Menu Close

Wellmark’s Iowa ACA Exchange Exit Prompts Civil Rights Complaint

Posted in Affordable Care Act, HIPAA and the HITECH Act, Privacy and Data Protection, Private Insurers, State Matters

An August 17 article in Bloomberg BNA’s Privacy Law Watch and other publications, “Wellmark’s 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 Pitney’s Eric Fader was quoted in the article.

The complaint claimed that Wellmark Blue Cross and Blue Shield’s withdrawal from the Iowa health-insurance exchange, or marketplace, deprived hemophiliacs of coverage and violated the Affordable Care Act’s 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 doesn’t prevent insurers from deciding to stop offering plans altogether.
Eric also expressed doubt about the hemophilia groups’ allegation that a Wellmark executive’s statements had violated HIPAA, questioning whether referring to a 17-year old male hemophiliac was sufficient to allow anyone to identify the individual. “I don’t understand why she [the executive] felt it necessary or appropriate to mention the patient’s gender and precise age in her speech, but it doesn’t 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.

Leave a Reply

Your email address will not be published. Required fields are marked *