Verisma
Compliance & Regulatory
Resources
Compliance & Regulatory Roundtable
Join us March 26, 2025 for a special interactive discussion on current regulatory topics. Seats are limited, so register today!
Regulatory Brief: Proposed Rule to Support Reproductive Health Privacy (April 2023)
Following the Supreme Court decision in Dobbs, President Biden directed that the Department of Health and Human Services (HHS) and the Federal Trade Commission review existing laws and regulations for opportunities to further bolster reproductive healthcare. This regulatory brief explains the April 2023 NPRM that was released as part of this initiative.
HIPAA vs. HITECH vs. Cures Act: A Fragmented Regulatory Landscape
The healthcare privacy landscape in the U.S. is fragmented, lacking a universal law and relying on a patchwork of federal and state regulations overseen by multiple agencies. This whitepaper sheds light on federal privacy laws, patient access regulations, and how the existing patchwork fails to offer comprehensive patient privacy protections.
5 Common “Tells” of a Fraudulent Request
Fraudulent requests are a growing concern with far-reaching risks, from compromising sensitive patient data to violating privacy regulations and facing potential legal consequences. We compiled a list of “red flags” for the HI community as a reference to identify and stop these attacks.
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In the News
March 17, 2025
Significant Changes at CMS Innovation Center
ICD10monitor | The Centers for Medicare & Medicaid Services (CMS) Innovation Center is overhauling its model portfolio to save taxpayers nearly $750 million by ending underperforming programs and adjusting others. Key terminations include the Maryland Total Cost of Care, Primary Care First, End-Stage Renal Disease Treatment Choices, and Making Care Primary models. CMS stated that they are shifting their strategy to emphasize preventive care, patient empowerment, and competition within the healthcare system.
March 12, 2025
Hybrid Intelligence Requires “Double Literacy”
Psychology Today | Hybrid intelligence, the integration of human cognition and artificial intelligence, requires a new form of “double literacy” for effectiveness. This includes human literacy, understanding psychology, sociology and ethics, and algorithmic literacy, understanding AI capabilities and limitations. The A-Framework (awareness, appreciation, acceptance, accountability) can guide organizations in developing hybrid intelligence capabilities, emphasizing the ethical responsibility humans have in embedding values into AI systems.
March 3, 2025
CDO Role in Health Care Shifts to Focus on AI, Compliance
Becker’s Hospital Review | The role of chief data officer in hospitals and health systems has evolved significantly, driven by value-based care and the need for better interoperability, according to Advocate Health CDO Tina Esposito and Sutter Health Chief Data and Analytics Officer Kiran Mysore. While the growth of the position has slowed as most organizations have already filled it, the rise of artificial intelligence has highlighted the importance of data management, with the role of chief AI officer expanding in tandem.
February 24, 2025
AI-Driven Prior Authorization Denials Raise Concerns Among Physicians, AMA Survey Reveals
HIT Consultant | A new survey from the American Medical Association reveals growing concern among physicians about AI in prior authorization decisions by health insurers. According to the survey, 61% of physicians worry that AI-powered tools are increasing denials, potentially harming patients and driving up unnecessary healthcare costs.
February 18, 2025
Interoperability from ED to EMS Picked Up Speed, NEMSIS Says
Healthcare IT News | Better data sharing between EMS and hospitals is improving emergency care, response times, and first responder morale. National reporting of hospital outcome data jumped from 0.9% in 2021 to 3.1% in 2024. Access to hospital data helps EMS teams make informed decisions, improve training, and streamline reimbursements.
Need a roadmap to maintain compliance?
Regulatory Links
HIPAA – HHS Offices for Civil Rights (OCR) and the National Coordinator for Health Information Technology (ONC)
Individuals’ Right under HIPAA to Access their Health Information 45 CFR 164.524
Patient Access to Health Records
Information Related to Mental and Behavioral Health, including Opioid Overdose
Frequently asked HIPAA questions
Elizabeth McElhiney, MHA, CHPS, CPHIMS,
CDH-L, CRIS, CC
Elizabeth collaborates with clients to implement evidence-based best practices and oversees Verisma’s thought leadership initiatives. She has worked in health information (HI) and release of information (ROI) for 15+ years, covering all areas of the industry from customer service to compliance. Elizabeth is also the regulatory chair at the Association of Health Information Outsourcing Services (AHIOS). She earned a masters of health administration (MHA) with a specialization in health informatics from Capella University, and a bachelor of arts (BA) in political science from Illinois Wesleyan University.