Medical insurers checking terrorist list

[Major Variola (ret)]

Some Insurers Checking Provider Lists for Terrorists

     Joyce Frieden
     Associate Editor, Practice Trends


Insurance plans say they now must cross-reference lists of business
partnersincluding providersagainst a federal list of known or
suspected terrorists.

As a result of an executive order issued shortly after Sept. 11, 2001,
many health plans say that they are now required to compare their
provider, member, and applicant lists with a list of potential
terrorists maintained by the Treasury Department's Office of Foreign
Assets
Control (OFAC).

If we didn't have to do it, we probably wouldn't, said Helen Stojic,
spokeswoman for Blue Cross Blue Shield of Michigan, which is matching
the names on the OFAC list against its database of 4.8 million members
and 20,000 providers. [But] we did not see it as something that was
voluntary.

Other plans that are checking member and provider databases with the
OFAC list include Cigna and Aetna US Healthcare. So far, none of
those three plans has found any matches to the list.

The executive order states that any transaction or dealing by United
States persons or within the United States in property  blocked
pursuant to this order is prohibited, including but not limited to the
making or receiving  of funds, goods, or services to or for the benefit
of
those persons listed by the government. Because there was some
confusion about whether the order applied to health insurers, the
American
Association of Health Plans-Health Insurance Association of America
sought more information from the Treasury Department.

The Treasury Department sent back an informal guidance document
explaining that the executive order applies to government agencies and
private companies including health plans and insurers and that one
method for health plans and insurers to comply is to search their
records
to see if there are any individuals or businesses that match the names
on the OFAC list.

If a plan does receive an insurance application from someone on the
list, it is obligated not to issue the policy, and if it has
inadvertently
already issued a policy to a person on the list, plan officials are
supposed to contact the Treasury Department.

Although the document did not say that comparing lists was the only way
to find out if an insurer is doing business with a suspected terrorist,
I haven't heard of any other method, Ms. Stojic said.

The federal government is not alone in requiring health insurers to
comply with the executive order, noted Fred Laberge, spokesman for Aetna

US Healthcare, in Hartford, Conn. We've seen similar requests from
state departments of insurance saying, We've seen this executive order;

demonstrate that you're complying with it. Florida and New York are
among the states that have made these requests, he said.

Since member and provider lists change constantly, the cross-referencing
will be ongoing, plans say. It includes scanning of our databases
on a periodic basis to screen new customers and transactions on the OFAC
list, said Cigna spokeswoman Amy Turkington.

Plans say these checks do not compromise any personal health information
or raise any privacy concerns under the Health Insurance
Portability and Accountability Act (HIPAA).

We're not sharing any information about our members beyond checking the
list of names, said Aetna's Mr. Laberge. Private medical
information is not even being looked at or asked about.

Still, civil libertarians are not happy with the order. We know that
databases are filled with errors, said Virginia Rezmierski, Ph.D., of
the
school of public policy at the University of Michigan, Ann Arbor. If a
patient's account is mistakenly frozen because he or she is thought to
be
on the OFAC list, what does that do to someone getting ready to have a
procedure?

Checking names against the OFAC list is not as bad as using claims data
to do the same thing, Dr. Rezmierski said. However, by
approaching terrorism and deterrence of it in this way, we've
effectively thrown out the entire notion of innocent till proven guilty.
We are now
guilty until there's no match. Instead of going from knowledge about the
behavior of an individual and having cause to do this violation, we're
violating everyone.

Jay Stanley, communications director for the technology and liberty
program at the American Civil Liberties Union, said he was concerned
that
this is part of an overall trend of the government enlisting private
individuals and companies into its information-gathering and enforcement

proceedings.

Obviously, it's a good thing if no one does business with true
terrorists, Mr. Stanley said. But the problem is that there are no
established
guidelines for due process in how one gets placed on these lists.
Mistakes have been rife, especially when you are talking about Arab
names
 which have to be translated into a different alphabet.

Mr. Stanley noted that such lists are set up primarily to prevent
terrorists from laundering money through unsuspecting American
corporations.
As far as I can tell, nobody uses health insurance to launder money.
There are basic questions that need to be asked about the cost and
benefit of targeting here.

February 2004  Volume 32  Number 2
http://www2.eClinicalPsychiatryNews.com/scripts/om.dll/serve
login: cypherpunks/writecode