RE: Onsite Employer clinic impacts when the employer is a coveredentity health plan

[White, Karen]

Title: Message

Even thought the health plan is a covered entity, the employer who sponsors the plan is not a covered entity.  The people who work for the employer who help administer the plan have special rules to follow in their position of plan sponsor, but they aren't a covered entity and neither is the employer.  There must be a firewall between the plan administration staff and other staff or of other functions of this staff.  The clinic is sponsored by the employer - not the health plan.   Karen H. White Vice President Medstat Phone:  734-913-3496 Fax:  734-913-3338 E-mail:  [EMAIL PROTECTED]   -----Original Message----- From: Tucci-Kaufhold, Ruth A. [mailto:[EMAIL PROTECTED] Sent: Thursday, March 27, 2003 9:35 AM To: WEDI SNIP Privacy Workgroup List Subject: RE: Onsite Employer clinic impacts when the employer is a covered entity health plan   "... self-funded, self-administered ERISA plan..." ===> this is defined as a health plan in the transactions rule ... therefore a Covered Entity.   "...Clinic Staff Members" ===> are they licensed, providers of healthcare services as defined by the Rules?  If so, then they are "indirect" providers of healthcare services.    "...The data " is not provider or employer data ... it is "Patient Data" ... Personal Health Information (PHI).   Ruth Tucci-Kaufhold HIPAA Systems Analyst MAHI Co-Founder  UNISYS Corporation 4050 Innslake Drive Suite 202 Glen Allen, VA  23060 (804) 346-1138 (804) 935-1647 (fax) N246-1138 [EMAIL PROTECTED] -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Sent: Wednesday, March 26, 2003 8:53 PM To: WEDI SNIP Privacy Workgroup List Subject: RE: Onsite Employer clinic impacts when the employer is a covered entity health plan Is everyone in agreement that the clinics are not a covered function of this hybrid entity - assuming they are not covered health care providers in their own right (no electronic transactions) - it is also true that they provide direct treatment and are employees of a larger organization that is covered - is the logic that the health records the clinics maintain is not protected because their component is not covered?  Would the answer be different if the organization outsources the clinic function to physicians who are covered health care providers in a context aside from their activities for the employer at the clinic?  -----Original Message----- From: White, Karen [mailto:[EMAIL PROTECTED] Sent: Wednesday, March 26, 2003 5:29 PM To: WEDI SNIP Privacy Workgroup List Subject: RE: Onsite Employer clinic impacts when the employer is a covered entity health plan The clinics aren't "covered entities" because they are providers who do not submit any of the covered transactions electronically.  They also aren't a health plan; therefore they aren't covered.   Karen H. White Vice President Medstat http://www.medstat.com Phone:  734-913-3496 Fax:  734-913-3338 E-mail:  [EMAIL PROTECTED]   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Sent: Wednesday, March 26, 2003 4:15 PM To: WEDI SNIP Privacy Workgroup List Subject: Onsite Employer clinic impacts when the employer is a covered entity health plan   All,   Consider the following scenario:  an national manufacturing employer is a self-funded, self-administered ERISA plan maintaining onsite clinics at several plants.  The clinics submit no electronic standard transactions (e.g. claims), but restrict their administrative and treatment activities to pre-employment physicals, OSHA-related exams and first aid.  Records maintained are employer-related only (occupational health), not part of the health plan, and are shared with the plant safety officer only in the context of OSHA and worker's comp activities.  In this situation would clinic staff members be required to:   1.  Provide a copy of a HIPAA Privacy Notice and obtain good faith effort to obtain written acknowledgement to employees prior to any "treatment" activities.   Could the clinics take the position that all records are employment related, and therefore reasonably be allowed to:   2.  Eliminate all records maintained in the clinics from a designated record set - arguing that it is not "provider" but employer data (distinct from the DRS of the health plan), and not allowing employees access to these records under the 164.524 standard.   3.  On the same basis, not provide accounting of disclosures for releases of  OSHA-related information maintained at the clinics.   Please let me know your thoughts.   Warm regards,   Ned vanSise The Sentennial Group [EMAIL PROTECTED] 678.485.6709 (mobile) 888.322.4410 (toll free) 866.544.9450 (toll free facsimile)   The contents of this email are confidential.  Please do not forward without permission.  If you have receive this email in error, please destroy and notify the sender.   --- The WEDI SNIP listserv to which you are subscribed is not moderated. 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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 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