BrokerNetUSA -
[Cached Version]
Published on: 3/19/2001
Last Visited: 8/8/2001
Our members are very concerned , according to Nicole Allen , director of government affairs for the Washingtonbased Council.They don't know how the rules will affect their group health insurance business and their ability to shop policies and provide solutions..
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The problem , Ms. Allen said , is that the HHS privacy regulations , which were mandated by the Health Insurance Portability and Accountability Act , were not written with intermediaries in mind.
Moreover , she said , many of the practical problems with the regulations probably will not emerge until insurance brokers have had to spend some time living under them.Therefore , Ms. Allen said , it is not fully clear yet what type of clarification will be needed.
The HIPAA privacy regulations , she noted , will not take effect until April 14 , 2003.However , according to Ms. Allen , brokers need to begin working immediately on setting up compliance systems.
One issue facing brokers , she said , is an administrative requirement that all covered entities must designate someone to serve as a privacy compliance officer responsible for receiving complaints and inquiries about privacy policies and practices.Currently , Ms. Allen said , most brokers do not designate anyone as the privacy compliance officer.
In addition , she noted , the regulations limit disclosure of information for certain legitimate purposes , such as claims and billing , to the minimum necessary to accomplish the purpose.However , Ms. Allen said , the term minimum necessary is very fuzzy.Brokers could face problems tracking claims , she suggested.Perhaps an even more significant issue facing brokers involves multiple recordkeeping , according to Ms. Allen.
The regulations exclude certain types of insurance from its scope , including workers' compensation , life , disability , auto , property-casualty and most types of reinsurance , she said.However , this forces brokers to set up two recordkeeping systems for health-related information , Ms. Allen said-one for health plans and the other for these excluded lines.
Moreover , she said , this could put brokers in a conflicted position involving health information.Suppose , Ms. Allen said , an individual who had a heart attack does not reveal this fact on an application for life or disability insurance.The broker , she said , is barred from transferring the information from the HIPAA covered line to the excluded lines.
But what is the broker's fiduciary duty to the life or disability insurer if the broker knows that the application is false , Ms. Allen asked.Segregating HIPAAcovered information from other healthrelated information will create conflicts for brokers , she predicted.
Ms. Allen said that brokers will also have to comply with notice requirements under the HIPAA regulations that differ from the notice requirements under the Gramm-Leach-Bliley Financial Services Modernization Act.Brokers , she said , will have to keep in mind what type of notice is required for what purpose.
Ms. Allen said that some type of harmonization of the different privacy requirements is needed.Insurance brokers , she said , help consumers by facilitating these transactions.
Without some type of guidance , Ms. Allen said , brokers will have greater difficulty providing the services that consumers expect and deserve.
Copyright National Underwriter Company Aug 6 , 2001