BUSINESS WIRE - 44 Montgomery St, 39th Floor, San Francisco, CA 94104; Tel: (415) 986-4422; FAX: (415) 788-5335 - 4 March 1997.

The Health Insurance Portability and Accountability Act (HIPA) that President Clinton signed in August 1996 will have far reaching implications towards the reform of the nation's health care delivery system. HIPA:

-- eliminates the possibility that individuals can be denied insurance coverage due to a preexisting medical condition;

-- prevents insurers from denying coverage to any individual or company based on any type of health risk factors; and lastly,

-- establishes several measures to crack down on fraud and abuse in the nation's health care system.

The fraud and abuse laws created by HIPA, which are currently under intense study by the medical profession:

-- increase reporting and enforcement activities,

-- extend the rules to apply to most federal health programs to private health insurance plans, and

-- create a new criminal health care fraud statute.

It is the latter fraud and abuse issues that concern physicians and the Tennessee Medical Association. "HIPA is a complex piece of legislation and can have a devastating affect on a doctor's office practice if the law is misunderstood or ignored. We are spending a great deal of time and resources to help physicians across the state understand the positive patient protection points included in HIPA as well as highlighting the potential pitfalls for practices," said Don Alexander, TMA Chief Executive Officer.

One of the more hotly debated concepts included in HIPA is the Medical Savings Account or MSAs. Supported strongly by physicians and opposed by some legislators, MSAs are available now to self-employed individuals, smaller employers and previously uninsured individuals. MSAs allow individuals to make their own choices about whom they choose to deliver their routine medical care.

As a result of HIPA, physicians and hospitals who are partnered with a health plan through an integrated delivery system may find it more costly to provide quality care. However, as with any new legislation, it will be some time before the impact of the new law is clear.

The Health Insurance Portability and Accountability Act and its impact on the medical community is the focus of this month's feature article in Tennessee Medicine.

Other features included in this month's issue are:

-- Voluntary HIV Testing of All Pregnant Women (A report from the TN Department of Health)

-- Actions of the Board of Medical Examiners

-- The Insider's View-The Board for Licensing Health Care Facilities

-- Ask TMA -- medical legal questions for doctors

The Tennessee Medical Association is a 6,800-member professional organization for medical doctors dedicated to protecting the health care interests of patients and enhancing the effectiveness of physicians throughout the state. Tennessee Medicine is the official membership magazine of the TMA, published monthly, featuring both scientific and socioeconomic information for physicians and their office staff.

CONTACT: The Tennessee Medical Association Russ Miller, 800/659-1862

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