Coupons, Discounts and Privacy · [PRESENTATION TITLE] (Type over this by editing on the theme...
Transcript of Coupons, Discounts and Privacy · [PRESENTATION TITLE] (Type over this by editing on the theme...
Orlando World Center Marriott
Orlando, Florida
September 10-13, 2012
The Blue National Summit is a program of the Blue Cross and Blue Shield Association, an Association of independent Blue Cross and Blue Shield Plans. Copyright © 2012.
Coupons, Discounts and
Privacy
Thomas D. Bixby
Thomas D. Bixby Law Office LLC
Mary Kay Dudley
Blue Cross Blue Shield
Association
[PRESENTATION TITLE] (Type over this by edi t ing on the theme master)
Coupons are hot!
• Groupon and other sites
• Clipping coupons online
Privacy and HITECH Act restrictions . . .
Coupons, Discounts, & Privacy
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“Marketing” restrictions
“Hybrid entity” status
Privacy Rule & HITECH Act
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May not use/disclose PHI for “marketing”
• Written authorization
Marketing is:
• Making a communication
• About a product or service that
• Encourages recipient to use or purchase the product or service
“Marketing” Restrictions
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“Marketing” Restrictions
Broad definition includes:
• Traditional marketing about products & services
• Every-day activities, e.g., provider directories
• Coupons
Exceptions apply
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“Marketing” Restrictions
Exceptions for
• Health-related products/services offered by Blue Plan
• Provider directories and
• Value Added Items & Services
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“Marketing” Restrictions
Value Added Item or Service
• Health-related products/services
• Available only to Blue Plan member
• Add value to (but not part of) benefit plan
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“Marketing” Restrictions
Add value to benefit plan
Available only to Blue Plan member
• Not available to the general public
• E.g., same discount offered in Sunday paper
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“Marketing” Restrictions
Health related
• Glasses/contacts
• Eye exams
• Health club membership
• But not ticket to movie theater
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55¢ off LEAN CUISINE® varieties when you buy THREE LEAN CUISINE® varieties
SAVE 50¢ Fiber One® when you buy ONE BOX any flavor Fiber One® Chewy Bar
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SAVE $1.00 Nature Made® off any Nature Made® product
SAVE $3.00 AmLactin® Lotion on ONE Bottle of AmLactin® Lotion
For people with extra-dry skin . . .
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50¢ off Equal® Sucralose when you buy any ONE Equal® Sucralose
$1.75 off Centrum® Silver® Multivitamin when you buy any ONE Centrum® Silver® Multivitamin
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15% OFF Get 15% OFF Your Order at Famous Footwear.
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“Marketing” Restrictions
Determining what “health related” means
Communication must be “health care operation”
• Population-based activity
• Improve health or reduce costs
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“Marketing” Restrictions
Proposed “health related” test:
• If the member uses/purchases product or service,
• Is the purpose of the member’s use/purchase reasonably likely to be
• Improving member’s health or reducing costs?
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“Marketing” Restrictions
Apply “health related” test to:
• Eye glasses/contacts
• Eye exam
• Health/fitness club
• Movie theater tickets
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55¢ off LEAN CUISINE® varieties when you buy THREE LEAN CUISINE® varieties
SAVE 50¢ Fiber One® when you buy ONE BOX any flavor Fiber One® Chewy Bar
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SAVE $1.00 Nature Made® off any Nature Made® product
SAVE $3.00 AmLactin® Lotion on ONE Bottle of AmLactin® Lotion
For people with extra-dry skin . . .
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50¢ off Equal® Sucralose when you buy any ONE Equal® Sucralose
$1.75 off Centrum® Silver® Multivitamin when you buy any ONE Centrum® Silver® Multivitamin
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15% OFF Get 15% OFF Your Order at Famous Footwear.
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HITECH Act Restriction
No payment
• May not receive payment for communication
• Directly or indirectly
Vendor’s receipt of payment
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“Marketing” Restrictions
Coupon checklist
• “Health related”? (Reasonably likely to use coupon to improve health or reduce costs?)
• Available only to Blue Plan members?
• Payment for communications (direct or indirect)?
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“Hybrid Entity” Status
Entity that performs multiple functions
• Functions that make entity a health plan
• Non-health plan functions
Examples: Health insurer that:
• Also sells life insurance
• Collects Health Risk Assessments for employer
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“Hybrid Entity” Status
Identify “components”
• Health care components (“covered functions”)
• Non-health care components
Establish firewalls
• One-way flow of protected health information
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“Hybrid Entity” Status
Health care component’s PHI:
• No “disclosure” to non-HC component
• No access by non-HC component
• Security Rule safeguards—treat non-HC component as 3rd party
• Employees “wearing two hats”
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Orlando World Center Marriott
Orlando, Florida
September 10-13, 2012
The Blue National Summit is a program of the Blue Cross and Blue Shield Association, an Association of independent Blue Cross and Blue Shield Plans. Copyright © 2012.
Questions
Thomas D. Bixby
Thomas D. Bixby Law Office LLC
Mary Kay Dudley
Blue Cross Blue Shield
Association