The other possibility is that the broker, as a agent (I'm assuming this is
one type of agent that you are inquiring about)is a business associate of
the group health plan, or otherwise related to the plan sponsor of the group
health plan, and is called out in the amended plan document as one of the
entities allowed to use and disclose PHI on the group health plan's behalf
for the purpose of administering the plan.  164.504 (f) recognizes that once
plan documents are appropriately amended in accordance with HIPAA
requirements, the plan sponsor may be sharing PHI with agents as long as the
plan sponsor "ensure(s) that any agents, including a subcontractor, to whom
it provides PHI received from the group health plan agree to the same
restrictions and conditions that apply to the plan sponsor with respect to
such information."

Our most common "agent" is a broker and, at least in our situation, they are
commonly involved in handling PHI on behalf of the group health plan for the
purpose of assisting with administering the plan.

Julie McCarter
Great-West Life

-----Original Message-----
From: Bill Bernath [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, March 27, 2002 6:13 AM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Re: Agent's Rights to PHI


Cathy, we've be wrestling with this for a bit.  I wish it was as simple as
it sounds, but we see the agent falling into a couple of categories - one
that works directly for us, that is,  a paid employee of BCBSNC.  We'll
assume that this agent is representing our interests.  The other category is
agents that are not employees, but instead are representing either the
member or the group health plan.   For either category, but especially for
the non-employees, we are leaning towards absolutely no disclosure of PHI
(without proper signed authorization on file, of course).  So far, we have
not been able to come up with instances where an agent would 'need' PHI.  If
someone in the group can make a case for it, I'd be glad to put it in our
mix for further consideration - thx- b

Bill Bernath
Blue Cross Blue Shield of North Carolina 
Privacy Office
(919) 765-7006
[EMAIL PROTECTED]


>>> <[EMAIL PROTECTED]> 03/26/02 08:05PM >>>
Does anyone in the WEDI SNIP Privacy Workgroup know the
industry's perspective and the Agents perspective on whether
Agents should have rights to PHI.  I would really appreciate
your input on this.

Thank you.




Cathy Kiaha
Manager, Education and Communications
HIPAA PMO

PHONE:   (818) 234-3154
FAX:     (818) 234-3841
E-MAIL:  [EMAIL PROTECTED] 

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