P-C Insurers Slam Health Privacy Guidelines
Washington
New privacy guidelines issued by the U.S. Department of Health and Human Services still do not resolve insurance industry concerns about workers compensation claims, insurer officials say.
"We remain very concerned about parts of the regulation that may significantly undermine state regulation of workers compensation and disrupt the consideration and payment of claims," said Bruce C. Wood, assistant general counsel with the Washington-based American Insurance Association.
Nancy Schroeder, assistant vice president with the National Association of Independent Insurers in Des Plaines, Ill., added that NAII is also disappointed by the lack of clarification on issues related to workers' comp. However, she said, NAII is pleased that the new guidelines do clarify concerns over personal injury products, such as auto insurance.
HHS issued the guidelines to help ease concerns over privacy regulations issued in April. The regulations were mandated by the Health Insurance Portability and Accountability Act of 1996.
The main insurance industry concern over the regulations related to the "minimum necessary" standard, under which healthcare providers must take reasonable steps to limit the use or disclosure of protected health information to the "minimum necessary" to accomplish the intended purpose. Property-casualty insurers are concerned over the standard's impact on claims processing.
For personal injury coverage, Ms. Schroeder said, the guidelines do provide clarification. Specifically, they say that disclosures of information authorized by the affected individual are exempt from the standard. "This includes authorizations that covered entities may receive directly from third parties, such as life, disability or casualty insurers, pursuant to the patients application for or claim under an insurance policy," the guidelines say.
In effect, according to Ms. Schroeder, the guidelines say HHS will accept authorizations signed by claimants that were sent to the claimants by a p-c insurer. "We hope the medical community will see this as clearly as we do," she added.
But in the workers comp area, Mr. Wood said that the guidelines do not address industry concerns. Indeed, he said, the "minimum necessary" standard places healthcare providers in the position of making what is effectively a legal determination of the relevancy of information a workers comp carrier requires.
Moreover, he said, it raises the issue of federalizing the workers comp system. There are inherent complications, he said, in dealing with standards set by two different government levels.
Mr. Wood said the regulation needs to be revised. "We remain hopeful our concerns will be rectified in a revised rule," he said.
HHS said that it will issue further technical assistance materials to resolve issues not addressed in the recently issued guidelines. In addition, HHS said, it will propose modifications in rulemaking procedures as necessary.
Reproduced from National Underwriter Property & Casualty/Risk & Benefits Management Edition, July 20, 2001. Copyright 2001 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.
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