Corporate Wellness Blog

As scary as they seem at first glance, complying with HIPAA’s privacy rules may be relatively painless.

Contrary to common belief, the rules – with a few key exceptions – apply only to a fraction of the medical information Benefits handles.

As long as the organization remains legally “hands off” of employee’s private health information, you can dodge most of the HIPAA bullet.

For HIPAA privacy purposes, your firm is considered “hands off” even when you obtain de-identified personal information, aggregate claims data and routine enrollment info.

Bottom line – If your organization’s heath plans are fully insured and the claims administered through a TPA, the insurance company – not your firm – bears the brunt of the HIPAA privacy compliance responsibility.

One major exception –  medical cafeteria plans. In most cases, you’ve two compliance options –

• Process reimbursement requests first through your TPA, with the TPA making sure the claim qualifies under the terms of the cafeteria plan before your firm reimburses it, or

• Create a written cafeteria plan privacy policy, issue a notice to workforce, appoint a privacy officer and amend your plan documents.

Rarely affects FMLA

Many people  - including health care providers – misunderstand how health insurance portability and accountability act (HIPAA) affects medical certifications for FMLA leave.  The key – health insurance portability and accountability act (HIPAA) only applies to personal information that filters through your health plan, not certifications obtained from a doctor.

Under FMLA, you’re allowed to obtain the minimum information you need to approve and administer leave. In like fashion, HIPAA doesn’t apply to most workers’ comp, return-to-work notices or disability claims.

Even so, it pays to be cautious how you ask for and use the information. Other state and federal privacy laws often protect the same types of info people  assume falls under health insurance portability and accountability act (HIPAA).

Following procedures

The health insurance portability and accountability act (HIPAA) privacy rules are heavy on paperwork and procedure.

But as long as your firm follows  the info-gathering process spelled out in your health plan documents, the HIPAA privacy rules should present few major obstacles.