Getting “Hip” With HIPAA

Since we are on a bit of a statutory roll here, we thought we would continue to knock out a few more primers on some of the most important statutes that impact our business. Starting with this “strange animal.” Word to the wise, it has nothing to do with African semi-aquatic mammals of a similar sounding name.

This statute (known formally as the Health Insurance Portability and Accountability Act) was passed in 1996 during the Clinton era discussions about healthcare reform. It covers many areas important to everyone who needs healthcare, but there are some particular aspects of this law that we wanted to highlight, specifically as they interact with both Privacy Act requirements (a topic for a blog post coming soon), and of course our favorite two civil rights bills, the ADA and the Civil Rights Act of 1991.

Title I of HIPAA was the first real attempt to limit the ability of health insurers to exclude individuals for coverage based on pre-existing conditions. It is nowhere near as declarative in this regard as Obama’s current law, which is why we support this critical aspect of healthcare reform. This however, we anticipate will become less of an important piece of this statute as some form of Obamacare comes into practice.

Title II of HIPAA however, still has a lot of teeth, and we anticipate that this segment of the legislation will only grow in importance. Specifically, this section deals with the creation of standards for the dissemination of healthcare related information. Again this is tied into Privacy Act issues we’ll discuss another day, but these provisions are critical in maintaining not only medical privacy for individuals but their basic Constitutional Rights under both the ADA and The Privacy Act which include not only privacy but the right of due process. In the former, for one, it directly addresses the right of a PWD, for example, to better control who knows what about their disability. As the ADA is very clear on the rights of individuals who are “perceived” to have disabilities (whether they have them or not), this statute compliments that legislation for this demographic in very positive ways.

The so-called “Security Rule” deals with electronically transmitted medical information specifically. In other words, one has to be very careful where and how medical records are transmitted and stored on what databases and who should have access to them. This is the part of HIPAA that has proved to be particularly problematic for some of the larger IT players (and indeed some state actors, starting with North Carolina) to comply with.

Our service provision model we believe not only creates an answer for some of those ongoing issues and problems, we also plan to give access to advertisers to a very valuable demographic while protecting our customers’ medical privacy. We believe our model is unique among IT players who are entering this space or have wanted to for some time (such as Google and Facebook). What the specifics are we will decline to elaborate upon further at this time, but we have provided one model we intend to use on this site. Click on the taxi to the left of the blog post and we hope readers will see what we mean.

We as a company will be operating in some very highly regulated waters. We actually think its a very good thing. One of what we believe to be the value adds we bring to the table is a profitable operating model that actually makes its business case BECAUSE of regulation rather than in spite of it. While this may not be the case for every private enterprise out there, we think that some of the ideas and models we have created set new benchmarks and open new doors to profitability and innovation.

The “Greening” of Medicaid

It’s no accident that the real targets of “Republican” attempts to cut the federal budget focused on the environment (EPA) and of course “entitlements” (which always includes government-funded health insurance of some sort).  These are both complicated issues which of course our company is designed to address.  That said, we aim to tackle the problem as a private sector, bottom-line and profit-focused business.  As such of course we straddle a lot of divides, starting with “partisan identification.”

We aim to avoid that.  To create our business case, we have assumed that just about everyone needs clean air to breath, clean water to drink and well, when you get sick, you need care.

That doesn’t mean that you can always throw money at the problem, which is why we are attempting to be so bi-partisan.  The reality is that our first service model aims to actually increase and improve service while reducing the annual expenditure by the federal and state government of North Carolina by about $300 Million a year.  At present, the state only picks up about 1/3rd of the cost of Medicaid/Medicare in-state, so we are pretty confident that no matter what impact we have, the Feds, logically, will be twice as enthused as the neighbors.  We think also it’s hard to argue with our motives, no matter where on the political spectrum you place yourself.

The fact is that Medicaid, like most government services (and let’s face it, the private sector) is shot through with the costs of petroleum that until recently were all but invisible to both policymakers and advocates alike because of the drum-beat of pro-petroleum forces.  With the cost of petroleum now over $100 a barrel (again), and of course alternatives like ours readily available, there is no getting around this 600lb guerrilla in the living room.

As we were recently tasked to do, our first guidepost is to remove about 240,000,000 BTUs of petroleum-based energy (annually) from Medicaid (in Department of Energy lingo).   That’s only from our Charlotte HQ, FYI, at the smallest number of taxis we plan to operate.  The demand is so great that we could easily save far more than that.  Our first service model is so efficient, in fact, that it will also drastically reduce the amount of energy it takes (from a strictly scientific perspective) for the government to help Medicaid patients get their meds refilled (a requirement under both the ADA and Title VII).   As much wind that blows from Washington on the “people’s mandate” to cut the budget, when it comes to some government services (such as Medicaid) there is no getting around the reality that civil rights cost money.  That’s something that is always left out of these discussions.  It can’t be anymore.  It creates a “floor” of service provision that the federal government is required to meet per the Constitution.  The states must also follow under some “tricky” legal quirks, known broadly as “Title II.”

We know that this is an awfully academic subject filled with tiring legal mumbo jumbo, so in the interests of brevity, we are used to just saying “it’s required.”  Unlike say strict “treehuggers” however, we have the luxury of pointing to a document that can’t be dissed (too much), although it appears these days that everyone and their little sister is a Constitutional scholar (no matter how much some people also seem to think that other historical dates enshrined in paperwork, such as the 14th Amendment, happened at the time of George and Tom.)

We do advocate the recycling of paper and other appropriate items, but we are rather partial to the Constitution and think it shouldn’t be shredded for inclusion in the local landfill.  For that reason, we are taking the stance that we are.  We think ultimately, it will be seen as no more inciteful of anything other than a very comfortable and healthy if not “green” bottom line.