Re: Self insured health plans NPP
Without going into a lot of discussion about the difference between the plan sponsor and plan administrator activities, the plan administrator is responsible for this. If you are also the plan administrator, than you have both responsibilities. Your SPD should state who is the plan administrator for easy reference. [EMAIL PROTECTED] 03/13/03 07:40AM We are an acute care hospital providing health insurance to our employees as a self-insured plan. As the plan sponsor we are required to amend our group health plan document to comply with HIPAA. Are we also responsible for drafting and providing to our employees a Notice of Privacy Practice, or is that the responsibility of the health plan? Bonnie R Millman Privacy Coordinator Bayhealth Medical Center 640 South State Street Dover, Delaware 19901 302-744-6728 __ CONFIDENTIALITY NOTICE: The information contained in this e-mail message and any attachment(s) is intended only for the confidential use of the intended recipient(s) named above. This e-mail message and any attachment(s) may contain confidential health information or other confidential information that is legally privileged and exempt from disclosure under applicable law. If the reader of this e-mail message is not the intended recipient or the employee agent responsible for delivering it to the intended recipient, you should be aware that any dissemination, distribution, copying or action taken in reliance on the content of this e-mail message or any attachment(s) is strictly prohibited. If this e-mail has been received in error, please notify us immediately via e-mail at [EMAIL PROTECTED] and delete or otherwise destroy the original message, any attachment(s) and copies. Thank you for your cooperation. --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
RE: Minimum necessary
A live person on the phone is not limited to what can be provided in a 271 response or a 277 or any other HIPAA required response. Talking to a person on the phone is not considered the use of electronic media, as defined by 162.103. Direct Data Entry, which is the subject of the limitation to which you are referring, cannot have incentives for its use (See 196.925(4)). A prohibition on incentives for other modes of electronic media communications are what is intended, not limiting the usefulness of picking up a phone and trying to get a situation resolved by speaking to a live person. Schmidt, Lee M [EMAIL PROTECTED] 03/05/03 04:26PM Assuming the inquiry was through a phone call and that the HMO Client were covered entities, the phone rep should provide the same level of benefit information made available through the 271 response and any HMO eligibility web applications to which the provider has access. In short, there can be no incentive for the provider to use one mode of inquiry over another which means all avenues of disseminating eligibility information must provide the same level of detail. Understand that the 271 does provide comprehensive benefit information, but at this time the government regulates that the minimum response to an eligibility inquiry is a yes/no. Thanks, Lee M. Schmidt Magellan Behavioral Health HIPAA / I.T. Project Manager, Claims Applications Local: (314) 387-5445 Toll Free (St. Louis): 1-800-450-7281 ext: 75445 New Cell: (314) 960-0964 Fax: 314-387-5655 or 314-292-1120 (Electronic) E-Mail: [EMAIL PROTECTED] mailto:[EMAIL PROTECTED] -Original Message- From: Jonathan Fox [mailto:[EMAIL PROTECTED] Sent: Wednesday, March 05, 2003 1:04 PM To: WEDI SNIP Privacy Workgroup List Subject: Minimum necessary Now that Privacy is right around the corner, a lot of people are re-examining some of the Transactions work that has been done. Here is a question that has privacy (minimum necessary) implications. A provider performs an eligibility inquiry with their local HMO. The HMO responds with yes the member is eligible and here is a list of their benefits. Clearly, the minimum requirements of the functionality of the transaction have been met, but how far can a payer go in giving additional information (COB, HIC number, Group Number, Plan Number, etc, before you cross the minimum necessary (privacy) line. Certainly, many of these pieces of information are not needed to get a claim paid by that payer. Is it the responsibility of the payer and/or is it within their right to divulge information about other policies they may have. This is not a question about transaction functionality, as the transaction clearly accommodates this data, but there seems to be a slight contradiction with the minimum necessary clause of the Privacy rule. Thoughts please??? Jonathan Fox Independent Health --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which
RE: acknowledgement of Notice of Privacy Practices (NPP)
Just wanted to add for some of those who aren't knee-deep in HIPAA that the acknowledgment requirement discussion is a health care provider issue. For health plans the acknowledgment requirement in 164.520(c)(2) is not applicable. Health plans should be able to satisfy their notice requirement via normal first class mail; just like mailing SPD's, COBRA notices, etc. Patricia Hamby [EMAIL PROTECTED] 02/17/03 04:29PM Would this maybe fall under reasonable and may depend upon the size of the CE? Great question. Interested to see what others have to say. Patricia Hamby HIPAA Compliance Project Manager XANTUS Healthplan of Tennessee, Inc. (615) 463-1612, Office (615) 279-1301, Facsimile http://www.xantushealthplan.com/hipaa/page3.html -Original Message- From: Noel Chang [mailto:[EMAIL PROTECTED]] Sent: Monday, February 17, 2003 3:35 PM To: WEDI SNIP Privacy Workgroup List Subject: Re: acknowledgement of Notice of Privacy Practices (NPP) I haven't taken the time to research this enough to cite any references in support of my position, but my initial reaction is that just mailing the NPP is not adequate to make a good faith effort. The requirement is that you make a good faith effort to obtain written acknowledgment of their receipt of the NPP. If all you do is mail the NPP, what have to done to try and document they received it? If you have a return form for the patient to send back I guess you can then argue that you did do something to try and obtain their acknowledgment but is just a form with no return envelope or postage a good faith effort? I'd say no but that is just my opinion. Even if you included a return envelope and postage I don't know that I would consider that a good faith effort. The Rule says you have to distribute the notice by the first delivery of service. For the moment lets ignore electronic delivery of service or of the NPP. That aside, if you only have to deliver the notice the first time the individual physically sets foot in your facility, how hard is it to get someone to hand them a couple of sheets of paper and sign an acknowledgment? Keep in mind the acknowledgment is just that they RECEIVED the Notice. Not that they read it, not that they understand it. You can hand it to them, they can through it in the trash (hopefully a recycling bin so you can use it on the next patient), and you can still ask them to sign a statement that says they RECEIVED the Notice. Unless you are one of the rare entities that have implemented a truly paperless patient record system, you have a paper chart for every patient. Someone in your facility is probably handling that chart when the patient comes in. If the reception of patients into your facility is not centralized so you cannot hand out the forms at one patient check-in desk, then perhaps you need to de-centralize the distribution of the NPP. Whoever sees the patient needs to look at the chart and determine if the patient has received an NPP or if they need to be given one. One thing I am doing with some clients is implementing an NPP Receipt Acknowledgment form that is on a distinct color paper so you can immediately recognize whether or not there is an acknowledgment form in the chart. Remember you only need to get their acknowledgment once, even if you subsequently revise the Notice, so there is no need to look at the acknowledgment to see when they signed it, what version of the NPP they were given, or anything else. Just glance at the chart to see if there is a fuscia piece of paper (or whatever unique color you prefer). If there isn't, ask them to sign an acknowledgment form as you hand them a copy of your NPP. I work only with small group practices and solo practitioners so I'm sure there are issues for larger players, asside from pure volume of patients, that I have not had to consider. I have to admit though, I never thought the requirement to distribute the NPP and obtain an acknowledgment would require any additional resources like part time employees. Noel Chang Noel Chang -- Open WebMail Project (http://openwebmail.org) -- Original Message --- From: [EMAIL PROTECTED] To: WEDI SNIP Privacy Workgroup List [EMAIL PROTECTED] Sent: Mon, 17 Feb 2003 14:27:30 -0500 Subject: acknowledgement of Notice of Privacy Practices (NPP) On April 15, 2003, we are anticipating that we simply do not have the staff available to supply all patients that walk in our door with our NPP. It's hard to find someone to do a job like this for only 3-4 months! We plan to hire college students to accomplish this task when school let outs in May. Nevertheless, in order to be compliant with the April 15, 2003 deadline, is it acceptable to mail out our NPP to scheduled patients ahead of time? Is the fact that we are mailing them out (and let's say we can keep track of who got SENT one) sufficient in itself to meet the requirement of a
