The Office for Civil Rights of the US Department of Health and Human Services, in conjunction with the Workgroup for Electronic Data Interchange (“WEDI”), has announced a series of four free webinars on compliance with the latest Omnibus HIPAA/HITECH final rule, which implements significant changes in the requirements imposed upon health care organizations, providers, and
Health Privacy Liability Issue Proceeds to NY Court of Appeals
In last week’s decision in Doe v. Guthrie Clinic, Ltd., the Second Circuit Court of Appeals certified to the New York Court of Appeals the issue of whether a medical corporation may be liable for the unauthorized disclosure of medical information, when the employee responsible for the breach was not a physician and was
Out-of-Network Billing – New Hope for Patients
Unexpected bills to patients for out-of-network medical care have been a problem for years. Patients, their providers – both in and out-of-network – and the insurance carriers (the “payors”) have likely been involved at one time or another in the sometimes messy situation triggered by an out-of-network provider submitting a claim for charges. Payors have
First HHS Settlement for Small HIPAA Breach
On January 2, 2013, the US Department of Health and Human Services announced a $50,000 settlement with Hospice of North Idaho for a data breach involving the theft of a lost, unencrypted laptop computer containing the health information of 441 patients.
This settlement is the first for a reported breach affecting fewer than 500 individuals.
Compliance Certifications Due By 12/31
Just a reminder to New York State Medicaid providers that certifications under the NYS Social Services Law and the Federal Deficit Reduction Act are due no later than December 31.
All New York State Medicaid providers who are required to have a compliance program under Social Services Law Section 363-d must certify that their compliance
Electronic Health Records Come Under OIG Scrutiny
The Health Information Technology for Economic and Clinical Health Act (the “HITECH”) Act of 2009 aims to have all hospitals and physicians use electronic health records (“EHRs”) for all persons in the United States by 2014. Federal and State financial incentives, electronic billing requirements, and the need for ever-increasing collaboration and sharing of information among
Is Medicare Fee for Service Dead?
A post on the KevinMD blog written by Bob Doherty, Senior VP of the American College of Physicians, says that regardless of who wins the 2012 Presidential election, the fee-for-service payment methodolgy to physicians under Medicare may be dead.
The health reform proposals from President Obama and Governor Romney approach Medicare from different angles, but
Are Mandatory Price Controls the Answer to America’s Health Care Woes?
In this election season, both presidential candidates offer plans to deal with the rising cost of providing health care services, the President’s “Obamacare” by increasing the number of insured individuals through Health Insurance Exchanges, and reducing costs for a continuum of services through Accountable Care Organizations; and Governor Romney by a consumer-driven approach through Medicare
OMIG to Withhold Payments for “Credible Allegations of Fraud”
The New York State Office of the Medicaid Inspector General (“OMIG”) recently finalized regulatory changes to New York State law which relate to the withholding of payments to Medicaid providers when there is a “credible allegation of fraud.” A credible allegation of fraud is defined as an “allegation that has indicia of reliability and has
Health Systems as Providers and Insurers
Historically, health care services have been paid for by health insurance companies which accept monthly premium payments from employer groups and individuals. The premium for defined health care services is due whether the insureds under the policy use the benefits or not. Built into the premiums are additional administrative costs including fees paid to insurance