cmonfils | February 3, 2012
Some employers will soon feel the impact of one of the major provisions of the 2009 economic stimulus package. Specifically, health care providers, health plans and health care clearinghouses will be the targets of new government audits focusing on Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy and security compliance.
cmonfils | January 27, 2012
Among other things, 2012 will be the year of the Department of Health and Human Services (“HHS”) Office of Civil Rights (“OCR”) pilot audit program to assess compliance with the Health Insurance Portability and Accountability Act (“HIPAA”) Privacy and Security Rules and Breach Notification standards. The American Recovery and Reinvestment Act of 2009, in Section 13411 of the HITECH Act, required that HHS conduct periodic audits to monitor and ensure compliance with HIPAA. OCR will implement this requirement through a pilot program of 150 audits from November 2011 through December 2012, including an initial wave of 20 audits that will inform how the remaining audits will be conducted. OCR has established a HIPAA Audit Program website.
cmonfils | January 25, 2012
The Department of Health and Human Services (HHS) issued interim final regulations addressing standards for electronic funds transfers (EFTs) applicable to health care claims payments transmitted by health plans to health care providers.
cmonfils | January 22, 2012
The IRS is hitting the ground running. Just a few days into 2012, we received Notice 2012-09, which addresses reporting health care coverage costs on Forms W-2. Following are a nine more things that Glass says we can expect from the federal government this year.
cmonfils | January 15, 2012
The Department of Health and Human Services plans to audit 150 plan sponsors and employers to make sure employee health and financial records are adequately protected. Creating appropriate policies and procedures, instituting a risk assessment and training employees are keys to compliance, experts say.
cmonfils | January 13, 2012
A mandatory uniform standard for health plans to pay claims electronically was adopted in rules issued Jan. 5 by the U.S. Department of Health and Human Services (HHS). The rules are designed to help health care providers match payments received with the “remittance advice” transactions that plans are already sending them under an existing HHS standard.
cmonfils | January 10, 2012
It’s one of the less pleasant healthcare trends of 2011: information is becoming less secure while enforcement is growing more stringent.
According to a recent Ponemon research study, data breaches alone have risen by 32%. Ninety-two percent of all healthcare institutions report they’ve experienced one in the past two years, and each such incident costs an average of $2.2 million. At the same time, the Department of Health and Human Services recently began conducting formal audits of HIPAA-compliance, with accompanying risk of civil and even criminal penalties. The Joint Commission on Accreditation of Healthcare Organizations has announced a “ban” on physician texting, stating that SMS is not an acceptable method of communicating patient information.
cmonfils | January 8, 2012
www.myhealthguide.com
MyHealthGuide Source: Chris Dimick, American Health Information Management Association (AHIMA), 1/4/2012, AHIMA Field Guide
CHICAGO — The healthcare industry has been inundated with change in recent years and health information management (HIM) professionals are being challenged to re-evaluate and prioritize initiatives that will have the most impact on the profession. Seven of the nation’s top initiatives will be monitored throughout the year by AHIMA’s HIM experts and are discussed in this month’s Journal of AHIMA cover story, “Field Guide: Seeing the Trees Through the Forest in 2012.” (more…)
cmonfils | January 5, 2012
MyHealthGuide Source: The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), 12/19/2011
Editor’s Note: The ICD-10-CM is a morbidity classification published by the United States for classifying diagnoses and reason for visits in all health care settings. The ICD-10-CM is based on the ICD-10, the statistical classification of disease published by the World Health Organization (WHO). Effective October 2013, the ICD-10-CM will replace the current ICD-9-CM. (more…)
cmonfils | January 3, 2012
Employer’s Guide to Self-Insuring Health Benefits December 2011 | Vol. 19, No.3
The recently proposed summary of benefits and coverage (SBC), while still a work in progress, will fill a currently unmet need for a tool enabling plan participants to comparison-shop for coverage, federal regulators told a recent conference. They sought to allay plan sponsors’ concerns that the SBC is redundant, confusing or even regressive. (more…)
cmonfils | December 27, 2011
The Department of Health and Human Services (“HHS”) has begun a pilot program of HIPAA privacy and security audits for health care providers and health plans, and the audits will have some very short turnaround times.
cmonfils | December 22, 2011
Executive Summary: The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently launched a pilot audit program as part of its HIPAA enforcement efforts. OCR intends to audit a range of HIPAA-covered entities and plans to use resulting audit reports to determine what types of technical assistance should be developed and what types of corrective action are most effective. Audits conducted during the pilot phase will conclude by December 2012. In addition to the audit program, OCR will continue to accept HIPAA-related complaints from individuals.
cmonfils | December 21, 2011
Self-Insurer December 2011 Issue, Volume 38
By Michael Friedman and John Eggertsen
The subtleties of subrogation Analysis, or when drafting plan Language it is not so simple to say what you mean in a way a court will understand it.
For those who stick with this discussion of the Court’s assessment of the subrogation and reimbursement provisions in Two ERISA Plans, it will become abundantly clear that courts will review such provisions with the proverbial fine tooth comb, and that careful and explicit drafting is required in order for a plan administrator to enforce a plan’s rights. (more…)
cmonfils | December 16, 2011
The Self-Insurer November 2011 Issue & Volume 37
By: John Hickman, Esq., Alston & Bird, LLP
New Fees for Group Health Plans Loom on the Horizon
The Affordable Care Act (ACA or the “Act”) imposes two new temporary fees with respect to group health plans that go into effect in the near future:
cmonfils | December 2, 2011
http://www.modernhealthcare.com/article/20111128/MAGAZINE/311289955/
