States raise privacy worries over HIX

August 20, 2013 in Medical Technology

As the Department of Health and Human Services invests $67 million in insurance exchange navigators and $150 million more in enrollment assistance, some attorneys general are raising privacy and fraud concerns.

The attorneys general of Alabama, Florida, Georgia, Kansas, Louisiana, Michigan, Montana, Nebraska, North Dakota, Oklahoma, South Carolina, Texas and West Virginia – 13 of the 36 states set to have federally-run insurance exchanges – are asking HHS Secretary Kathleen Sebelius for answers to several privacy questions.

Among them: Where does liability rest when a consumer outreach program causes harm through the use of personal information?

HHS recently awarded $67 million in grants to 105 organizations to serve as navigators, helping consumers choose and select qualified health plans in-person, over the phone or online. In May, HHS announced $150 million worth of grants available for in-person enrollment assistance programs at community health centers.

[See also: HHS allots $241M for state insurance exchange IT.]

The attorneys general said they’re concerned that HHS can not “adequately protect the privacy of those who will use the assistance programs,” because the current guidance and rules have “numerous deficiencies.”

HHS’s final rules lay out principles for consumer assistance data management, discuss various federal penalties for identity theft, and call for “reasonable operational, administrative, technical and physical safeguards to ensure confidentiality, integrity and availability and to prevent unauthorized or inappropriate access.

The attorneys general say those guidelines are too broad to guarantee that consistent safeguards are put into practice.

“For example, the guidelines appear to provide significantly less protection to consumers with respect to navigators than the states have provided with respect to insurance agents and brokers,” the attorneys wrote.

They criticized HHS’ final navigator rules for not mandating licensing, as is required of insurance brokers and agents in most states. HHS’s rules call for states to ultimately decide whether consumer assistance groups are licensed, but require that at least one navigator group in each state not be a licensed broker or agent.

They criticized HHS’ personnel guidelines for not requiring background checks and for not explicitly disqualifying convicted criminals from working as navigators, calling the standards “less demanding than many federal privacy requirements, such as those applicable to federal census workers.”

HHS is requiring navigators to be certified, after completing a 20-to 30-hour training program and passing an exam.

[See also: Insurance exchanges running late.]

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Article source: http://www.healthcareitnews.com/news/states-raise-privacy-concerns-over-hix

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