RIMS Sounding Off
Allen, Anne B., Risk Management
What is the sound of 4,500 voices from industries of various shapes and sizes? It's either the Tower of Babel or a RIMS position statement. While it may seem impossible to lead such a diverse and broad membership toward consensus, we live in an unprecedented era of opinion. In the last few months the Society has issued new position and policy statements on issues as varied as health information privacy and year 2000 coverages. What has RIMS said recently?
On PARCA--It may seem long ago, but it was only last year that The Patient Access to Responsible Care Act (PARCA), H.R. 1415, sponsored by Rep. Charles Norwood (R-GA), was the scourge of employer groups in Washington, D.C. Although the bill died in the 105th Congress, patients' rights will continue to be debated in the 106th. PARCA would have created a layer of federal health care mandates on top of state laws and regulation. RIMS felt that the attempted goal, providing federal uniformity to managed care laws, would have placed too much of a burden on the states in administering their own rules. PARCA's mandates would have limited employers' ability to establish preferred provider networks and their flexibility to establish self-insured health plans. RIMS argued that the bill would wipe out the cost-saving benefits of any self-insured health care plans by subjecting them to the same state regulation for health care plan administration and requiring the same mandated coverages as traditional indemnity, HMO or managed care plans.
On Health Information Privacy--This issue, along with employer liability for health plans, has been one of the main drivers in forcing risk managers to look at health benefits. The health information privacy debate made it clear that health care reform has become so far-reaching that it cannot help but affect traditional P&C programs. RIMS' position was based on examination of a number of federal proposals and a model bill approved in 1998 by the National Association of Insurance Commissioners. RIMS felt that such proposals, hinging on employee authorization before most information could be released, could actually limit access to care. The Society pointed out that most proposals would restrict employers' access to health records and experience and loss data, necessary tools in the evaluation and enhancement of risk management programs. They would also preclude the employer from making informed decisions regarding both group health and workers' compensation claims. …