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McBrayer Blogs
Showing 22 posts in Department of Health and Human Services (HHS).
PHI May Be In More Places Than You Think
A recent HIPAA settlement serves as an important reminder that protected health information (PHI) may be stored on “ordinary” office equipment such as printers, photocopiers, scanners and fax machines, and not just on computer hard drives. On August 14, 2013, the Department of Health and Human Services (HHS) announced a settlement with the not-for-profit managed care plan Affinity Health Plan, Inc. (“Affinity”) for over $1.2 million in connection with HIPAA Privacy and Security breaches stemming from PHI stored on a photocopier hard drive. More >
Tools for the Trade: Understanding HIPAA
As a result of the intricate details and requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), it comes as no surprise that HIPAA Privacy and Security Rules can cause challenges and confusion for even the most sophisticated providers. With this in mind, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) has recently provided tools meant to educate both consumers and providers on HIPAA. More >
More on the Final HIPAA Omnibus Rule
To follow up our previous blog on the Final Omnibus Rule (“Rule”) regarding HIPAA and HITECH, 78 Fed.Reg. 17, Part II, 5566-5702 (Jan. 25, 2013), which modifies 45 CFR Parts 160 and 164, we will now discuss the changes to the Breach Notification Rule. The modifications will greatly reshape how Covered Entities and Business Associates view a breach. More >
HHS Issues Final HIPAA Omnibus Rule
The U.S. Department of Health and Human Services (“HHS”) recently announced its issuance of the highly-anticipated regulations or Final Omnibus Rule (“Rule”) relating to the modification of the HIPAA Privacy, Security, and Enforcement rules under the Health Information Technology for Economic and Clinical Health Act (“the HITECH Act”). 78 Fed.Reg. 17 Part II (January 25, 2013) modifying 45 CFR Parts 160, 162, 164. The Final Rule, 78 Fed.Reg. 17 Part II, 563 pages in length, makes significant changes of which all providers need to be aware. A complete examination of the sweeping changes cannot be done in one article, so we will make a general summary of the most important changes. More >
Senate Finance Committee Takes an In-Depth Look at Fraud & Abuse
Earlier this week, I discussed the HHS and DOJ Annual Report for the Health Care Fraud and Abuse Program. HHS and DOJ are not the only ones who are determined to purge the health care industry of its woes. On January 31, 2013 a group of six current and former members of the Senate Finance Committee released a comprehensive report detailing recommendations on combating waste, fraud and abuse in the Medicare and Medicaid Programs. More >
Annual Report Details Record Breaking Success in Health Care Fraud Prevention
The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), required the establishment of a national Health Care Fraud and Abuse Control Program (“HCFAC”). The HCFAC Program is a joint Department of Justice (“DOJ”) and Health and Human Services (“HHS”) coordination of federal, state and local law enforcement activities to combat fraud committed against all health plans, both public and private. More >
THE KENTUCKY HEALTH BENEFIT EXCHANGE: LITTLE GNOME FACTS
“Like Travelocity but for health insurance” is how Executive Director Carrie Banahan and Deputy Director Bill Nold of the Office of Kentucky Health Benefit Exchange describe the developing Kentucky Exchange. More >
Compliance Plan – A Provider’s Defense
The Office of the Inspector General (“OIG”) has always encouraged Medicare and Medicaid providers to implement a compliance program. For 14 years, as a matter of fact, OIG has provided compliance guidance in 11 healthcare sectors (including: hospitals, nursing facilities, home healthcare, hospice and third-party billers). With the passing of the Patient Protection and Affordable Care Act (“PPACA”), compliance plans and programs are now mandatory for any provider enrolled in a Federal health care program, including Medicare. More >
Kentucky Health Cooperative Insurance, Available in 2014
The Supreme Court Decision of June 28, 2012 upholding the Patient Protection and Affordable Care Act (“PPACA”) in National Federation of Independent Business, et al., v. Sebelius , Secretary of Health and Human Services, et al., reignited the creation and implementation of Consumer Operated and Oriented Plan programs (“CO-OPS”). CO-OPs are aimed at offering small businesses and individuals more affordable health insurance options, especially in states where there are a few insurance carriers capitalizing the market with plans that are not economically targeted at the smaller insurance market. More >
Fraud, Waste and Abuse Controls Under The Affordable Care Act
The Affordable Care Act (“ACA”) strives to improve our health care system in three main areas; by expanding consumer protections, strengthening Medicare and reducing health care costs. One key way the government hopes to achieve these goals is through tougher fraud and waste controls. Given the focus on prevention, penalty and recovery, compliance plans are of the utmost importance for all health care providers. First we examine all of the elements incorporated in the ACA that pertain to fraud, abuse and waste before we can begin to develop a compliance plan for our facilities. The new law contains a host of tools aimed at enforcing fraud and waste prevention. Let’s review: More >
