Posted by Employer Wellness | Posted in Employer Wellness | Posted on 29-05-2010
As scary as they seem at first glance, complying with HIPAA’s privacy rules could be relatively painless.
Contrary to common belief, the rules – with a few key exceptions – apply only to a fraction of the health information Benefits handles.
As long as the company remains legally “hands off” of employee’s private medical information, you can dodge most of the HIPAA bullet.
For HIPAA privacy purposes, your firm is considered “hands off” even when you obtain de-identified personal information, aggregate claims data and routine enrollment info.
Bottom line – If your organization’s health plans are fully insured and the claims administered through a TPA, the insurance corporation – not your firm – bears the brunt of the health insurance portability and accountability act (HIPAA) privacy compliance responsibility.
One major exception – medical cafeteria plans. In most cases, you’ve two compliance choices –
• Process reimbursement requests first through your TPA, with the TPA making sure the claim qualifies underneath the terms of the cafeteria plan before your firm reimburses it, or
• Develop a written cafeteria plan privacy policy, issue a notice to staff members, appoint a privacy officer and amend your plan documents.
Rarely affects FMLA
Many individuals - including healthcare providers – misunderstand how HIPAA affects medical certifications for FMLA leave. the key – HIPAA only applies to personal information that filters through your health plan, not certifications obtained from a doctor.
Under FMLA, you’re allowed to obtain the minimum information you need to approve and administer leave. In like fashion, HIPAA doesn’t apply to most workers’ comp, return-to-work notices or disability claims.
Even so, it pays to be careful how you ask for and use the information. Other state and federal privacy laws often protect the same kinds of info people assume falls under HIPAA.
Following procedures
The HIPAA privacy rules are heavy on paperwork and procedure.
But since your firm follows the info-gathering process spelled out in your medical plan documents, the health insurance portability and accountability act (HIPAA) privacy rules should present few major obstacles.