Kristen- We are a third party billing service for a facility in NY state that administers the HCBS waiver program along with Intensive Psych Rehab Treatment(IPRT), Medicaid Service (MSC)and Supported Employement (SE).
I spoke with NY State DOH and received the same answer, they (our client) are a CE under HIPAA. Just another input! ~Brenda Sorry. Its my experience your lawyer got it right. > > Chris Brancato > > -----Original Message----- > From: Kristen Emerson [mailto:[EMAIL PROTECTED]] > Sent: Thursday, January 09, 2003 12:53 PM > To: WEDI SNIP Privacy Workgroup List > Subject: Re: NPP and home & community-based waiver programs > > Our agency has received an outside legal opinion that we are a covered > entity. > > One of the main reasons is that our agency administers Medicaid Waiver > programs along with our other programs. > > It was determined that we provide health care services. > > "Health Care means preventive, diagnostic, therapeutic, rehabilitative, > maintenance, or palliative care, and counseling, service, assessment or > procedure with respect to the physical or mental condition, or functional > status, of an individual that affects the structure or function of the > body." > > We perform a comprehensive assessment on each client based on their mental, > and functional status, etc. We also provide case management which is cited > in the regulations as a health care service (Final Rule, 8/17/200 pg. > 50315), along with home health care services, medical transportation, > counseling, occupational therapy, etc. > > We transmit all client information electronically in our client tracking > system software, including encounter information, reporting of services for > payment by the state agency, enrollment, and to determine eligibility. > > I feel that our agency is definitely collecting personal health information > and transmitting it electronically based on the standard transactions. > Unfortunately I am not sure that HIPAA was meant to snag human service > agencies like mine into its grasp but with its very broad scope, I fear it > has. > > If anyone else out there can point me in a direction that says otherwise or > give me your opinion on this I would welcome it. > > Thanks in advance, > > Kristen Emerson > Management Analyst/HIPAA Compliance Officer > Mid-Florida Area Agency on Aging > > > > ----- Original Message ----- > From: Deanna S Mool <mailto:[EMAIL PROTECTED]> > To: 'Kristen Emerson' <mailto:[EMAIL PROTECTED]> > Sent: Thursday, January 09, 2003 11:03 AM > Subject: RE: NPP and home & community-based waiver programs > > I know Illinois is still struggling with whether the HCBW program is > covered. Have you determined that it is? > > -Deanna S. Mool > (Outside counsel State HIPAA project) > > -----Original Message----- > From: Kristen Emerson [mailto:[EMAIL PROTECTED]] > Sent: Wednesday, January 08, 2003 11:49 AM > To: WEDI SNIP Privacy Workgroup List > Subject: NPP and home & community-based waiver programs > > The agency I work for awards financial assistance to local service provider > agencies for the provision of direct services to older persons living in > mid-Florida. These local organizations translate state and federal monies > into tangible community-based services for older individuals. The process > that an older person may come into our system is described below. > > A case manager working for one of our lead agencies conducts a comprehensive > assessment of the clients needs and develops a care plan for each client. > The lead agency either provides the service directly or the case manager > contracts with a third-party for the service (example: home healthcare > agency). Upon delivery of the service, the entity which provided the > service will report services to our agency as a request for payment. Our > agency ultimately will pay for the cost of the service. With each client > there is usually a chain of subcontracts to provide them with their > services. > > My question is: > > Is the client entitled to the NPP from each provider? > > The first contact with the client will be the case manager for the lead > agency performing the assessment. I believe the NPP for the lead agency > must be provided at this point. > > Then the case manager creates the care plan and request services, lets say > home healthcare from ABC, Inc. ABC, Inc. goes out to the client and provides > the services. Do they need to provide their NPP before delivery of any > service? > > Ultimately they are entered into a client tracking system that we have > access to but since we do not directly provide services to them, I believe > we are just business associates and therefore the client does not need a > copy of our NPP. > > The big issue is that one client could have several different entities > providing them service based on their care plan. Would each separate entity > be required to provide their NPP to that client? > > I hope that what I am asking is clear and please let me know if > clarification is needed. > > Thanks in advance, > > Kristen Emerson > Management Analyst/HIPAA Compliance Officer > Mid-Florida Area Agency on Aging > > --- > 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 Brenda K. Burton MEDEXTEND 877-491-7650 Available on Instant Messenger as: medextend Please Note: This email is intended only for the person/entity as specifically addressed in the TO:,CC: or BCC: portion of the heading of this email as originally addressed from the domain 'medextend.com'. Opinions expressed herein are not a substitute for legal advisement or other professional advice. --- 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
