U.S. Benefits Group Fifth National HIPAA Summit A Case Study in Employer HIPAA Privacy Compliance Approaches Fred J. Thiele, JD, MBA Legal Compliance Manager.

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Presentation transcript:

U.S. Benefits Group Fifth National HIPAA Summit A Case Study in Employer HIPAA Privacy Compliance Approaches Fred J. Thiele, JD, MBA Legal Compliance Manager U.S. Benefits Group Intel Corporation Chandler, AZ November 1, 2002

U.S. Benefits Group Page 2 11/1/02 Employer Case Study – Intel ® Intel is “covered entity” under HIPAA regs by virtue of fact that it maintains a self- funded group health plan Cross-functional HIPAA privacy compliance team assembled in January 2002 –Representatives from Benefits Design/Ops, Call Center, HRD, Occ Health, Gen. Acctg., HR Legal –Coordination with other corporate privacy initiatives (e.g., SSN) –Trained in basic “ins and outs” of HIPAA privacy

U.S. Benefits Group Page 3 11/1/02 Employer Case Study – Intel ® First task: Root out all uses or disclosures of “individually identifiable health information” in company –Accomplished via comprehensive information inventory conducted by team Aggregate inventory subjected to two tests for classification purposes: –“Protected Health Info.” vs. Non-PHI LOA, STD/LTD, and “de-identified” or “summary health” items fell out as non-PHI –“Treatment, Payment, H/C Ops” vs. Non-TPO All PHI items at Intel were TPO, which is favored over non-TPO and thus has fewer restrictions

U.S. Benefits Group Page 4 11/1/02 Employer Case Study – Intel ® Inventory turned up 10 unique uses and disclosures of PHI –Drafted compliant internal guidelines/procedures tailored to these uses and disclosures Applying “minimum necessary” and proper safeguards Good news is that business disruption will be minimal since company already does fine job honoring privacy Group health plan documents and supplier contracts revised as required –Amended plan documents to allow plan sponsor access to PHI (Sec (f)) –Implemented “business associate” (BA) agreements with outside suppliers Corp. Purchasing negotiated model HHS language into new/existing supplier contracts

U.S. Benefits Group Page 5 11/1/02 Employer Case Study – Intel ® Key tasks remaining on roadway to compliance... –Designation of privacy official –Execution of training and communication plans Training for Benefits Ops, Call Center Privacy notice distribution; revision of employee handbook (SPD), Call Center scripting –Quality Assurance Final review of all relevant HHS regs/guidance against compliance processes leading up to 4/14/03

U.S. Benefits Group Page 6 11/1/02 Employer Case Study – Intel ® Biggest challenges throughout project: –Seizing upon ERISA preemption to shield company from any stronger state privacy regs –Possible independent CE status of Occ Health under “health care provider” definition in regs –Differentiating “consents” from “authorizations” Final regs render former almost irrelevant –Understanding shifting concept of “marketing” so as not to get tangled in its grasp Company wanted to ensure that popular disease management and wellness initiatives didn’t cross line

U.S. Benefits Group Page 7 11/1/02 HIPAA Privacy Compliance Project High Level Project Timeline Ongoing Review of HHS Regs and Guidance Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr Team Org. Analysis Compliance Plan Design Guideline Preparation Plan Docs Amendment Implementation Training Communications QA Compliance Date (4/14/03) We are here