Coronavirus prep

lynn_glenmont wrote: »

rheddmobile wrote: »

AnnPT77 wrote: »

missysippy930 wrote: »

I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
https://privacyruleandresearch.nih.gov/pr_06.asp

I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

On the related subject of people claiming that HIPAA and the ADA give them the right to not wear a mask if they claim a disability, with such individuals often claiming it is illegal to even ask what the disability is.

The ADA has issued a statement which says that a business can indeed ask what the disability is for the purpose of making reasonable accommodations (for example, someone with a breathing issue would need different accommodations from someone who gets panic attacks when their face is covered or someone who needs to see lips to sight-read) and that in any case “reasonable accommodations” doesn’t mean you get to not wear a mask. An example of reasonable accommodations might include curb-side pickup, or having someone shop for you, or wearing a face shield instead of a mask. It never means the disabled person just gets to ignore the rule and endanger others.

Unless you're talking about the American Dental Association, the ADA is a piece of legislation (the Americans with Disabilities Act), and I don't understand how a piece of legislation can issue a statement.

lynn_glenmont wrote: »

AnnPT77 wrote: »

lynn_glenmont wrote: »

AnnPT77 wrote: »

missysippy930 wrote: »

I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
https://privacyruleandresearch.nih.gov/pr_06.asp

I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly".

FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

T1DCarnivoreRunner wrote: »

Theoldguy1 wrote: »

lynn_glenmont wrote: »

AnnPT77 wrote: »

lynn_glenmont wrote: »

AnnPT77 wrote: »

missysippy930 wrote: »

I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
https://privacyruleandresearch.nih.gov/pr_06.asp

I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly".

FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

My company is self insured (with a 3rd party to administer claims). With 45k US employees by the time you add in dependents and retirees covered there are easily 150k people+ in the insurance pool. We have another 60k employees worldwide which would also have self funded company insurance but there would be some interplay with governmental insurance programs so don't have a clear picture of that liability. Enough that statistical abnormalities won't move anything. As @AnnPT77 mentioned there may be some sort of umbrella type policy carried but never heard of it.

Mine is self-insured also with a 3rd party administrator and we only have around 10K U.S. employees.

lynn_glenmont wrote: »

AnnPT77 wrote: »

lynn_glenmont wrote: »

AnnPT77 wrote: »

lynn_glenmont wrote: »

AnnPT77 wrote: »

missysippy930 wrote: »

I just read an article from Bloomberg Business week about some businesses instructing employees not to discuss cases of other employees who have Covid-19. This practice is being justified by employers because of hipaa regulations. I would think that employers would want other employees to be aware of coworkers that have the disease, so they can do everything humanly possible to prevent contracting Covid, and the spread in, and outside, the workplace. Instead, some employers are threatening “disciplinary actions”. The article sites the right for others to know about cases of infected coworkers as safety violations in the workplace and not covered by hipaa regulations. Some employers are telling employees with COVID-19, not to inform coworkers. This has been the trend across the country among employers. There have been thousands of complaints to OSHA regarding this. This concerns me and is a dangerous, for people in the workplace, as well as the general public.

Unless there's been a recent dramatic reinterpretation, or there's something unusual about these businesses, they would not be "covered entities" under HIPAA. "Covered entities" are health care providers, related health care clearinghouses, and health plans. The privacy rules portion of HIPAA applies only to "covered entities".

I say this based on having been a participant in my employer's HIPAA implementation, so received a good deal of education about its provisions, but there is a summary here:
https://privacyruleandresearch.nih.gov/pr_06.asp

I can visualize *very unusual* situations where an employer might possibly have some HIPAA privacy rules obligations sort of as an employer, but IMU a normal employment situation isn't one of them. IMU, just being an employee of something like a health care provider wouldn't be enough, either, with respect to this "tell the co-workers or don't" stuff.

I'm not a deep legal expert on this stuff. If someone here is, they should speak up. However, it's a thing that I coincidentally needed to understand much more fully than Joe Average does.

For sure, in the current crisis, HIPAA is being used as an explanation for things that are howlingly ridiculous BS (like why a store can't ask if someone has a medical condition that prevents mask use).

I'm sure that it's 100% not true that because HIPAA is about "health care privacy", it must mean that anything about my health that I might want to be private (or that someone else wants to stay secret) must be protected by anyone or everyone, can't be asked about, etc.

I think if your employer "self-insures" to cover medical care for employees that they would be a covered entity (i.e., they don't provide medical insurance through an insurance company but instead pay claims for employees' medical services directly out of the company's pocket, and thus would be seeing the claims and listed services). I've never actually known of a company that did that, but it's a theoretical possibility.

Even before this crisis, I heard anecdotes of companies' using HIPAA as a reason not to be transparent about health risks to employees or customers. You already used the language I would have chosen (ridiculous BS), but you get extra points for "howlingly".

FWIW, my "company" (a university) self insured. But - and I think this is common, maybe not universal - they used a health insurance company as an intermediary. The university paid the claims costs (and presumably some administrative fees, though I never read the contract), but the intermediary dealt with all the billing, medical billing codes, co-pays, provider network to the extent applicable, and all that specialized stuff. The U considered it financially advantageous to assume the risks (of fluctuating health costs, vs. paying a standard amount per employee for regular insurance, which transfers the risk to the insurance company), but the U didn't want to add the administrative complexity of handling all the billing details.

In that "self insured" scenario, the university was *not* a covered entity, even for most/all of what was involved on our side of the administrative processes. Obviously, this is very situation specific, so I can't speak for other scenarios' details. I did become aware of some other institutions who were also using 3rd party administrators/intermediaries in a similar way, but had no reason to look into wildly different cases.

The extent to which the U was a covered entity turned out to be much narrower than we had originally expected. Mostly, it was the clinical centers associated with the med schools, their pharmacies and similar health care support functions, and the student health center (basically a clinic).

I hadn't considered a situation in which the employer outsourced the administration of the plan and was only financially responsible, although I see how that makes sense. As I said, I've never actually encountered an entity that self-insured. I don't think I would want to work for one, as the pool would be so small that I would be afraid a couple of statistical anomalies in terms of catastrophic events would bankrupt the system. That's interesting. Was it a private or a public university?

Public, large. Shifting to round numbers, say 10,000 regular employees (faculty, administrative) over the course of a year, around 10,000 or so student employees at any given time, twice that over the course of a year. The insurance pool would've been mostly the full-time regulars (plus spouses/dependents), so well more than 10K people there, plus an unknown-to-me number of retirees (full insurance for a lot of those under 65 (and families), at that time, just like if they were still employed, though they don't offer that deal to newer hires anymore) and medicare supplemental for those retirees over 65 (and surviving spouses).

It would be a mix of white collar and blue collar (big food service organization, groundskeepers for giant campus, custodial staff for a couple of hundred buildings, skilled trades of many types), police, professionals (doctors, lawyers, pharmacists), etc. That's a decent-ish population to average over.

I don't know if there was a layer of catastophic risk insurance somewhere in the mix, but I never heard of it. (It was a big enough place that it would self-insure for quite large risks, and externally insure only the excess, in some categories. There was an Office of Risk Management to deal with that and a bunch of other stuff - like avoidance of risk in the first place.)

I don't know whether all this stuff is the same now, or not. I've been retired for quite a while now.

Interesting. I worked for two different public universities (one medium to large and one extremely large) as a student employee (undergrad and grad) and don't remember getting insurance as an employee. Of course, it was many decades ago, and both were part-time jobs. Much different landscape these days, I'm sure (or I hope).

moonangel12 wrote: »

TonyB0588 wrote: »

Had a COVID19 reality this week.

My wife had a medical procedure today. Preparation in the preceding days involved having a COVID19 test - no one can enter our hospitals without being tested first. I went with her, but watched from outside the door. She enjoyed that, and the doctor said she got an A+ for the way she took that thing in her nose and her throat.

At the hospital today, no one allowed inside apart from the patient. She's been there before and I'd usually go with her to the room and through all the preparations until she's actually wheeled into the operating theater. Not so with COVID19 around. So they quite nicely asked me to go home and wait for a call. On my return they pushed her out to the car, instead of me going in to bring her out like previous times.

Certainly the "new normal".

I hate the new normal for stuff like this - I had a routine procedure done 2 weeks ago and I missed having my husband by my side...

ahoy_m8 wrote: »

Terribly disturbing. Couldn't believe my eyes when saw potential for vaccine approval prior to trial completion. WTF.