Recent COBRA/HIPAA News

January/February 2007

• The Price of Privacy: HIPAA has Far-Ranging Implications



• Man Convicted In Clinic Identity Theft And Medicare Fraud Case



• Paperless Record Storage Calls for Strong Controls



• Held Hostage by Health Care (1/29/07) - BusinessWeek Online



• When Privacy Rules 'Cuff Police

The Price of Privacy: HIPAA has Far-Ranging Implications (2/11/07) - Globe Gazette


Patients at some medical clinics are given pagers to call them when it's time to see the doctor.

Lines at the pharmacy no longer start at the counter but at a sign posted a few feet back.

These changes are being made to protect the privacy of the individual after the enactment in April 2003 of the Health Insurance Portability and Accountability Act (HIPAA).

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Man Convicted In Clinic Identity Theft And Medicare Fraud Case (1/24/07) - U.S. Attorney


R. Alexander Acosta, United States Attorney for the Southern District of Florida, and Jonathan I. Solomon, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, announced that a Fort Lauderdale jury today convicted defendant Fernando Ferrer Jr., of Naples, Florida, of all eight (8) counts of a Superseding Indictment, which charged him with one count of conspiring to defraud the United States, one count of computer fraud, one count of wrongful disclosure of individually identifiable health information, and five (5) counts of aggravated identity theft.

Sentencing has been scheduled for April 27, 2007, in Fort Lauderdale, before United States District Judge James Cohn. At sentencing, Ferrer Jr. faces a maximum statutory term of imprisonment of five (5) years on the conspiracy count; a maximum statutory term of imprisonment of five (5) years on the computer fraud count; a maximum statutory term of imprisonment of ten (10) years on the wrongful disclosure of individually identifiable health information count; and a maximum statutory term of imprisonment of two (2) years on each count of aggravated identity theft.

The case involved the theft and transfer of medicare patient information from the Cleveland Clinic in Weston, Florida. Defendant Ferrer Jr. purchased the patient information from co-defendant Isis Machado, a former Cleveland Clinic employee, who pled guilty on January 12, 2007 and testified against Ferrer at trial. The theft resulted in the submission of more than $7 million in fraudulent medicare claims, with approximately $2.5 million paid to providers and suppliers. According to the Justice Department, this is the first Health Insurance Portability and Accountability Act ("HIPPA") violation case that has gone to trial in the United States.

Mr. Acosta commended the investigative efforts of the Federal Bureau of Investigation, the Cleveland Clinic, as well as the Centers for Medicare and Medicaid Services and their contractors, EDS, Trust Solutions and First Coast Service Options. This case is being prosecuted by Senior Litigation Counsel Neil Karadbil.

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Paperless Record Storage Calls for Strong Controls (2/2/07) - Springfield Business Journal


Many organizations are moving to paperless document filing and storage systems - systems that may be closer to "less paper" than completely "paperless." Even so, the bottom line with any information system is to carefully choose the personnel who have access to it.

For health care providers in today's litigious society, it has become increasingly important to protect both patient and employee personal health information, especially considering the legislative and media emphasis on privacy.

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Held Hostage by Health Care (1/29/07) - BusinessWeek Online


With the democrats ascendant, the political climate is ripe for another push for universal medical coverage. Kelly Services Inc. Chief Executive Carl T. Camden, a proponent of fixing health care once and for all, is taking advantage of the opportunity by rolling out new rhetorical ammunition. Workers, he says, are increasingly shackled to their jobs for no reason other than to cling to their employers' health insurance coverage. These are people, he says, "who don't leave a job even though they're unhappy and would be more productive somewhere else."

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When Privacy Rules 'Cuff Police (1/13/07) - UnionLeader.com


Federal HIPAA privacy rules that limit what police can tell the public increasingly make it harder for officers themselves to do their jobs.

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December 2006

• Federal Agencies Finalize Rules on Health Nondiscrimination

Federal Agencies Finalize Rules on Health Nondiscrimination (12/12/06) - EBSA


The U. S. Department of Labor's Employee Benefits Security Administration (EBSA), Internal Revenue Service and Department of Health and Human Services today announced the publication of final rules that provide guidance in complying with the nondiscrimination provisions of the Health Insurance Portability and Accountability Act (HIPAA). The final rules also provide guidance on the implementation of wellness programs.

HIPAA's nondiscrimination provisions generally prohibit a group health plan or group health insurance issuer from denying an individual eligibility for benefits based on a health factor and from charging an individual a higher premium than a similarly situated individual based on a health factor. Health factors include: health status, medical condition (including both physical and mental illnesses), claims experience, receipt of health care, medical history, genetic information, evidence of insurability (including conditions arising out of acts of domestic violence) and disability.

EBSA also issued updated frequently asked questions at www.dol.gov/ebsa on HIPAA's nondiscrimination requirements to assist the employee benefit community in complying with the new rules.

The final rules were published Dec. 13, 2006 in the Federal Register. The rules will be effective on the first day of the plan year beginning on or after July 1, 2007. For calendar year plans, the new rules generally apply beginning Jan. 1, 2008.

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