Rachel:
I agree with what you said about provider
consents (ignoring the new NPRM for the moment), but I'm not sure of the point
you're making. The original question related to disclosures by health
plans, not providers.
Patricia I. Carter, J.D.
Gray, Plant, Mooty, Mooty &
Bennett, P.A.
3400 City
Center
33 South Sixth
Street
Minneapolis, MN
55402
Phone:
612-335-7867
Fax:
612-333-0066
Email:
[EMAIL PROTECTED]
Patricia,
I'm not an attorney, but I believe that consent is
required by all direct treating providers to use and disclose protected health
information for treatment, payment or operations. This consent is a one-time
event and good until/unless revoked by the
individual.
Other than that, I would agree that this consent would
cover the subrogation issue.
Rachel
Rachel Foerster
Rachel Foerster & Associates, Ltd.
Phone:
847-872-8070
Subrogation is part of "payment," and as
TPO would not generally be subject to the authorization requirements, but
rather to the consent requirements (and a health plan need not -- even before
the NPRM-- get consent for TPO uses and disclosures.)
Patricia I. Carter, J.D.
Gray, Plant, Mooty, Mooty & Bennett, P.A.
3400 City Center
33 South Sixth Street
Minneapolis, MN 55402
Phone: 612-335-7867
Fax: 612-333-0066
Email: [EMAIL PROTECTED]
Hi All,
Have any of the payers on the list confronted the problem of
how health plans getting Disclosure Authorization to subrogate claims
with auto/property/casualty/hazard insurance companies... For example,
because the auto insurer is not a CE nor a BA how can the Health Plan share
PHI with the auto insurer when it is looking for them to subrogate the claim.
Getting authorization from the member is going to be hard because they have no
motivation to provide it and may actually have a disincentive to do so because
they do not want their auto insurance rates to go up. The auto co won't
subrogate without the information.
Tips on where to go to get guidance or thoughts on the matter
would be much appreciated....
Jim Moores - HIPAA Team Leader - Privacy
Antares Management
Solutions
23700 Commerce Park Road
Beachwood, Ohio
44122-5832
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