A federal regulation that protects consumers from unsolicited telemarketing calls has also emerged as a significant barrier for healthcare organizations that coordinate patient care--including health insurers.
In 1991, Congress passed the Telephone Consumer Protection Act (TCPA), which directed the Federal Communication Commission (FCC) to adopt rules regarding telemarketing, an article from Lexology explains. The FCC subsequently prohibited companies from calling a residential telephone line using a prerecorded voice without consent, and later added additional protections for cell phone numbers. If a call is deemed healthcare-related or delivers a healthcare message, the Health Insurance Portability and Accountability Act rules apply. If it’s not healthcare-related, the TCPA rules apply.
But those regulations have created a roadblock for health insurers, Michelle Turano, vice president of government affairs for WellCare, testified before a house subcommittee hearing last week. Turano said many state Medicaid contracts require insurers to reach out to beneficiaries to review benefits or conduct health risk assessments, but restrictions on automated calls to cell phones make that process difficult and expensive.
“The uncertainty surrounding the FCC’s interpretation of TCPA has had a chilling effect on the ability of WellCare and other managed health care plans to conduct this kind of outreach to members,” Turano said, adding that even doctor appointment reminders can carry tremendous legal liability.
Turano said that reconciling the burdensome regulations under TCPA with HIPAA, which covers all healthcare communication and does not make a distinction between land lines and cell phones, would provide healthcare organizations with a clearer understanding of when and how they are permitted to contact beneficiaries.
Studies show that automated phone calls can help patients remember to fill blood pressure medication, boost overall medication adherence and can help reduce physician office no-shows.