As covered on Reed Smith’s Life Sciences Legal Update blog, Affinity Health Plan, Inc. (Affinity) recently reached a $1.2 million settlement with the HHS Office for Civil Rights related to potential violations of the Health Information Portability and Accountability Act of 1996 (HIPAA). Affinity self-reported a breach after learning from a CBS Evening News investigative
HIPAA
HHS Considering HIPAA Privacy Rule Amendments to Allow Reporting of Mental Health Data to National Instant Criminal Background Check System
HHS is soliciting comments on whether to amend the HIPAA Privacy Rule to expressly permit covered entities holding information about the identities of individuals who are disqualified from possessing or receiving firearms on mental health grounds to disclose limited information to the National Instant Criminal Background Check System. Comments on the rule will be accepted…
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…
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 It’s Here: OCR Releases Long Awaited HIPAA/HITECH Final Rule
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 site. Major Department of Health and Human Services (HHS) regulations are highlighted after the jump.Continue Reading Obama Administration’s Regulatory Agenda Points to Busy 2013 for HHS
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…
OCR Announces First HIPAA Breach Settlement Involving Less than 500 Individuals
The HHS Office for Civil Rights recently announced its first settlement and corrective action plan following a HIPAA breach affecting fewer than 500 individuals. Additional information about the settlement is available on Reed Smith’s Life Sciences Legal Update blog.
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…
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…
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…
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…
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…
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…
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…
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…
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…
Version 5010 Enforcement Discretion Period Ends June 30, 2012
CMS is reminding all HIPAA-covered entities that the enforcement discretion period for the upgrade to Version 5010 electronic standards ends on June 30, 2012. Entities that are not compliant as of July 1, 2012 will be subject to enforcement action under the existing HIPAA transaction and code set enforcement process.
HHS Resources on Patient Access to Health Data
The HHS Office of Civil Rights has released a number of resources to reinforce an individual’s right to access their personal medical information, including: a Right to Access Memo, "The Right to Access and Correct Your Health Information" Video, and "Your Health Information Privacy Rights" Pamphlet. The OCR notes that while HIPAA has always included…
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…
CMS Call on Medicare FFS Implementation of HIPAA Version 5010 and D.0 (April 25)
On April 25, 2012, CMS is hosting a National Provider Call/webinar regarding the current status of Medicare FFS implementation of HIPAA Version 5010 and D.0, including possible outstanding fixes impacting the Part A and Part B Version 5010 transition.