Wiki Workers Comp and HIPAA

Mrsrpc

Guru
Messages
130
Location
Mooresville, NC
Best answers
0
The CPB course works says, "According to the U.S. Department of Health and Human Services (HHS), the HIPAA Privacy Rule does not apply to entities that are either workers’ compensation insurers, workers’ compensation administrative agencies, or employers, except to the extent they may otherwise be covered entities. However, these entities need access to the health information of individuals who are injured on the job or who have a work-related illness to process or adjudicate claims, or to coordinate care under workers’ compensation systems."

Why does it read to me like, " HIPAA does not apply.... except when it does." ?

There is some VERY ambiguous language in the entire course, without qualifying information surrounding it to make it meaningful. This is just one example. What do these statements in quotes actually MEAN? Can anyone help me understand?
 
The CPB course works says, "According to the U.S. Department of Health and Human Services (HHS), the HIPAA Privacy Rule does not apply to entities that are either workers’ compensation insurers, workers’ compensation administrative agencies, or employers, except to the extent they may otherwise be covered entities. However, these entities need access to the health information of individuals who are injured on the job or who have a work-related illness to process or adjudicate claims, or to coordinate care under workers’ compensation systems."

Why does it read to me like, " HIPAA does not apply.... except when it does." ?

There is some VERY ambiguous language in the entire course, without qualifying information surrounding it to make it meaningful. This is just one example. What do these statements in quotes actually MEAN? Can anyone help me understand?


I think it's pretty clear. HIPAA does not apply to work comp. However, a work comp carrier may have other reasons to be subject to HIPAA.

For example - a hospital could be self-funded for workers' compensation. Even though HIPAA doesn't apply to the self-funded workers' compensation coverage, HIPAA still applies to them as a hospital.
 
Last edited:
I think it's pretty clear. HIPAA does not apply to work comp. However, a work comp carrier may have other reasons to be subject to HIPAA.

For example - a hospital could be self-funded for workers' compensation. Even though HIPAA doesn't apply to the self-funded workers' compensation coverage, HIPAA still applies to them as a hospital.
Your example is EXACTLY the kind of qualifying language needed throughout this course if it is to be meaningful enough to properly prepare us for working in the field. Thank you.
 
Top