Can Insurance Companies Share Medical Records With Employers?

In an effort to keep employees healthy and safe, many employers are turning to insurance companies to access employee medical records. But can insurance companies share medical records with employers? The answer is yes, but there are some restrictions in place that employers should be aware of.

In this blog post, we will discuss the legal issues surrounding sharing medical records between insurance companies and employers, as well as ways that employers can ensure they remain in compliance with the law.

What is HIPAA?

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects the confidentiality of certain health information. HIPAA applies to health plans, healthcare providers, and other entities that handle protected health information (PHI).

Under HIPAA, covered entities may not use or disclose PHI without the individual’s written authorization. Covered entities must also take measures to protect the security of PHI.

Employers are not considered covered entities under HIPAA. However, employers may have access to PHI if they have a business associate agreement with a covered entity. Business associate agreements are contracts between covered entities and their business associates that outline how PHI will be used and protected.

If an employer wants to obtain an employee’s medical records, the employee would need to sign a release form authorizing the disclosure of their PHI.

Can employers request access to employee medical records?

Yes, employers can request access to employee medical records, but there are some restrictions on what they can see. Employers can only see information that is directly related to the employee’s job performance or ability to do their job. They cannot request access to information about the employee’s personal health or family medical history.

What happens if an employer finds out an employee has a pre-existing condition?

If an employer finds out that an employee has a pre-existing condition, they may be concerned about the potential cost of treatment for the condition. If the employee is covered by a group health insurance plan, the employer may request information from the insurance company about the coverage and potential costs. However, the insurance company is not required to provide this information to the employer.

Are there any exceptions to the rule?

Yes, there are a few exceptions to the rule. If an employer has a self-insured health plan, they are not bound by HIPAA rules and can request medical records from the insurance company without the employee’s consent.

Additionally, if an employer requires employees to undergo a fitness for duty exam, they can request medical records relevant to that exam without the employee’s consent. Lastly, if an employee files a workers’ compensation claim, their employer can request medical records relevant to that claim without the employee’s consent.

Conclusion

In conclusion, insurance companies can share your medical records with employers if you provide written consent. Although the law allows for it, there are several important considerations to keep in mind when deciding whether or not to sign this type of release form.

Knowing your legal rights and understanding the risks associated with sharing sensitive information is essential before taking such a step. Ultimately, it is up to you as an individual to weigh these factors and make the best decision for yourself.