How is this possible? We can't bring on HIPAA-compliant vendors with offshore support, even if data is de-identified. And we can't allow FTEs or contractors to work offshore in the case that they have family overseas or are relocated overseas, not even temporarily. Every new offshore employee hired is a RIF'd employee here. Also, if you go out to Glassdoor and look at the reviews for the India operations, the problems will sound very familiar. Offshore doesn't mean better leadership. I personally do not want my PHI or PPI accessible overseas, and I'd imagine many more members in any health plan would feel the same. PHI on the dark web is 300+ times greater in value than credit information to criminals. The last thing this company needs to do right now is eliminate compliance, regulatory and legal in this predatory environment. https://www.thehindubusinessline.com/info-tech/carelon-global-solutions-to-expand-workforce-in-india/
7 replies (most recent on top)
Medicaid contracts that do allow offshore with a BAA for PHI are not any more protected since the BAA cannot be enforced overseas. There is nothing stopping someone from taking a photo of a screen, for example, and uploading that data for more money than they make in their day job without any real threat of prosecution from the US government. https://www.mondaq.com/unitedstates/government-contracts-procurement--ppp/328562/state-false-claims-act-analysis-does-your-state-contract-prohibit-offshore-outsourcing#
There are currently 10 Medicaid markets we serve that cannot be touched by offshore/Carelon in any way per their state contracts. It is probably the only reason we still have some onshore associates in GBD.
Are their federal laws and regulations for housing Care OHI or state ones for CAID?
I work directly with and support some Carelon work. I can tell you that this will end up backfiring big time on Elevance. They move more and more work offshore on a weekly basis. They can’t even handle the work they get, yet we keep sending more. At some point this house of cards they created will collapse.
I would be interested in what the markets have to say about this. Do they even know? Should they know (yes).
These guys are betting the farm on Carelon. Seems like a risky bet!
Isn't Carelon "unregulated"?