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Path: utzoo!mnetor!spectrix!clewis
From: clewis@spectrix.UUCP (Chris Lewis)
Newsgroups: can.general
Subject: Re: Borrowed records from Revenue Canada
Message-ID: <201@spectrix.UUCP>
Date: Wed, 26-Nov-86 16:05:24 EST
Article-I.D.: spectrix.201
Posted: Wed Nov 26 16:05:24 1986
Date-Received: Wed, 26-Nov-86 17:55:55 EST
References: <623@water.UUCP> <192@spectrix.UUCP> <274@cognos.UUCP>
Reply-To: clewis@spectrix.UUCP (Chris Lewis)
Distribution: can
Organization: Spectrix Microsystems Inc., Toronto, Ontario, Canada
Lines: 88

In article <274@cognos.UUCP> glee@cognos.UUCP (Godfrey Lee) writes:
>Did anyone see the news report that the suspect "has opened"/"wants to open"
>an agency to track down people for a fee?

Oops, forgot about that one.  Yes, indeedy, it would be good for "skip 
tracing".  Interestingly enough, in Ontario, the OHIP enrollment file
is even better - the dates are frequently far more up to date, because
even tax avoiders (and others attempting to avoid payments) want to keep
their OHIP coverage up-to-date.  Until 1978/9 police were able to obtain
such information - the general manager of OHIP didn't realize that the
legislation enabling the existence of OHIP didn't allow it.  Not any more.  
However, there were far more private investigators using pretext calls 
to OHIP for the same end.  

As an example of where things are compared to what they were like in 1978
(when the Health Records Commission started), OHIP didn't know how many copies
of the OHIP enrollment fiche were made, where they went and never noticed
any going missing (quite a few copies did - though, most likely they were
simply misplaced or destroyed without being reported to the COM group).

One of the more interesting (and sneaky) techniques we ran into for collection
agencies acquiring info was:
	1) Send letter saying "You have won....(something or other)" along
	   with a cheque for $5 "Deposit Only" to debtor.
	2) Find out the name of the debtor's bank from the cancelled cheque.

I was asked to report a few other incidents that the Commission found:

1) Catastrophic OHIP data processing oversight:

	It is the practise of OHIP to collect several days worth of data
	entry at one of their district offices (there were 7 in 1978-79)
	and do an audit on them.  Once every couple of months.  This is 
	done by taking the several days worth of claims (in the order of
	100,000-400,000 claims) and running them through a program that would
	generate a letter of the form:

	    Dear <account holder>

	    Our records indicate that you, or members of your family
	    [remember OHIP numbers are for whole families, not individuals]
	    saw the following doctors on the following dates:

	    Dr A, <date>
	    Dr B, <date>
	    ...

	    Could you please inform us if any of this information is
	    incorrect?

	Note that there is no diagnostic code, service code or family member
	name.
	
	In one particular case, the account holder knew that one of
	the doctors was a OB/GYN, and reasoned out that it was his daughter
	(mid teens) who made the visit.  To make it brief, his reaction
	had as end result his daughter committing suicide.

	When this occured, OHIP made some changes to their auditing program,
	such that when the diagnostic code or service code was a socially
	embarrassing thing (eg: abortions, D&C's, VD treatments - 20
	codes in all, probably more now) the letters do *NOT* contain 
	any reference to the associated visit.  I was asked to personally 
	inspect the OHIP code to ensure that this was being done properly.  
	It was - sorta.  When the senior analyst gave me the code, he said 
	"it makes me want to cry" - if written in C (it was in a 
	particularly grotty COBOL style), the code would have looked 
	something like:

	int skipdiag[] = {100, 200, 202 ... }; /* 10 entries, sorted */

	skipclaim(code) {
	    if (binarysearch(skipdiag, code))
		return(TRUE);
	    else if (code == 400 || code == 501 || code == 722...) /* 10 clauses */
		return(TRUE)
	    else
		return(FALSE);
	}

	I gather that the analyst responsible for this piece of junk
	got thoroughly yelled at.
-- 
Chris Lewis
Spectrix Microsystems Inc,
UUCP: {utzoo|utcs|yetti|genat|seismo}!mnetor!spectrix!clewis
ARPA: mnetor!spectrix!clewis@seismo.css.gov
Phone: (416)-474-1955