Commercial Litigation Blog

Does the Health Insurance Portability and Accountability Act (HIPAA) or Graham-Leach-Bliley Act (GLBA) make you apprehensive about sharing claims information with other carriers?  Consider these links below when evaluating whether or not to send claims documents and even medical records to another insurance carrier:

HIPPA
FAQ's - hhs.gov/hipaafaq/providers/covered/

The HIPAA Administrative Simplification regulations specifically exclude from the definition of a “health plan” any policy, plan, or program to the extent that it provides, or pays for the cost of, excepted benefits, which are listed in section 2791(c)(1) of the Public Health Service Act, 42 U.S.C. 300gg-91(c)(1). See 45 CFR 160.103. As described in the statute, excepted benefits are one or more (or any combination thereof) of the following policies, plans or programs:
•    Coverage only for accident, or disability income insurance, or any combination thereof.
•    Coverage issued as a supplement to liability insurance.
•    Liability insurance, including general liability insurance and automobile liability insurance.
•    Workers’ compensation or similar insurance.
•    Automobile medical payment insurance.
•    Credit-only insurance.
•    Coverage for on-site medical clinics
•    Other similar insurance coverage, specified in regulations, under which benefits for medical care are secondary or incidental to other insurance benefits.

GLBA

15 USC §6821 (e)  Non-applicability to insurance institutions for investigation of insurance fraud. ftc.gov/privacy/glbact/

No provision of this section shall be construed so as to prevent any insurance institution, or any officer, employee, or agency of an insurance institution, from obtaining information as part of an insurance investigation into criminal activity, fraud, material misrepresentation, or material nondisclosure that is authorized for such institution under State law, regulation, interpretation, or order.