RALEIGH — A new policy issued in mid-October for Atrium Health Care’s prescription delivery service CarolinaCARE had initially blocked parental access once a child turns 12 years old. That policy has been reversed, North State Journal has learned.
“Beginning Nov. 1, 2023, children ages 12-17 will need to create a new account on the CarolinaCARE website in order to see or order their prescription medications,” the policy change notice stated. “Parents will no longer be able to view or manage their child’s prescriptions. If you have a child who will turn 12 after this date, this change will automatically take place on their 12th birthday.”
The mid-October policy change letter has been scrubbed from the Atrium Health CarolinaCare website, however, a version exists on the archiving website the Internet Wayback Machine.
The Frequently Asked Questions section for the new policy confirmed that “On the child’s 12th birthday, parental access is automatically blocked and parents will no longer see their child’s prescriptions.”
Atrium responded in an emailed statement to questions posed by North State Journal.
“CarolinaCARE is Atrium Health’s home delivery pharmacy that provides prescription services specifically to our teammates and their family members who are enrolled in our health benefits plan,” the Atrium statement reads. “In order to ensure compliance with North Carolina General Statutes §§ 90-21.4(b) and 90-21.5(a) pertaining to medical consent and privacy rights for teenagers, we recently notified subscribers to CarolinaCARE that enrolled minors would need to create their own, separate digital account.”
The Atrium statement went on to say the change “pertains to prescription medications and mirrors what already exists for their medical records,” and that “Allowing unrestricted parental access to medications would be contrary to statutory prohibitions on parental notification in circumstances where the minor has sought and consented to their own care.”
The statutes cited by Atrium refer to a provision called “Minor’s consent sufficient for certain medical health services.”
Under that statute, a minor “may give effective consent to a physician licensed to practice medicine in North Carolina for medical health services for the prevention, diagnosis and treatment of (i) venereal disease and other diseases reportable under G.S. 130A-135, (ii) pregnancy, (iii) abuse of controlled substances or alcohol, and (iv) emotional disturbance.”
The statute, combined with Atrium’s new policy, could mean that minor children as young as 12 would have access to prescriptions for abortion drugs as well as hormone and puberty-blocking medications without parental knowledge or consent.
Due to the statute citations, as worded, the new Atrium policy does not appear to immediately run afoul of the recent law enacted by the North Carolina General Assembly; however, based on the law’s language, it could in the future.
House Bill 808 (Session Law 2023-111), which blocks gender transition surgeries and the prescribing of hormone and puberty blockers to minors, contains an exception for minors who have started treatments before August 1, 2023, and those treatments are required to be “active” as of August 1, 2023.
Other exceptions to the law include a reasonable medical judgment by a doctor that continuance and/or completion of treatment is in the “best interest of the minor.” Additionally, the minor’s parent or guardian has to give consent for continuation or completion of the treatment.
Atrium’s policy change does not appear to violate the health and well-being provisions in the new Parents’ Rights law as that law leaves intact the statutes Atrium cites in its statement.
North State Journal received information on Nov. 9 that the policy had been reversed.
In a letter to subscriber members, CarolinaCare referenced the earlier policy blocking parental access and stated it was changing the policy back to its original status for 12 to 17-year-old minors.
“After considering feedback from members and consulting with our legal and compliance teams, we are pleased to announce we have restored the system to its prior state and implemented a proxy access procedure which allows us to remain in compliance with state law,” the notice reads. “Effective immediately, the insured teammate and their covered spouse may access prescription records and information and submit refills for all covered minor children, except for specific classifications of prescriptions specifically defined by North Carolina state law for adolescent patients.”
The notice went on to say, “Generally speaking, those prescriptions are for the treatment of certain types of reproductive health, communicable diseases (including sexually transmitted diseases, HIV and AIDS), substance abuse and behavioral health-related conditions.
The document directed subscribers to check with their own doctors or pharmacists to “determine if specific drugs prescribed for adolescents covered under your health plan are among those covered by the privacy shield law.”
The notice also contained a “Consent for Access acknowledgement form” that may be signed for “your adolescent may waive their statutory right to privacy when receiving these types of medications, allowing full access by permitted household users to the CarolinaCARE portal, including the ability to order refills online.”
The partial text of the notice and screenshot of the notice sent to North State Journal can be accessed on our website.
North State Journal has a request for comment, including a verification request regarding the notice, placed with CarolinaCare.
In response, CarolinaCare sent a full copy of the notice, including the form required for parents to complete in order to restore access to their child’s prescription information. That form also allows minors the ability to block their parent’s access at will.
“Parent/guardian unrestricted access via CarolinaCARE can be revoked at any time by the Adolescent Patient,” the Consent for Full Access form states.
The section the child must sign gives the child a phone number they can call at any time to block their parent from accessing their account.
“I understand I can stop my parents/legal guardians and others who have access to view the CarolinaCARE account, collectively, from looking at this information at any time by revoking access by contacting 1-866-697-6800,” the form states.