The building services industry has always had a commitment to maintaining the confidentiality of its clients.

The Health Insurance Portability and Accountability Act (HIPAA) will cause some corporations, especially health-care facilities, to increase their confidentiality requirements even more. For building service contractors, it means that conducting business with any health-related client will be more challenging, possibly resulting in increased employee training costs, rising liability insurance premiums, and changing cleaning procedures in the building.

What is HIPAA?
HIPAA has four primary objectives: administrative simplification; fraud and abuse reduction; health-insurance portability; and the protection of the privacy of health information.

To simplify administrative activities, the new HIPAA standards will require all doctors and hospitals to complete the same forms and formats. This will improve communication between all parties and save money. The new standards also reduce the opportunities for fraud and abuse, such as doctors or hospitals double-billing for rendered services. Fraud and abuse of the health-insurance system will diminish due to the new forms, processes and procedures set forth in the HIPAA regulations.

The health-insurance portability section of the act applies to group health plans and self-insured group health plans. The key provisions of this portion of HIPAA are guaranteed access to insurance for small businesses and guaranteed renewal of insurance.

Insurance companies that sell coverage to large business must now sell that coverage to all small businesses as well, and must include both full- and part-time personnel. Better still, coverage cannot be refused because of the health factors of your employees. However, there are still some situations where your company can be denied health coverage.

Guaranteed privacy
The Department of Health and Human Services (DHHS) recently implemented the final portion of the HIPAA — privacy and security. The DHHS realized the importance of the confidentiality of patient information and of patient rights to the access and use of that information. These federal regulations were enacted by Congress to give private individuals more control over their own health information.

HIPAA enacts limitations on the use of a patient’s private health information. It gives patients more control of the use and disclosure of their information. It establishes limitations on the use, storage and release of healthcare records. It enacts safeguards to protect private health information and holds violators accountable for those violations of the privacy rights.

Serving medical clients
Clinics, insurance companies, billing centers and doctors may limit access to areas where medical records are stored or being worked on. Depending on how the businesses and their legal departments interpret HIPAA privacy regulations, they may specify certain hours that areas may be cleaned so that their staff is present to ensure confidentiality of documents, or they may forbid access entirely.

A BSC’s medical clients may ask them to sign confidentiality agreements requiring any information that is identifiable not be disclosed to other parties, and may require background checks for employees that may come into contact with protected health information.

Information or documents that contain protected health information cannot be disposed of with the regular trash, so disposal methods may be changed. Many companies are shredding documents once just thrown in the trash or using special secured disposal boxes for documents that contain identifiable information. These boxes are locked and their contents picked up by companies specializing in secured-document destruction.

Companies face very large fines for disclosing protected health information. They can also be barred from doing business with Medicare; the latter can be the death knell for a medical provider.

Unfortunately, it is quite likely that general liability insurance costs for those businesses servicing the healthcare industry will rise to cover any perceived risks and clients may request increased limits of liability when working at their facilities. Eventually, medical customers might make requests for issuance of insurance policies that are designed specifically for HIPAA.

How HIPAA affects employees
When offering group health plans for your employees, the insurance companies must give you information about their right to change premium rates, coverage renewal, exclusions, pre-existing conditions and their service areas. This information should help you in determining the best policy for your company.

There are multitudes of new non-discrimination rules that apply to group-health-plan issuers. Now, health factors cannot be used to discriminate between individuals in the group plan. Enrollment cannot be denied based on health or previous health-care costs, although eligibility may be based on legitimate job classifications or hours worked.

In other words, if you meet the health plan’s eligibility requirements, you must be allowed to enroll. Health factors cannot be used to determine individual group health plan premiums, but factors such as age, gender or geographic location may be used for determination of premiums. Also, if a group health plan does not have a policy of applying pre-existing-condition exclusion to all of its members, then exclusion cannot be applied to your coverage. You cannot be charged higher premiums for your coverage for a chronic illness. Enrollment cannot be based on passing a physical.

One important factor in the act is that Worker’s Compensation is not covered under HIPAA; thus, these medical records are not considered privileged. The privacy rule permits covered entities to disclose protected health information to workers’ compensation insurers, employers, and other persons or entities involved in workers’ compensation systems, without the individual’s authorization.

Your responsibilities
HIPAA does not require businesses to offer a health plans to its employees, nor does it regulate benefits, but if your company does offer a health plan, it must comply with all HIPAA requirements. If you have a group health plan and discontinue it and offer individual policies instead, HIPAA considers you to still be sponsoring a group health plan. You cannot discriminate against an individual based on his or her health and cannot deny an individual policy based on that.

The Health Insurance Portability and Accountability Act of 1996 affects every business, every industry, every individual in America, and its full effect may not be felt for years. Overall, HIPAA gives the consumers more control of their confidential medical records and the right not to be penalized for pre-existing conditions. But, professional service providers, we will be held more responsible and liable with our medical customers and may have to adjust work schedules.

Richard M. Heeth, B.S., LP, CCEMT-P, NREMT-P, DMT-A, CHT, CFP, is a critical care and flight paramedic in Dallas, and has a safety consulting firm, Heeth & Associates, Inc. Richard is a member of the National Association of Safety Professionals and the Air Medical Physicians Association.

This article was co-authored with Dannette Young Heeth of Building Contractors, Inc., a national service provider with headquarters in Dallas. Dannette is a 25-year veteran in the building services industry.




POSTED ON: 8/1/2003