Dear Lisa,

We are examining that very question right now.

To start, let me explain one of the guiding principles of Washington, DC:
When you ask a question, and the response starts with "I don't know,
but...." They've answered your question and you move along.

In this instance and other HIPAA-related areas, it seems nobody has
definitive information. So we're stuck with not moving along.

With that said, here's what we've determined.

* The Privacy Rule explicitly prohibits  the use of protected health
information in employment decisions.

* HHS created the "construct" of a health plan that may not exist as a
separate entity from the employer. Nevertheless, such a barrier must be
created in some fashion.
In larger firms, where there may be a separate team dealing with the health
plan, creating such a bright line may be relatively simple. But unless your
organization is a Fortune 1000 company, you may run into problems and will
have to establish an analogous construct internally to deal with the
regulation.

* Where the same person or people have responsibilities for overseeing the
plan (and thus are the plan for the purposes of HIPAA) and have
responsibilities in other areas for the employer, the following suggestions
have been made in the absence of hiring dedicated personnel for the plan:

* More precisely define job descriptions to indicate when a person is acting
on behalf of the plan versus the employer as defined under HIPAA. For
example, employers (sponsors) have a right to collect summary information
without triggering the Privacy Rule.

* Create policies that follow through with those job descriptions.

* Ensure that those people who act on behalf of the plan have little and
preferably  nothing to do with employment decisions.

* Hope that HHS really means it when it expects reasonable efforts and is
willing to rely on professional judgments.

As with everything else in HIPAA, it is not so much what you do that counts,
but on whose behalf you do it.

Hope this helps.
Dennis Melamed
Editor
Health Information Privacy Alert
(202) 296-3069

-----Original Message-----
From: Lisa Amerino-Marshalko [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, March 20, 2002 9:36 AM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED];
[EMAIL PROTECTED]
Subject: RE: Employers impacted


We also have made the same interpretation.  However, we are unclear about
how this applies to electronic exchanges that are part of standard
transactions and code sets.  How do you know when a standard transaction is
being conducted by the self insured health plan or the employer sponsor of
that health plan?  I am asking because the self-insured health plan is a
covered entity, but not its employer.  (This differentiation is actually
referenced in FAQs from DHHS.)

>>> Mary Michal <[EMAIL PROTECTED]> 03/19/02 08:00PM >>>
 The health plans of self-insured employers are indeed Covered Entities and
subject to Electronic Transactions and Privacy Rules.  We have analyzed the
Rules and developed compliance materials.

Mary Michal

-----Original Message-----
From: McCall, Allen
To: '[EMAIL PROTECTED]'
Sent: 3/19/02 10:53 AM
Subject: Employers impacted



Has anyone determined if/how self-insured employers are impacted by
HIPAA.  I am hearing that the health plan portion of the company must
comply with Rule 1.

Has anyone figured this out?

Allen McCall
Sierra Systems
10900 NE 8th Street, Suite 400
Bellevue, WA 98004-1455
Telephone:  (425) 586-5438
Mobile:  (425) 894-0790
Fax:  (425) 586-5439
[EMAIL PROTECTED]
http://www.sierrasystems.com <http://www.sierrasystems.com>


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