Health Law Monitor

PREPARED TO COMPLY? - HITECH ACT ENFORCEMENT SET TO BEGIN

On February 17, 2010, HHS will begin to enforce changes to the HIPAA enacted through the HITECH Act.  The new requirements imposed by the HITECH Act will have a significant impact on the privacy and security of personal health information and compliance efforts of affected healthcare Covered Entities and their Business Associates.  The HITECH Act has expanded the direct applicability of the Privacy and Security Rules to Business Associates.  Significant changes may be necessary to comply with the new requirements.  

The 'Other' Health Care Reform Moves Ahead

The federal government moves ahead with its incentive program for the adoption of electronic health records.

 

Jackson Kelly lawyer James W. Thomas recently wrote an article that explores a pair of coordinated regulations issued by the U.S. Department of Health and Human Services on Jan. 13 which will define “meaningful use” for electronic health record systems.

 

To read Thomas’ article that appeared in the Jan. 29, 2010 edition of The State Journal, click here.  

 

The State Journal is a weekly business newspaper in West Virginia.

CMS CLARIFIES SUPERVISION REQUIREMENTS FOR OUTPATIENT SERVICES

CMS recently released its 2010 Outpatient Prospective Payment System (“OPPS”) rule clarifying the requirements for supervision of certain hospital outpatient services. The rule makes clear that if direct physician supervision is required for the performance of an outpatient service, this level of supervision may not be assumed to exist in a hospital setting. Rather, a hospital must establish a plan or policy to ensure that the direct supervision required by the Centers for Medicare and Medicaid Services (“CMS”) for a particular outpatient service is available. Read More.

NEW REGULATION INCREASES PENALTIES FOR HIPAA VIOLATIONS

HHS issued its interim final rule increasing penalties for privacy and security violations under the HIPAA. The new rule significantly increases the maximum penalty for civil violations of HIPAA, and decreases the defenses available to providers. The new penalty amounts apply to HIPAA violations occurring on or after February 18, 2009.  For more information about these requirements, click here.

CMS Issues Options for Providers to Comply with EMTALA in Anticipation of H1N1

In anticipation of a possible H1N1 virus outbreak this flu season, CMS has released guidance concerning EMTALA requirements during disasters and pandemics.  CMS has outlined compliance options that are permissible under EMTALA and that grant providers with flexibility to handle extraordinary increases in emergency department visits.  The options include setting up alternative screening sites on the hospital campus, off-campus screening at hospital-controlled sites, and community screening clinics at sites not under hospital control.  To read more click here.

HHS and FTC Issue Final Breach Notification Rules

To better protect the privacy of personal health information, the Department of Health and Human Services (HHS) and the Federal Trade Commission (FTC) have published new rules implementing the HITECH breach notification requirements.  Healthcare providers and other covered entities regulated under HIPAA will be required to provide notice to individuals, HHS, and, potentially, the media when unsecured protected health information is breached.  These new rules extend the notification requirements to business associates and vendors of electronic health records, while strengthening the requirements for covered entities.  The notification requirements apply to any breach on or after September 23, 2009.  For more information about these requirements, click here.

Medicare Revs Up Secondary Payer Enforcement

 

 “Medicare Secondary Payer” is the term used when the Medicare program does not have primary payment responsibility for medical claims (that is, another entity has the responsibility for paying a medical claim before Medicare). Current law makes Medicare the secondary payer to group health plan coverage in certain situations, and the secondary payer to all forms of liability insurance (including self-insurance), no-fault insurance, and workers’ compensation.

Amendments to Civil False Claims Act Create Additional Hurdles for Healthcare Providers

On May 20, 2009, President Obama enacted the Fraud Enforcement and Recovery Act of 2009 (FERA). This sweeping legislation included comprehensive changes to the civil False Claims Act (FCA), marking the first time in over twenty years that the FCA has been amended.  These changes expand the breadth and scope of the FCA, thereby providing the government with important new tools in its fight against fraud.  These changes have significant implications for health care providers, especially if overpayments have been received under the Medicare and Medicaid programs.

Providing Care to Federal Employees May Mean Affirmative Action Plans and Additional Compliance Requirements.

If you provide medical services to federal government employees, you may be a government contractor without knowing it.  It is important to realize that what you don’t know can hurt you. 

FTC “Red Flags Rule” – Enforcement Delayed Until August 1, 2009

The Federal Trade Commission (“FTC”) has delayed enforcement of the new “Red Flags Rule” until August 1, 2009, to give creditors and financial institutions more time to develop and implement written identity theft prevention programs.  The Red Flags Rule applies to any business that provides goods or services to consumers on credit.  During this delay, the FTC will release a template that will be designed to help low risk entities comply with the law.  This template will be posted on the FTC’s website, www.ftc.gov.  For more information about how the Red Flags Rule will affect health care providers, follow the link.

If you have any questions or need further assistance, please feel free to contact either James W. Thomas or Lindsay R. Darling with the Jackson Kelly Health Law Group.