Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.
|
|
 |
 |
How Far Does HIPAA Go?
Nov 29, 2005
With the recent release of a WAL-MART memo on corporate efforts to reduce healthcare costs, it seems that HIPAA does not prevent an insurance company, or third party billing company, from releasing fairly detailed statistics on a group of employees.
First, have you had a chance to read this memo? If not:
http://www.npr.org/templates/story/story.php?storyId=4975919
And here's another WAL-MART tactic that indicates and anti-worker stance:
http://www.freerepublic.com/focus/f-news/666837/posts
My question is: Does HIPAA allow frequent and detailed employee health profiles to be sent that would allow, by the process of elimination, for HIV+ employees to be identified?
More specifically, does HIPAA allow the day (and or time) that a doctor visit took place to be provided to an employer (who would just check their timesheets to determine which employee(s) to fire)?
Regards,
Tom
|
 |
|
 |
|
Response from Ms. Franzoi
HIPAA provides extensive requirements for group health plans regarding pre-exisiting condition exclusions, certification of coverage, discriminatory eligiblity and premiums, mandatory special enrollment and protection of health care information. Employers can only get access to detailed health information to the extent that it is needed in the administration of the plan. In an insured plan, this would be limited information, typically total claims incurred by disease, specific drug costs, etc. but this would be on a plan basis not by individual. If it is a self-insured plan (unless the plan is administered (claims adjudicated) in-house), the employer would only see information on claims incurred by disease, dollars spent by Rx, etc. The only time participant specific information would be disclosed would be if the participant asks for assistance with a claim (and then the employer would most likely have the participant sign a release acknowledging what information can be disclosed) or in the event of a large claim where a stop-loss carrier is involved and is requesting specific information in order to process the stop loss claim.
With respect to your timesheet question, that is outside the scope of HIPAA.
|
|
|
 Please remember that this forum is designed for educational purposes only, and experts are not engaged through this
forum in rendering legal or medical advice or professional services. Experts appearing on this page are independent and are solely responsible
for editing and fact-checking their material. Neither The Body nor any sponsor is the publisher or speaker of posted visitors' questions or the experts' material.
Questions and messages posted to this forum are not statements of advice, opinion, or information of The Body, Body Health Resources Corporation or any sponsor of this
forum. While neither The Body nor Body Health Resources Corporation regularly reviews posted content, we reserve the right to delete, move, or
edit postings if we deem it appropriate under the circumstances. Visitors submitting questions remain solely responsible for the content of their
messages.
Information provided by experts is general only and should not be used for diagnosing or treating a health problem or a disease, or relied upon as
legal or other professional advice. This information is not a substitute for professional advice or care. If you have or suspect you may have a
health or legal problem, you should consult your own health care provider or your attorney.
Copyright notice.
|
|
|
|
