Tag Archives: HIPAA

Administration Proposes ACA Insurance Waiting Period Rule

On March 21, 2013, the Internal Revenue Service, Employee Benefits Security Administration, and CMS published proposed rules providing that a group health plan (or health insurance issuer offering group health insurance coverage) may not apply any waiting period that exceeds 90 days, in conformance with the ACA. Under the proposed regulations, waiting period would be … Continue Reading

It’s Here: OCR Releases Long Awaited HIPAA/HITECH Final Rule

The Office for Civil Rights ("OCR") of the Department of Health and Human Services released today the long awaited, and much anticipated, omnibus final rule modifying the HIPAA Privacy, Security, Breach and Enforcement Rules. The final rule, which implements the statutory requirements of the Health Information Technology for Economic and Clinical Health Act ("HITECH") and the Genetic Information Nondiscrimination Act ("GINA"), is comprised of four final rules and addresses the July 2010 HITECH proposed rule, the Breach Notification and Enforcement interim final rules, as well as the October 2009 GINA proposed rule (collectively, the "HITECH Final Rule"). Notably, the HITECH Final Rule does not address the May 2011 proposed accounting and access report rule.… Continue Reading

Obama Administration’s Regulatory Agenda Points to Busy 2013 for HHS

On January 8, 2013, the Obama Administration published its latest semiannual regulatory agenda, outlining planned regulatory initiatives in a number of policy areas. The Federal Register version of the agenda includes only a portion of the regulations in the pipeline, however; the full agenda has been posted on the Office of Management and Budget (OMB) web … Continue Reading

CMS Announces 90-Day Enforcement Discretion Period for HIPAA Eligibility & Claim Status Operating Rules

On January 2, 2013, CMS announced a 90-day “enforcement discretion period” with respect to operating rules mandated by the ACA for two transactions: eligibility for a health plan and health care claim status. Specifically, the CMS Office of E-Health Standards and Services (OESS) will not initiate enforcement action until March 31, 2013, with respect to … Continue Reading

Awaiting the Final HITECH Rule: HURRY UP AND WAIT!

As the year draws to a close, industry is speculating about the release date of the long-awaited Health Information Technology for Economic and Clinical Health Act (“HITECH”) final rule, which is expected to address modifications to the Privacy, Security, Enforcement, and Breach Notification Rules. While the publication date has not yet been announced, it is … Continue Reading

OCR Issues Guidance on De-identifying Protected Health Information

The HHS Office of Civil Rights (OCR) recently released guidance on methods to de-identify protected health information in compliance with the HIPAA Privacy Rule. The guidance, which is summarized on the Reed Smith’s Life Sciences Legal Update blog, is intended to assist covered entities and business associates in understanding what de-identification is and how de-identified … Continue Reading

ONC Invites Comments on Stage 3 Meaningful Use Policy

The Office of the National Coordinator for Health Information Technology (ONC) has issued a Request for Comment (RFC) on Stage 3 meaningful use recommendations, which will “target a collaborative model of care with shared responsibility and accountability.” In releasing the RFC, the ONC acknowledges “today’s challenges in setting up data exchanges,” but recommends that Stage … Continue Reading

CMS Publishes Corrections to Administrative Simplification, IPPS/LTCH PPS Rules

On October 4, 2012, CMS published technical corrections to the agency’s September 5, 2012 final administrative transactions rule that adopted a unique health plan identifier standard and delayed the implementation date for the International Classification of Diseases, 10th Revision (ICD-10) coding update from October 1, 2013 to October 1, 2014. CMS also published a rule … Continue Reading

OIG Recommends Improvements to CMS Response to Health Information Breaches

The OIG has given the CMS mixed reviews regarding the extent to which it meets American Recovery and Reinvestment Act (Recovery Act) requirements to notify affected beneficiaries when the privacy or security of their protected health information is compromised. In the report, “CMS Response to Breaches and Medical Identity Theft,” the OIG assesses how CMS … Continue Reading

HHS Adopts Unique Health Plan Identifier, Delays Implementation Date for ICD-10

On September 5, 2012, the HHS published a final rule that establishes new requirements for administrative transactions that are intended to improve the utility of the existing HIPAA transactions and reduce administrative burden and costs. Specifically, the rule adopts the standard for a national unique health plan identifier (HPID) and establishes requirements for the implementation … Continue Reading

HHS Publishes Operating Rules for Health Care Electronic Funds Transfers (EFT) and Remittance Advice Transactions

On August 10, 2012, the Department of Health and Human Services (HHS) published an interim final rule with comment period setting forth operating requirements for EFTs and electronic remittance advice (ERA) transactions. The rule, which was mandated by the ACA, is the third in a series of regulations intended to streamline health care administrative transactions, … Continue Reading

HIPAA Electronic Funds Transfer, Remittance Advance Standards

HHS has announced via a web posting that its adopting without change its January 10, 2012 interim final rule with comment period adopting standards for health care electronic funds transfers (EFT) and remittance advice transaction under HIPAA. HHS did not adopt any changes to the regulation in response to public comments, so “industry implementation efforts … Continue Reading

GAO Examines HHS Action on Privacy and Security of Prescription Drug Data

The GAO has issued a report entitled “Prescription Drug Data: HHS Has Issued Health Privacy and Security Regulations but Needs to Improve Guidance and Oversight.” The report assesses the extent to which HHS has established a framework to ensure the privacy and security of Medicare beneficiaries’ protected health information when data on prescription drug use … Continue Reading

HHS Proposes Unique Health Plan Identifier, Delays Compliance Date for ICD-10

On April 17, 2012, HHS published a proposed rule that would to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition (ICD-10) diagnosis and procedure codes from October 1, 2013 to October 1, 2014. HHS notes that many provider groups have expressed concerns about their … Continue Reading

Safeguarding Health Information: Building Assurance through HIPAA Security Conference (June 6 & 7)

The National Institute of Standards and Technology (NIST) and the HHS Office for Civil Rights are co-hosting a conference on Safeguarding Health Information: Building Assurance through HIPAA Security on June 6 and 7, 2012 in Washington, D.C. The event will address the present state of health information security, and practical strategies, tips and techniques for … Continue Reading

Medicare Claims Must Use Version 5010 Format By April 1, 2012

CMS is reminding Medicare providers that the enforcement discretion period for updated HIPAA ASC X12 Version 5010 (Version 5010) standard ends March 31, 2012. All Medicare fee-for-service transactions must be in version 5010 format by April 1, 2012; transactions using 4010 formatting will be returned as unprocessable. CMS reports that the “vast majority of provider … Continue Reading

CMS Call: Medicare FFS Implementation of HIPAA Version 5010 and D.0 Transaction Standards (Feb. 16)

On February 16, 2012, CMS is hosting a Special National Provider Education Call regarding Medicare fee-for-service (FFS) implementation of HIPAA Version 5010 and D.0 transaction standards. The call will focus on addressing recommendations made by the industry as well as outstanding fixes impacting the Part A and Part B Version 5010 transition.  Registration is required.… Continue Reading

HHS Rule on Adoption of Standards for Health Care Electronic Funds Transfers

On January 10, 2012, HHS published an interim final rule with comment period that implements an ACA provision requiring the adoption of a standard for electronic funds transfers (EFTs). By streamlining standards for the format and data content of EFT transmissions, HHS estimates that health system administrative costs will be reduced by up to $4.5 … Continue Reading

Medicare Implementation of HIPAA Version 5010 and D.0 Transactions (Jan. 25)

On January 25, 2012, CMS will host a National Provider Call regarding Medicare fee-for-service (FFS) implementation of HIPAA Version 5010 and D.0 transaction standards. The target audience for this call includes vendors, clearinghouses, and providers who need to make Medicare FFS-specific changes in compliance with HIPAA Version 5010 requirements. Registration is required.… Continue Reading