Hi Kathy:

Long time no speak! Hope you are well.

Interesting FAQ. Don't you wish these examples had some more specifics?
Anyhow, believe it or not, there are insurance companies that would
certainly qualify as health plans, that do subcontract claims processing
to TPAs. I can easily see enrollment and premium data going from an
employer group to the insurance company and enrollment data going on
from the insurance company to the TPA. That seems to be one application
that fits the answer to this FAQ.  Based on different arrangements for
claims funding and payment and other "deals" between plan and TPA there
may be additional real world situations where the answer to this FAQ
might make sense. Would prefer to know what HHS had in mind rather than
speculate like this.

Jim

-----Original Message-----
From: Bakich, Kathryn L. [mailto:[EMAIL PROTECTED]] 
Sent: Wednesday, October 17, 2001 6:22 AM
To: '[EMAIL PROTECTED]'
Subject: RE: Third Party Administrator's

Jim, I agree with you.  However, there is somewhat contradictory advice
coming out of the FAQs on the employer/TPA question.  Compare the two
FAQs
cited below.  The first FAQ says exactly what you said.  The second
includes
the following sentence:  

"This means that in cases where the health plan would be required to use
a
standard transaction within itself, the transaction would have to be
standard when conducted between the health plan and its TPA."

I can't explain this last sentence.  Any help?

http://aspe.os.dhhs.gov/admnsimp/q0041.htm
http://aspe.os.dhhs.gov/admnsimp/q0162.htm

Kathy Bakich
The Segal Company
Washington DC

-----Original Message-----
From: Jim Moynihan [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, October 16, 2001 6:52 PM
To: [EMAIL PROTECTED]
Subject: RE: Third Party Administrator's


Hi Cindy:

1) It will be interesting to hear the responses of others to this first
question. As an employer you are not a covered entity with regard to
HIPAA and Workers Compensation "plans" are not qualified health plans
and not covered by HIPAA. Given this scenario you might have a problem
obtaining HIPAA language in your contracts.

2) If you are self-insured your TPA must support HIPAA transactions or
your plan may be subject to fines. This is a "business associate"
relationship. Most of the transactions they will have to support connect
them to providers for EDI claims processing. As an employer you might
want to communicate with the TPA via the enrollment standard (834) but
you do not have to use it as an employer. The 834 contains many features
not in the HIPAA Implementation Guides to connect your organization to
many different benefit administrators. 

Are you thinking of any other information exchanges between you and the
TPA? These would include stop loss premiums, claims funding and payment,
stop loss claims submission and payment, etc. There was a Medical Stop
Loss Work Group for 2 years at x12 that adapted the standards for
employers, TPAs and Stop Loss Carriers but much of that work did not
make it into the HIPAA Implementation Guidelines. Marcia McLure and I
co-chaired that committee which did its work in the mid-nineties. Few
TPAs were willing to step up to the plate at that time. Nonetheless the
standards were changed to do what needs to be done should you wish to
adopt them. Good luck.

Jim Moynihan
McLure-Moynihan, Inc.
28720 Canwood Street Suite 208 
Agoura Hills, CA. 91301



-----Original Message-----
From: Cindy Nielsen [mailto:[EMAIL PROTECTED]] 
Sent: Tuesday, October 16, 2001 1:40 PM
To: [EMAIL PROTECTED]
Subject: Third Party Administrator's

As a provider of LTC, we fall under the "covered entity" description in
the HIPAA regs.  Obviously we have to be compliant with the Transactions
Standards for 837's and 835's, but I am uncertain about the below two
scenerios that deal with employee comp claims and benefits plans.

1. Some of our centers have TPA's that handle our workmens' comp claims.
Are we required to have something in our contract with them that
references HIPAA compliant verbiage. ( This more than likely deals more
with the privacy regulation).  

2.  We are self-insured but contract with a TPA to administer our
employee benefits program.  Does our contract with them need to
reference HIPAA verbiage?  When we transmit info to and from our TPA
that contain this benefit info do we need to transmit it the appropriate
ANSI X12 format or do the Transaction Standards not apply in this
situation?

Any assistance you can provide would be helpful.

Cindy M. Nielsen
Department Director, Information Security
Good Samaritan Central Office
Phone: 605-362-3252
Fax: 605-362-3991
email [EMAIL PROTECTED]





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