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Under HIPPA, a person’s medical information may not be legally disclosed to anyone without that individual’s consent. The exception is in the case of insurers and their sponsors (employer groups), where HIPPA specifically says that such personal information may be disclosed to both parties when that information is needed to make purchase or renewal decisions regarding their health plans.
Colorado state law allowing the use of health status questionnaires, and federal law (HIPPA) allowing this exception to medical privacy facilitates violation of another federal law, the ADA, which promises that this data be kept private in order to avoid job discrimination. But here's the "but" (from the HIPPA Preamble): "We learned ... that access to and use of protected health information by employers is of particular concern to many people. With regard to employers, we do not have statutory authority to regulate them. Therefore, it is beyond the scope of this regulation to prohibit employers from requesting or obtaining protected health information... We note, however, that employers must comply with other laws that govern them, such as nondiscrimination laws." So in the real world, when an insurer has to advise their employer client that a particular employee’s medical background will result in a large premium increase for the entire group, the employer has to quickly decide whether to accept the increase (and keep the employee), or “encourage” that employee to exit the group. Since the employer cannot withhold coverage for that one person unless he withdrew the plan for the entire group, what does he do?
One workday some months after Adrian returned to work subsequent to
her treatment, she was advised via a memo that insurance premiums were
going up for the entire group. This of course distressed her, as both she
and her husband had coverage under the employee health plan.
As the employee, Adrian’s share of the group premium was paid by her
employer, but her husband’s share as family coverage was paid directly
by her through payroll deduction. That deduction was going up
considerably. One of the partners of the business happened
by and asked her why she looked depressed. She answered “because of
the big premium increase.” The partner looked at her and unhesitatingly
said, “Because of you, our insurance premiums are going up.”
He walked away with no further comment.
The harassement that she had begun to feel earlier over
minor and contrived issues finally seemed to have a reason.
She resisted, put on a “happy face” and refused to quit,
convinced that her employer’s plan was to force her to resign.
HIPPA regulations do prohibit an employer from using this information to fire an employee:
"A group health plan may...not disclose protected health information to the plan sponsor for the purpose of employment-related actions or decisions..." This leaves the employer no other alternative than to contrive a "different" reason for dumping the problem employee! |
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