Tim McGuinness of "HIPAA Help Now" wrote that "...an auto insurance carrier providing PIP coverage would still be a covered entity...," but expressed a desire to see any statement from DHHS or OCR to the contrary.
Tim, take a closer look at the definition of "health plan," section 160.103, which says, in part: "(2) Health plan excludes: (i) Any policy, plan, or program to the extent that it provides, or pays for the cost of, excepted benefits that are listed in section 2791(c)(1) of the PHS Act, 42 U.S.C. 300gg�91(c)(1)..." Now you have to do some homework and look up the reference to 42 USC 300gg-91(c)(1), which lists the following excepted benefits: "(A)Coverage only for accident, or disability income insurance, or any combination thereof. (B)Coverage issued as a supplement to liability insurance. (C)Liability insurance, including general liability insurance and automobile liability insurance. (D)Workers' compensation or similar insurance. (E)Automobile medical payment insurance. (F)Credit-only insurance. (G)Coverage for on-site medical clinics. (H)Other similar insurance coverage, specified in regulations, under which benefits for medical care are secondary or incidental to other insurance benefits." Bill William A. MacBain, Principal MacBain & MacBain, LLC Health Care Management Consulting 1108 Hector St. Ithaca, NY 14850 607-256-1522 -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] Sent: Thursday, June 27, 2002 2:50 PM To: Tinsley, Carolyn; [EMAIL PROTECTED] Subject: RE: Medical Claims for a Property Insurance Organization However, I believe that the privacy provisions relating to PHI would still apply in the event of a PIP claim, even if the transaction requirements do not apply! Thus an auto insurance carrier providing PIP coverage would still be a covered entity, and have to comply with the Privacy and Security regs, right on down to the Agent level. Or so I have understood. If anyone has a specific statement from DHHS or OCR to the contrary, I would love to see it. Tim McGuinness, Ph.D. HIPAA Help Now Inc. (www.hipaahelpnow.com) [EMAIL PROTECTED] -----Original Message----- From: Tinsley, Carolyn [mailto:[EMAIL PROTECTED]] Sent: Thursday, June 27, 2002 1:57 PM To: 'Tomak-Maurer, Tonya (Chicago)'; [EMAIL PROTECTED] Subject: RE: Medical Claims for a Property Insurance Organization Auto & Property policies are specifically excluded under HIPAA, even for medical claims. State laws would still govern any confidentiality of health information. -----Original Message----- From: Tomak-Maurer, Tonya (Chicago) [mailto:[EMAIL PROTECTED]] Sent: Thursday, June 27, 2002 12:52 PM To: '[EMAIL PROTECTED]' Subject: Medical Claims for a Property Insurance Organization Anyone put thought into HIPAA and how it effects a property or car insurance organization who processes and pays for medical claims under their policies? 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