Friday, November 02, 2012


Following up on last Sunday's New York Times article, the Pittsburgh Post Gazette printed an article about the multi-state plans that will be offered in the state health insurance exchanges based on OPM contracts, similar to the FEHBP. The reporter observes that
Traditional insurers * * * would seem to have little incentive to assemble and sell a multistate plan when they can sell products in the exchanges directly.
"Many questions remain unanswered because the federal government has yet to issue the request for proposal that will outline the requirements" of the multistate plans, said Janice Maszle, spokeswoman for Highmark Inc., Pennsylvania's largest health insurer. "We do feel strongly that these plans must operate on a level playing field with the other qualified health plans on the exchanges, [which] will prevent adverse selection."
The Federal Times reports that "While insurers report a growing willingness of federal [employee health benefit plan] enrollees to tap into their systems to make use of their medical information, the size of the growth is mixed. It’s still small for most carriers, with the large majority of their federal membership still balking at using the health records system, even though electronic records advocates insist they offer widespread benefits to users."  The article does not mention that OPM's most recent initiative has been to require FEHB plans to offer their members "blue button" access to their electronic records. The Blue Button permits plan claim records to be readily imported into a personal health records program like Microsoft Healthvault or a spreadsheet. The FEHBlog thinks that this technology will be more useful when offered by a healthcare provider because the providers records directly deal with the member's health -- as opposed to payment for the member's health care. But experts have noted that while the medical community is getting accustomed to their brand new medical record systems, people sometimes need to fall back on their health insurance records, particularly in a pinch like "Superstorm" Sandy.

The FEHBlog has noted that the HHS Office for Civil Rights has been routinely slapping health care providers with $1.5 million fines under HIPAA when large volumes of electronic protected health information has been stolen. (Health plans are subject to these penalties as well but recently health care providers have been in the OCR bullseye.)  The FEHBlog took note of an U.S. Justice Department press release about a settlement with a check cashing company that failed to properly dispose of paper records containing confidential personal financial information subject to protection under the analogous Gramm-Leach-Bliley Act.
"A company that operates payday loan and check cashing stores in at least nine states has settled with the government over allegations that it violated federal regulations, the Justice Department announced today.   In April 2010, law enforcement officers retrieved boxes of intact consumer documents, including credit reports, from trash cans and dumpsters near four PLS Financial Services stores in the Chicago area.   The improper disposal of these documents led to an investigation by the Federal Trade Commission (FTC).  "
The company accepted a $101,500 fine. It's good advertising for shredding companies and a reminder to HIPAA covered entities including health plans about the need to shred documents containing personal health information. .

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