Caremark to get an explanation of their practice of contacting doctors to report patients who may not be adhering to their prescriptions. Here are excerpts from their response:

Taking medications as prescribed is one of the most important things patients can do to get and stay on their path to better health. Non-adherence to prescribed therapies comes at a significant cost to patients’ health and finances, as well as to the entire health system.

One of the ways we encourage adherence is through our clinical program that reviews members’ prescription refill behavior for maintenance medications, including drugs prescribed to help manage a patient’s cholesterol. Through this program, we send refill reminders and late-to-fill outreach to plan members and engage prescribers when members are past due for refills.

Our adherence outreach program is consistent with HIPAA and our own privacy policy… -Mike DeAngelis, Senior Director, Corporate Communications

I really have mixed feeling about this, as expressed above. What do you think? Do you want your druggist to notify your doctor when you don’t get a timely refill of a maintenance drug?

This week in Consumer World we featured an offer from Discover to get a free copy of your genuine FICO credit score. Before you sign up, however, you may want to check their privacy policy, which might better be described as their “not much privacy” policy.

*MOUSE PRINT:

First, hats off to Discover for finding an easy way to convey a complex privacy policy without pages and pages of dense text.

But that is where the good news ends. Discover clearly says that at least for a “short time” they are going to market their services to you. But they are also going to share much of your information, like name, email, and your online activity with both their own affiliates and with companies they are not affiliated with. And they are going to share your birth date and social security number with companies that service or market their products.

This all made MrConsumer a little uneasy — an unusual feeling for someone who is generally privacy insensitive.

You have to decide if the reward of a free FICO score is worth the price of your personal information being shared with others.

Playing off of Amazon’s wildly successful “Prime Day” last July, Wayfair.com declared its own holiday savings event last week called “Way Day.” In TV ads, they claimed to offer the lowest prices since Black Friday on that day.

To see if “Way Day” was hyping more discounts than they were actually providing, MrConsumer “randomly” chose 10 items from their various merchandise categories the day before Way Day, April 24, so they could be compared to the discounts offered on the same items the following day. We had no idea which items would be on sale and which would not be.

“Way Day” arrived, and here are Wayfair’s prices for the same items during their big sale.

*MOUSE PRINT:

Obviously, only checking 10 items is not a scientific, projectable survey. Nonetheless, the results of this spotcheck are interesting. Half the items were the same price or virtually the same price on “Way Day” compared to the day before. For example, the Price Pfister faucet was $82.86 on Way Day compared to $82.99 the day before. The GE dishwasher, however, didn’t even budge a penny from its $803 price.

But there were significant savings on some of the other five items. The pair of lamps dropped from $75 to $60.99. The rug went $277.99 down to $182.06. But the barbecue grill was only $6 less.

In total, the 10 items in our cart were selling for $1923.69 the day before the sale, but dropped to $1773.90 — for a “Way Day” savings total of $150.

So it looks like if one picked and chose carefully on “Way Day” and were familiar with Wayfair’s everyday prices, you could save some real bucks. Otherwise the savings might have only been slim or none.

Mandatory arbitration clauses that forbid class actions have been in the news lately as Congress and the president last fall struck down a new consumer rule prohibiting such clauses in contracts with banks.

Way before this action, Kohl’s department store cleverly stuck a clause into the terms and conditions on its website banning customers from getting together to sue the company.

*MOUSE PRINT:

It is not so out of the ordinary to see arbitration clauses forbidding class actions on retailers’ websites. What is unusual is the fact that Kohl’s seems to be saying that this restriction even applies to people who shop in their stores.

*MOUSE PRINT:

It says if you shop in their brick and mortar stores you are subject to the same restriction, and that “shopping in our stores constitutes your acceptance these terms.” Elsewhere in the terms it says if you don’t like these restrictions “you should not and are not allowed to…make purchases in our stores.”

What? So merely walking through the doors of a Kohl’s store I lose my right to be part of a class action against them? It sure seems so. (There is an argument to be made, however, that the combination of BOTH using their website AND shopping in their stores is what triggers the class action restriction. However, if that were true then only people who did both would lose the right to sue and certainly Kohl’s wants to prevent Internet users who never shopped in their stores to be covered by the class action prohibition.)

We asked Kohl’s how in the world the class action waiver could ever apply to people who only shop at their stores and were never put on notice that entering their stores triggered this restriction. (Last I checked, there was no notice on every door notifying shoppers they were about to lose those some consumer rights upon entering.)

The company did not respond.

Right after Christmas, Consumer World promoted a deal on a SensorGel pillow at Macy’s as “Bargain of the Week.” It was $20, but there was a $20 full price rebate.

In January, MrConsumer’s own rebate submission was denied by the rebate fulfillment house indicating that no receipt was received. Of course I had included it. Calling them quickly revealed that indeed they had my receipt in their records, and the rebate was approved.

Then in February, some consumers contacted me saying that their rebate was denied because they purchased the pillow online rather than in the store. Here is what one consumer was told when he engaged the rebate folks in a chat session:

After complaints like this starting coming in, we checked the fine print of the offer on the rebate form.

*MOUSE PRINT:

Clearly, right on the rebate form itself, both online and in-store purchases were permitted for this rebate.

Since it appeared that many purchasers may have had their rebates wrongfully denied, we contacted Macy’s PR folks, asking them to investigate, and if they discovered that customers were indeed owed money, that they honor those submissions. After multiple contacts, Macy’s did not reply to our inquiries.

So, MrConsumer had to use some back-channel methods to get Macy’s to do the right thing. He contacted the former CEO of Parago, the rebate fulfillment house that Macy’s uses, to ask her help. This remarkable woman dropped everything eight years ago to address a similar problem with a Norton rebate. She did the same again by contacting the new CEO at Blackhawk Network, the new owner of the fulfillment house.

A week later, a representative of Blackhawk called to say that after discussion with Macy’s and a review of all the denied rebates, they are making good for some 150 customers! And they are also going to more accurately state on the rebate form when an offer is restricted to in-store or online sales only.