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"A federal law designed to prevent employers and health insurers from discriminating against an individual based on their genetic predisposition to disease took effect late last month, signaling a new era where intermingling genetic advances and privacy concerns create new challenges in health care. But left out of the federal Genetic Information Nondiscrimination Act, commonly known as GINA, were privacy protections for individuals seeking long-term care, disability and life insurance coverage. Each of those areas was left up to the individual states. At least 10 states regulate the use of genetic information in long-term care insurance. But in California, privacy protections were left to expire by lawmakers in January 2008. Mark Billingsley, spokesman for state insurance commissioner Steve Poizner, said in an e-mail that there "appears to be a giant loophole" in California's insurance code regarding long-term care insurance and genetic privacy protections. He said he couldn't identify a single provision in the state code that would preclude a private insurer from requesting such a test for underwriting purposes. "

Legislation aimed at protecting the privacy rights of car owners is drawing objections from auto manufacturers and Progressive Insurance, which hopes to introduce a program in Washington state that charges drivers based partly on how and when they drive.\n\nThe American Civil Liberties Union of Washington is pushing for the legislation, which would require automakers and other companies to inform car owners of the presence of devices that record information about their driving habits.\n\nThat includes event data recorders, or black boxes, installed on most newer cars, as well as electronic equipment such as GPS devices and OnStar, the wireless subscription service from General Motors.\n\nIn addition to requiring notification, a bill sponsored by state Sen. Claudia Kauffman, D-Kent, would clarify that vehicle owners are the owners of the data. With a few exceptions, a court order or the owner's permission would be required in order for a third party to obtain it.\n\nCarrie Tellefson, a lobbyist for Progressive Insurance, testified last week at a House Transportation Committee hearing that Substitute Senate Bill 5574 would prevent the insurance company from introducing its pioneering MyRate insurance program into Washington.\n\nProgressive Insurance first tested the idea of usage-based insurance in 1999. The company introduced the current plan, called MyRate, in 2004 and now offers it in nine states, including Oregon.\n\nCustomers who agree to opt into the program plug a device into their car's onboard diagnostic system, usually somewhere under the dashboard near the steering column. The device records information about how, when, and how much the car is driven, and wirelessly transmits the data back to Progressive's servers.\n\nCustomers are either rewarded with a discount or penalized with a higher rate depending on the information collected.\n\nThe discount can be as much as 30 percent, and the surcharge up to 9 percent.\n\nCustomers can go online and look at perso

The federal government would subsidize up to 65% of COBRA health insurance payments for many individuals who have lost their jobs since Sept. 1, 2008, under an $825 billion stimulus package unveiled by House Democrats. COBRA provisions are supported by health insurance groups, including America''s Health Insurance Plans and the National Business Group on Health. However, AHIP said other parts of the plan tying increased investment in health information technology to stricter scrutiny of how health IT records are handled would make it more difficult for plans to coordinate care and streamline administrative costs. Dubbed the American Recovery and Reinvestment Act, the House bill allocates $39 billion to aid individuals attempting to continue paying health insurance premiums through the 23-year-old Consolidated Omnibus Budget Reconciliation Act program. COBRA allows employees who are terminated or leave their jobs voluntarily to remain in their former employer''s group health plan for up to 18 months, which can be extended to 36 months for those with extenuating life circumstances. However, because COBRA enrollees can be charged up to 102% of the full cost of coverage, many find the plans prohibitively expensive and, according to Hewitt Associates Inc., only about 20% enroll. A recent report by the consumer group Families USA found monthly COBRA premiums for family coverage were $1,069, or 83.6% of the average monthly unemployment insurance benefit of $1,278. In nine states, average COBRA payments exceeded unemployment benefits, the group found. Health groups have been largely supportive of the proposal, with AHIP President Karen Ignagni writing in a letter to House Speaker Nancy Pelosi that the group believes the move would "help ensure continuity of coverage and serve as an important lifeline for many workers who do not qualify for Medicaid, but still need help paying their health insurance premiums."

An insurance company seeking to challenge the authority of Canada's privacy legislation and the privacy commissioner in an auto injury case will have to go to the Federal Court to make its case, the New Brunswick Court of Appeal has ruled. In State Farm Mutual Automobile Insurance Company v. Privacy Commissioner of Canada and Attorney General Canada, State Farm argued that Canada's privacy regime does not apply to surveillance tapes the insurer commissioned following a motor vehicle accident in 2005. In March 2005, Jennifer Vetter, insured by State Farm, was involved in a motor vehicle collision with Gerald Gaudet. State Farm subsequently hired a lawyer in anticipation of litigation by Gaudet against Vetter. The insurer also hired private investigators that conducted video surveillance on Gaudet. Gaudet filed a request under Canada's privacy legislation, the Personal Information Protection and Electronic Documents Act (PIPEDA), that State Farm turn over to him the personal information it had compiled, including copies of the surveillance reports and tapes. State Farm went to the New Brunswick Court of Queen's Bench asking for "declaratory" relief on several issues. Among other things, the insurer asked for a court order declaring that PIPEDA did not apply to information obtained in a bodily injury damages claim. It also asked the court for an order confirming that the privacy commissioner had no right or authority to compel State Farm to turn over the documents. The privacy commissioner asked for a stay of proceedings in the New Brunswick court, arguing that the authority of the privacy commissioner was a matter for the Federal Court (which has jurisdiction over federal legislation such as the PIPEDA). The New Brunswick Appeal Court noted both the provincial and federal courts have jurisdiction to hear cases about the constitutionality of federal legislation. But only the Federal Court could determine the outcome of a direct challenge to the authority of the p

For most insurers, business intelligence means point solutions at best. But those carriers that weave analytics into the fabric of their organizations are equipped to drive more precision in pricing and greater profitability to the bottom line. For businesses that run on the analysis of information, insurers have proven notably reluctant to apply business intelligence (BI) and analytic technologies to risk management at both the corporate strategic level and in the front lines of underwriting. For a variety of reasons, enterprise risk management (ERM) solutions have been talked about far more than implemented, and BI and predictive analytics generally have been applied haphazardly or piecemeal, if at all. The financial crisis, however, has heightened interest in risk management technologies, owing to senior executives' fears of disastrous overexposure to risk. Their concerns are legitimate, but for insurance more than any other financial services sector, risk also is opportunity, and BI should be utilized more as a competitive weapon than a defensive shield. As insurance has become commoditized and investment returns have become less reliable, carriers' ability to more precisely analyze and underwrite risks can be a key source of competitive differentiation.

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With identity theft on the upswing, Aram Langhans thought he was simply being prudent when he asked the Yakima Heart Center to remove his Social Security number from its files. "They had my insurance card and my driver's license. What else did they need?" said Langhans, a retired public school teacher insured by Group Health. Langhans said he was initially hooked up to a portable heart monitor that he was to wear for 24 hours, but the disagreement over his Social Security number prompted upper-level personnel to change their minds. He said moments after the device was attached, he was sent to a restroom to remove it and turned away. Shawnie Haas, administrator of the Heart Center, an independent outpatient group practice, declined to discuss the incident. But she said in an e-mail statement that the practice protects patients' privacy. "The Yakima Heart Center is careful to collect data pertinent to ensuring accuracy of our patient's medical record. Routine information collected for all patients includes name, address, date of birth, Social Security number, gender, and other specific information that helps us verify that individual's identity and insurance enrollment or coverage data. We are careful to maintain confidentiality of all patient information in our system." According to state and federal regulators, private insurance companies have moved away from using Social Security numbers for patient identification. But health-care providers in the Yakima Valley say they routinely collect them as "backup" in the event that patients' insurance doesn't pay the claim.

"The school's policy seems to violate the Genetic Information Nondiscrimination Act (GINA), says Susannah Baruch of the Genetics and Public Policy Center at Johns Hopkins University. "Most generally," she says, "GINA prohibits health insurers and employers from using your genetic information against you." The law went fully into effect Nov. 21, and it prevents health insurers from collecting genetic information to make decisions about the insurance people get or how much it costs. The law also says an employer can't use it to make decisions about hiring, firing or job promotions. There are a few exceptions. The law doesn't apply to employers with fewer than 15 workers. And while it covers health insurance, it doesn't apply to life or long-term care insurance."

The problem with securing data and insuring its safety is that there is simply so much more stored electronically these days that opportunities for outside hackers or insiders to steal valuable, confidential information off a company's computer systems are growing exponentially, according to those in the insurance industry who make it their business to cover this expanding exposure. Indeed, "you can take out more data in a thumb drive now than people could take out in a super-computer 10 years ago," according to Kevin Kalinich, co-national managing director for Professional Risk Solutions at Aon. The risk of a data breach is very real for companies large and small across almost any industry, noted Mr. Kalinich. He cited a report from the University of California, Berkeley, that more data has been aggregated and stored in the last three years than in the entire history of mankind. He also noted that between 75 and 85 percent of Fortune 2000 companies have suffered a "material data breach," meaning there is a growing market for those selling insurance coverage for liability and repair costs, as well as loss control services. Companies that take an "it won't happen to me" approach to securing data need only look at news headlines to see that organizations are often hit by breaches, and as more data is being stored electronically, the potential for, and impact of possible breaches increase. Princeton, N.J.-based credit and debit processing company Heartland Payment Systems reported that it had been compromised in 2008 in a breach that involved up to 100 million records, which would be tops for number of records accessed in a breach. The Heartland incident would displace the 2007 breach of TJX, in which over 45.6 million credit and debit card numbers were stolen. The TJX breach, in turn, took the record set by a breach of CardSystems Solutions in 2005.

Fireman's Fund Insurance Co. this week unveiled what it says is the first coverage available to small and medium-sized businesses for losses from payment card data breaches. News of the policy came on the same day that a non-profit research organization reported that data breaches increased 47% last year. The idea behind the coverage, according to Brian Gerritsen, product director at Novato, Calif.-based Fireman's, is to give peace of mind to business owners who are diligent about complying with the Payment Card Industry data-security standard, or PCI, the card networks' uniform protection rules that all card acceptors are supposed to meet. "That's what we're really trying to insure against-business owners trying to do everything in their power to protect their customers' cardholder data, but still find themselves in a data-breach situation and out of compliance with the PCI standards or other security standards that may apply to them," he tells Digital Transactions News. To get the coverage, however, a merchant must clear a number of hurdles. An applicant must already have property or liability coverage from Fireman's as well as the company's general data-breach policy first offered in 2006. The new payment card coverage is an add-on to that earlier product. Coverage is available to retailers and most other card-accepting merchants, but not schools and hospitals, says Gerritsen. The insurer excluded the former because of their high rate of data breaches and the latter because they hold extremely sensitive medical and personal data. If breached, a covered merchant could recoup about $160,000 in resulting expenses. That includes up to $50,000 for a PCI-specific forensic investigation, system scans and software, and hardware upgrades to get card security up to snuff. The policy also provides up to $100,000, with a 5% deductible, for PCI fines-"contractual penalties" in industry lingo-and related costs such as chargebacks and issuersâ€

Taking genetic tests to assess potential health risks could mean cheaper medical insurance even if the results are not disclosed, a senior industry executive has told The Times. Customers who take personal DNA scans will pay lower premiums because insurers believe that they encourage a healthier lifestyle, according to Gil Baldwin, the managing director of Norwich Union Healthcare. The advent of tests for DNA variants that affect common disorders such as diabetes and heart disease has prompted fears of discrimination and the creation of a "genetic underclass" who cannot buy cover. Mr Baldwin insisted that his company did not see genetics as a tool for cherry picking low-risk customers but as a way of helping them to manage and reduce their risk of disease with the aim of lowering costs for both parties. In an interview with The Times, he said that people who take genetic screening are likely to act on the results and therefore present a much better risk profile. Insurers will reflect this in premiums, regardless of whether results are disclosed.

Americans are about to re-learn that bank deposit insurance isn't free, even as Washington is doing its best to delay the coming bailout. The banking system and the federal fisc would both be better off in the long run if the political class owned up to the reality. We're referring to the federal deposit insurance fund, which has been shrinking faster than reservoirs in the California drought. The Federal Deposit Insurance Corp. reported late last week that the fund that insures some $4.5 trillion in U.S. bank deposits fell to $10.4 billion at the end of June, as the list of failing banks continues to grow. The fund was $45.2 billion a year ago, when regulators told us all was well and there was no need to take precautions to shore up the fund.

Data security represents both a new market opportunity to sell insurance coverage and a new risk - especially for independent insurance agencies that may not be compliant with data security laws or have plans in place to protect their own companies from data breaches. While data security is an evolving issue, failing to protect data can have a huge financial impact on a company. The average total per-incident cost of a data security breach was $6.65 million, compared to an average per-incident cost of $6.3 million in 2007, according to the "U.S. Cost of Data Breach Study" conducted by data protection company PGP Corp. and information management research firm The Ponemon Institute. The PGP/Ponemon study indicated that data breach incidents cost U.S. companies $202 per compromised customer record in 2008, meaning that companies incur additional costs with an abnormal churn in lost customers. More than 84 percent of data breach cases in 2008 involved organizations that had more than one data breach. And, more than 88 percent of all cases in the study involved insider negligence. The cost of lost business continued to be the most costly effect of a breach, averaging $4.59 million or $139 per record compromised. Lost business now accounts for 69 percent of data breach costs, up from 65 percent in 2007, compared to 54 percent in the 2006 study. "After four years of conducting this study, one thing remains constant: U.S. businesses continue to pay dearly for having a data breach," said Dr. Larry Ponemon, chairman and founder of The Ponemon Institute. "As costs only continue to rise, companies must remain on guard or face losing valuable customers in this unpredictable economy." Includes video: Data Security Creating Insurance Agent Sales Opportunities

Woonsocket-based CVS Caremark Corp., the largest U.S. drugstore chain, has agreed to pay $2.25 million to settle federal charges that company employees compromised customer privacy by throwing prescription records and drug bottles into open trash bins. The Federal Trade Commission said its investigation with the Health and Human Services Department followed media reports that trash bins behind CVS pharmacies contained pill bottles bearing patient names, credit-card and insurance information, and Social Security numbers. The company also did not have adequate policies for disposing of that information, and did not sufficiently train employees to dispose of the information properly, the agencies said. The items that were not properly discarded included pill bottles, medication instruction sheets, computer order forms, payroll information, job applications and credit-card and insurance information. Those labels and forms contained personal information including Social Security numbers and credit card and insurance information, and in some cases, driver's license numbers and account numbers. Names of the patients' doctors were also included. The settlement "will restore appropriate privacy protections to tens of millions of people across the country," FTC chairman William Kovacic said in a statement. "It also sends a strong message" that organizations "are required to secure consumers' private information," he said.

Following complaints from Republicans, the White House has shut down a two-week-old e-mail tip line launched to take reports from citizens of "disinformation about health insurance reform." "An ironic development is that the launch of an online program meant to provide facts about health insurance reform has itself become the target of fear-mongering and online rumors that are the tactics of choice for the defenders of the status quo," wrote White House new media director Macon Phillips in announcing the change. "The White House takes online privacy very seriously," he added. The e-mail tip line, flag@whitehouse.gov, was launched Aug. 4 as part of the White House's Health Insurance Reform Reality Check effort, a campaign-style rapid-response effort reminiscent of the war room Obama for America launched in the summer of 2008 to fight online rumors about the then-senator's patriotism and religion. But coming from the head of state, rather than a political candidate, the new effort quickly sparked concern among Republicans about the propriety of government collecting information on private citizens' political speech.

"Reporting from Washington - When your doctor writes you a prescription, that's just between you, your doctor and maybe your health insurance company -- right? Wrong. As things stand now, the pharmaceutical companies that make those prescription drugs are looking over the doctor's shoulder to keep track of how many prescriptions for each drug the physician is writing. By obtaining data from pharmacies and health insurers, the drug companies learn the prescribing habits of thousands of doctors. That information has become not just a powerful sales and marketing tool for the pharmaceutical industry but also a source of growing concern among some elected officials, healthcare advocates and legal authorities. "

"Nearly every practicing doctor in the United States is being warned that their identities might have been stolen when the laptop of an employee of an insurance trade group was snagged from a car in Chicago. The laptop contained business and personal information such as Social Security numbers, addresses and certain identification numbers on the laptop of an employee from the Chicago-based Blue Cross and Blue Shield Association, a trade group for the nation's Blue Cross health insurance plans. The association confirmed that an employee "broke protocol and transferred to a personal laptop" information that was stolen in late August. No patient information was on the database, and so far, no doctor has reported a security breach. However, nearly 20 percent of the doctors listed in the database have their Social Security numbers as their medical-care provider identification, putting these health professionals at risk for identity theft, according to an article in the Chicago Tribune."

A Swiss insurance worker lost her job after surfing popular social network site Facebook while off sick, her employer said Friday. The woman said she could not work in front of a computer as she needed to lie in the dark but was then seen to be active on Facebook, which insurer Nationale Suisse said in a statement had destroyed its trust in the employee. "This abuse of trust, rather than the activity on Facebook, led to the ending of the work contract," it said. The unnamed woman told the 20 Minuten daily she had been surfing Facebook in bed on her iPhone and accused her employer of spying on her and other employees by sending a mysterious friend request which allows access to personal online activity. Nationale Suisse rejected the accusation of spying and said the employee's Facebook activity had been stumbled across by a colleague in November, before use of the social network site was blocked in the company.

Congress has been dithering over the adoption of a federal data security breach notice law for the last several years without coming to an agreement on a national standard for reporting breaches in the security of personal and financial data, but on February 17, data breach notice provisions applicable to health information were signed into law as part of the HITECH Act provisions of the massive economic stimulus legislation, H.R. 1 (111th Cong., 1st Sess. Feb. 17, 2009). Beginning no later than September 16 of this year, "covered entities" under the Health Insurance Portability and Accountability Act (HIPAA) will be required to give notice of breaches in the security of protected health information, and "business associates" of HIPAA-covered entities will be required to report such breaches to the covered entities. §13402(a) & (b). Currently, California and Arkansas are the only states that require that notification be given in the case of a breach in the security of medical or health insurance information. The HIPAA Privacy Rule currently does not contain a requirement that individuals be notified in the event of such as breach. However, some covered entities interpret the existing HIPAA Privacy Rule requirement that covered entities mitigate harmful effects of uses or disclosures of health information in violation of either the Privacy Rule or the entity's policies and procedures as suggesting that such notice be given, and many covered entities currently provide such notification.

A health care industry coalition on Monday released a prescriptive security framework that organizations can use to safeguard patient records as they increasingly move online. The framework, released by the Health Information Trust Alliance (HITRUST) -- which represents health care providers, pharmacies, insurers, biotech firms and medical device manufacturers -- is based on well-known standards such as COBIT, NIST and ISO 270001. But this is the first benchmark developed specifically for protecting health data. "It's tailored to protecting health information right out of the gate," Michael Wilson, vice president and chief information security officer of McKesson, the largest U.S. pharmaceutical distributor, told SCMagazineUS.com on Monday. "It's just a different sort of data. It's still structured [like other verticals], but there's a lot more of it in health care." The framework was created to improve adoption rates with regulations such as the Health Insurance Portability and Accountability Act (HIPAA) and increase patient confidence in the security of their information. It also arrives on the heels of the new $787 billion economic stimulus bill, about $20 billion of which is earmarked to encourage health care organizations to adopt electronic health records as a way to reduce the number of medical errors and save money. The stimulus bill, in itself, contains srict privacy and security regulations for patient information. The standards took about 18 months to devise and can be implemented by organizations of any size, according to HITRUST. "2009 will be a turning point for information security in the health care industry, when organizations will begin implementing the framework...and create a cascading effect that will impact and benefit the entire health care ecosystem," Daniel Nutkis, CEO of HITRUST, said in news release. Wilson said the framework also will enable companies such as McKesson to show their customers and business partners that they are taki

Just days after President Obama signed a law giving billions of dollars to develop electronic health records, a university technology professor submitted a paper showing that he was able to uncover tens of thousands of medical files containing names, addresses and Social Security numbers for patients seeking treatment for conditions ranging from AIDS to mental health problems. Using peer-to-peer applications, which computer users download to share files, most commonly music and movies, M. Eric Johnson, director of the Center for Digital Strategies at Dartmouth College in Hanover, N.H., was able to access electronic medical records on computers that had the peer-to-peer programs stored on their hard drives. The medical files contained detailed personal data on physical and mental diagnoses, which a hacker could use to not only embarrass a patient but also to commit medical fraud. One of the largest stashes of medical data Johnson discovered during two weeks of research he conducted in January was a database containing two spreadsheets from a hospital he declined to identify. The files contained records on 20,000 patients, which included names, Social Security numbers, insurance carriers and codes for diagnoses. The codes identified by name four patients infected with AIDS, the mental illnesses that 201 others were diagnosed as having and cancer findings for 326 patients. Data also included links to four major hospitals and 355 insurance carriers that provided health coverage to 4,029 employers and 266 doctors.