First let me say I have been on the provider side career wise more so than
the payer side but...

Other than demographic PHI why would the payer need to release my clinical
PHI to an agent and could this use/disclosure pass the minimum necessary
test.  I can see me the patient discussing PMH with an agent during an
enrollment/purchasing discussion.  That would be totally different situation
since the patient is the one releasing/disclosing the PHI about themselves.


Eddie G. Anderson
204 Blue Crab Cove
Emerald Isle, NC 28594
Phone 252-354-5111
Fax 866-286-8038
email [EMAIL PROTECTED]


-----Original Message-----
From: Langer, Judi [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, March 27, 2002 1:44 PM
To: [EMAIL PROTECTED]
Subject: RE: Agent's Rights to PHI


Many of you are interested in CIAB's argument, so I'm posting it to the
list. The actual paper was sent to me via hardcopy by a colleague who works
for a brokerage. I couldn't access it electronically since I am not a member
of CIAB. It is supposed to be posted on their website. Should you happen to
be a member, the CIAB website URL is:  http://www.ciab.com/index.jsp

Their argument, which consists of barely half a page in the paper, goes like
this:

1.  The definition of "health plan" includes a "health insurance issuer."
160.103.

2.  The definition of "health insurance issuer" includes an "insurance
service or insurance organization . . . that is licensed to engage in the
business of insurance in a state and is subject to state law that regulates
insurance."  160.103.

3.  Agents and brokers are either "insurance service" or "insurance
organizations" that are subject to state law.

4.  Hence, agents and brokers are "health plans," and therefore covered
entities under the HIPAA Privacy Rules.

In their analysis, they skip over the element of "licensed to engage in the
business of insurance." Obviously, there is a difference under state law
between having a license to MARKET insurance lines, and having a license to
ISSUE insurance lines. The term itself, "health insurance issuer" connotes
*issuing*, not marketing, insurance.

I'm of the opinion that if DHHS intended to include agents/brokers/producers
as covered health plans, then at the very least, somewhere in the Preamble
they would have made mention of that.  I haven't seen it.

It puzzles me why agents would want to assume a legal duty that is not
clearly theirs under the HIPAA Privacy Rules.  My colleague explained it as
"wanting to do things right." I'm not sure she knows what she is getting
herself in for!


Judith A. Langer, Attorney
HIPAA Project Director
Legal Department
Cobalt Corporation


-----Original Message-----
From: Langer, Judi [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, March 27, 2002 8:37 AM
To: [EMAIL PROTECTED]
Subject: RE: Agent's Rights to PHI


We have analyzed it the way Beth has.

Regarding the perspective of agent trade organizations, I have a paper from
the Council of Independent Agents and Brokers that is of the opinion that
agents/brokers/producers are actually covered entities (health plans).  If
anyone on the list is interested, I will summarize their argument.  I do not
agree with their analysis.  I have not yet found out what position NAHU
takes.


Judith A. Langer, Attorney
HIPAA Project Director
Cobalt Corporation (Blue Cross & Blue Shield United of Wisconsin)



-----Original Message-----
From: Beth Kranda [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, March 27, 2002 8:16 AM
To: [EMAIL PROTECTED]
Cc: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Re: Agent's Rights to PHI


There is a position paper present in the Privacy Policies & Procedures
whitepaper on Brokers and Agents.
I agree with Bill - that Agent is either
1 - a Business Associate of the Health Plan subject to the rights and
restrictions in his BA contract with me
2 - a Business Associate of the Employer/ERISA Plan subject to the same
restrictions as that Employer
3 - none of the above and has no rights unless I have an Authorization or
Personal Representative Form on file from the member.

-Beth Kranda

Bill Bernath wrote:

> 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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