HEALTH PLAN WEEK is reporting is this week’s issue that health plans could face stiff penalties under HIPAA if they use enrollment information to contact members without their permission and urge them to join grassroots advocacy campaigns or take a stance on a political issue.
As a case in point the article cites a September incident where Humana Inc. pulled 900,000 names and addresses from its Medicare Advantage database and sent those beneficiaries letters recommending that they fight against proposed “significant cuts” to the MA program. CMS ordered Humana to cease all such mailings, which it says violated the health insurer’s Medicare contract. CMS also says the letters might have violated HIPAA, and asked the HHS Office for Civil Rights (OCR) to investigate
However, Jeff Drummond, a partner Dallas-based law firm, says Humana could defend the use of its enrollment data as falling into the HIPAA exemption for operations, contending this was an effort to communicate benefits information to its members, much like describing changes in a drug formulary, he tells HPW.
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