To any one on the listserv who works for a Health Plan that has or is going
through NCQA accreditation under the 2001 Standards:
 
We are going through our review in September of this year.  Standard RR5 is
essentially a major part of HIPAA privacy regulation.  Standard RR5 has
pulled many of the HIPAA privacy requirements together and called them the
NCQA privacy guidelines.  We are in good shape for implementing almost all
of the NCQA requirements for Privacy except one of them, RR5.6 which NCQA
calls "Special Consents."  NCQA says we need a policy that covers special
consents from members who have sensitive conditions, like HIV/Aids, if we
need to use or disclose any PHI on those members. 
 
We feel our policy on Authorizations (as HIPAA calls them) covers this
requirement, but the mock reviewer we had says it has to be a completely
separate policy.  If anyone else out there is being reviewed for these same
2001 standards, would you mind sharing your policy?  We are not happy with
any drafts we've been able to come up with (and we have made sure to
research our state laws on sensitive medical conditions, - that avenue
didn't help us much.)
 
 

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