An August 17 article in Bloomberg BNAs Privacy Law Watch and other publications, “Wellmarks Iowa ACA Exchange Exit Prompts Civil Rights Complaint,” discussed an administrative complaint filed with the Department of Health and Human Services Office for Civil Rights (OCR) by three groups representing hemophiliacs. Day Pitneys Eric Fader was quoted in the article.
The complaint claimed that Wellmark Blue Cross and Blue Shields withdrawal from the Iowa health-insurance exchange, or marketplace, deprived hemophiliacs of coverage and violated the Affordable Care Acts nondiscrimination provision. Eric told Bloomberg BNA that the OCR might not act on the complaint because, while the ACA does bar insurers from denying coverage due to pre-existing conditions, it doesnt prevent insurers from deciding to stop offering plans altogether.
Eric also expressed doubt about the hemophilia groups allegation that a Wellmark executives statements had violated HIPAA, questioning whether referring to a 17-year old male hemophiliac was sufficient to allow anyone to identify the individual. “I dont understand why she [the executive] felt it necessary or appropriate to mention the patients gender and precise age in her speech, but it doesnt appear to me that this was a clear HIPAA violation,” Eric said. However, he did not rule out the idea that the OCR might use the incident as a teachable moment.