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Relationship between PHI, HSAs and ARRA


Guest Ira Hayes
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Guest Ira Hayes

We know the stimulus bill allows individuals covered by group health plans (GHPs) who pay in full out-of-pocket for covered plan services to bar providers from disclosing PHI to the GHPs. Do these new restrictions apply if the source of funds for 100% payment is pre-tax (e.g., FSA, HRA, HSA or 401(k))?

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Where in which stimulus bill did you see this?

Since there is more than 1 healthcare reform bill, and no one knows what will eventuallly pass, if anything,, Why be concerned at this point about what is in a stimulus bill rather than a healthcare reform bill ?

George D. Burns

Cost Reduction Strategies

Burns and Associates, Inc

www.costreductionstrategies.com(under construction)

www.employeebenefitsstrategies.com(under construction)

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Considering that if the stimulus bill really says what you say that it does, it would/could create some serious problems for claims administrators etc. So I wonder why there have been no responses.

I have not been able to find any reference to what you stated, in any of the many reviews/commmentaries/newsletters/clent alerts etc that have been published by the law firms and other benennfits coonsultants. So I have to wonder if either they all overlooked it or it is just of no importance.

I have browsed through all 407 pages of ARRA and could find no mention of such an item.. Maybe I overloked it. Can you give a more precise cite ?

George D. Burns

Cost Reduction Strategies

Burns and Associates, Inc

www.costreductionstrategies.com(under construction)

www.employeebenefitsstrategies.com(under construction)

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Guest Ira Hayes
Considering that if the stimulus bill really says what you say that it does, it would/could create some serious problems for claims administrators etc. So I wonder why there have been no responses.

I have not been able to find any reference to what you stated, in any of the many reviews/commmentaries/newsletters/clent alerts etc that have been published by the law firms and other benennfits coonsultants. So I have to wonder if either they all overlooked it or it is just of no importance.

I have browsed through all 407 pages of ARRA and could find no mention of such an item.. Maybe I overloked it. Can you give a more precise cite ?

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Guest Ira Hayes

George, the ARRA citation is Division B (Other Provisions), Title IV (HITECH ACT), Subtitle D, Part I, Section 4405 (a)(2). Several law firms have picked up ot this including Faegre and Benson and Groom Law Group.

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Thanks. Now I see it.

It should create some difficult situations for both underwriting and claims. It seems that an individual could do a "run around" and hide either a pre-existing condition or a new catastrophic illness/disease until they have set the conditions in their favor. It appears that you could do something like hiding a HIV positive result by paying for the testing etc in full out-of-pocket and seal the results etc.

In response to your question, I would say that if employer funds are the source for the payment, then no. Which would then eliminate HRAs. For an employee funds only FSA, I doubt it because in order to satisfy section 125 etc, the employee funds are treated as employer funds. For an employee funds only HSA, I would have to research before opining. In all cases where there are both employee and employer funds, I would think no, because the comingling would make it impossible to separate.

I am surprised that more is not being made of the issue.

George D. Burns

Cost Reduction Strategies

Burns and Associates, Inc

www.costreductionstrategies.com(under construction)

www.employeebenefitsstrategies.com(under construction)

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