Welfare Plans Edition
December 27 and 28, 2000
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HHS Publishes Final HIPAA Privacy Regs in Federal Register
Excerpt: "The new standards: limit the non-consensual use and release of private health information; give patients new rights to access their medical records and to know who else has accessed them; restrict most disclosure of health information to the minimum needed for the intended purpose; establish new criminal and civil sanctions for improper use or disclosure; and establish new requirements for access to records by researchers and others." (U.S. Department of Health and Human Services)
Old Before Its Time: HIPAA, and E-Health Policy (PDF)
November/December 2000 issue. Excerpt: "The cornerstone of federal policy on information technology (IT) in health care is an ambitious law that by a twist of fate was conceived just before network computing and the World Wide Web revealed themselves as the building blocks of a new electronic marketplace. As a result, federal policy making remains locked in a framework that does not properly fit the realities of current IT ..." (Rob Cunningham in Health Affairs)
E-Health, HIPAA, and Beyond (PDF)
November/December 2000 issue. Excerpt: "The chair of the expert advisory board on health data outlines the most important issues in developing a secure health information system." (John R. Lumpkin in Health Affairs)
Virtually Exposed: Privacy and E-Health (PDF)
November/December 2000 issue. Excerpt: "The United States is embroiled in a long-standing, contentious debate over how and to what extent individual privacy should be protected in the health care arena. Against this backdrop e-health enters the fray, bringing with it a universe of undefined, unregulated ventures. This paper addresses consumer-focused Internet services-- that is, services that target consumers who are accessing information and services." (Janlori Goldman and Zoe Hudson in Health Affairs)
E-Health: Technology Revolution Meets Regulatory Constraints (PDF)
November/December 2000 issue. Excerpt: "An Internet-driven heal th system poses new challenges for an area already thick with regulations." (Bruce Merlin Fried, Gadi Weinreich, Gina M. Cavalier, and Kathleen J. Lester in Health Affairs)
Vaporware.com: The Failed Promise Of The Health Care Internet (PDF)
November/December 2000 issue. Excerpt: "[T]he Internet will not solve the administrative redundancies, economic inefficiencies, or quality problems ... These phenomena are the result of economic, organizational, legal, regulatory, and cultural conflicts rooted in a health care system grown from hybrid public and private financing; cultural expectations of unlimited access to unlimited medical resources; and the use of third-party payers rewarded to constrain those expectations." (J.D. Kleinke, in Health Affairs)
The Internet and Managed Care: A New Wave of Innovation (PDF)
November/December 2000 issue. Excerpt: "[Internet-based] tools may enable new firms or employers to create custom-designed networks connecting their workers and providers, bypassing health plans altogether. Alternatively, health plans may use these tools to create a new consumer-focused business model.... Network computing may provide important leverage for health plans not only to retain their franchises but also to improve their profitability and customer service." (Jeff Goldsmith, in Health Affairs)
Health Care Reform And The New Economy (PDF)
November/December 2000 issue. Excerpt: "In a high-growth context, proponents of reform may no longer feel obliged to bundle expanded coverage with tighter cost containment. At the same time, the new digital environment may facilitate innovations intended to inform and expand consumer choice and to improve quality. The new environment elevates 'transparency' to a guiding principle. Health informatics has long been peripheral to reform and must now become more central." (Paul Starr, in Health Affairs)
What must be offered under COBRA if employee drops spouse "in anticipation" of a qualifying event?
Interesting discussion on our message boards. Join in! (BenefitsBoards.net)
DOL Issues National Medical Support Notice for Use by State Agencies as QMCSO (PDF)
Excerpt: "National Medical Support Notice to be issued by State agencies as a means of enforcing the health care coverage provisions in a child support order, and to be treated by plan administrators of group health plans as a qualified medical child support order.... This rule will affect group health plans, participants in group health plans, noncustodial children of such participants, and State agencies that administer child support enforcement programs." (U.S. Department of Labor)
DOL Makeover for Health Benefit Plans' Claims Procedures and Summary Plan Descriptions
Excerpt: "Compared to the current rules, the new rules require (a) greater disclosure to participants of plan claims procedures and provision to claimants of the complete and specific reasons for any claim denials and all information relevant to such denials; (b) more procedures intended to assure fair treatment of claimants and (c) faster decisions on both initial claims and appeals of denied claims." (McDermott, Will & Emery)
(Following also appears in Retirement Plans Edition)
Human Resources IT Roadmap
Excerpt: "Following is an overview of the types of HR applications with the greatest benefit for mid-sized businesses, along with a guide to vendors and service providers (see Appendix) that offer [HR software] tools: ..." (AccountingWeb)
State of the TPA Industry, and Forecast for the Future
Excerpt: "For 21 years, it has become a tradition for me to give a candid report on how the TPA & benefits industry looks, and forecast for the upcoming year(s). My 'expertise' is simply that the SPBA office serves as the central information clearinghouse for the industry (and TPAs themselves tend to be information clearinghouses in their market areas), so my knowledge is simply wisdom from you." (Society of Professional Benefit Administrators)
Companies Quietly Use Mergers, Spinoffs To Cut Worker Benefits
Excerpt: "GE is just one of many major companies that have cut employee benefits in connection with mergers and other deals. Mergers often lead to more visible forms of pain for employees, such as layoffs and plant closings. But when it comes to benefit cuts, workers and retirees often don't even realize they are happening because the language of pension and medical plans can be arcane and some companies tend to shroud benefit reductions in euphemism." (MSNBC.com)
| Pension Specialist II | for American Century Investments in MO |
| Pension Specialist I | for American Century Investments in MO |
| Conversion Manager | for Benefit Plan Services, Inc. in GA |
| 401(k) Administrator | for Warren, Averett, Kimbrough & Marino, LLC in AL |
| DC PLAN ADMINISTRATOR | for Third Party Administrators, Inc. in NH |
| Employee Benefits Consultant | for Employee Benefits Brokerage/Consulting Firm in NY |
| Relationship Manager - Total Benefits Outsourcing Large Plan Services (LPS) | for Fidelity Investments in MA |
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