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Compliance & Regulatory
Resources
Compliance & Regulatory Roundtable
Join us May 15, 2024 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
April 22, 2024
Biden-Harris Administration Issues New Rule to Support Reproductive Health Care Privacy Under HIPAA
US Department of Health and Human Services | “The Biden-Harris Administration is providing stronger protections to people seeking lawful reproductive health care regardless of whether the care is in their home state or if they must cross state lines to get it. With reproductive health under attack by some lawmakers, these protections are more important than ever,” HHS Secretary Xavier Becerra said.
April 17, 2024
ONC Releases New Test Kit Focused on Prior Authorization
Health IT Buzz | The DaVinci Prior Authorization Support Test Kit, a voluntary kit that has been rereleased by the Office of the National Coordinator for Health IT, offers developers and those who implement health IT tools the ability to test IT systems’ support for prior authorization. The kit, which uses the HL7 Fast Healthcare Interoperability Resources standard, aims to help developers begin to test their prior authorization workflows, with a focus on FHIR-specific components.
April 10, 2024
CMS Proposes 2.6% Payment Hike for Hospitals Next Year
Fierce Healthcare | The CMS has released a draft Inpatient Prospective Payment Systems rule for fiscal 2025. The draft proposes raising payments for hospitals that participate in the IPPS Quality Reporting Program and are meaningful EHR users by 2.6% next year, which is estimated to increase total hospital payments by $3.3 billion. Other proposals include raising payments for hospitals treating people who are homeless, increasing new technology add-on payments for novel gene therapies to treat sickle cell disease, and creating a separate payment for small hospitals maintaining a buffer stock of essential drugs.
April 8, 2024
Lawmakers Craft Bipartisan Privacy Bill
MeriTalk | The chairs of the House and Senate Commerce committees unveiled legislation aimed at preserving an individual’s privacy rights and preempting some state laws, but it would allow states’ laws targeting health data to remain in effect. The bill would allow people to opt out of a company’s algorithms that are used to make health care and other decisions.
April 1, 2024
3 Ways Prior Authorization Transformation Will Change Health Care
Medical Economics | CMS finalized requirements to streamline the prior authorization process (PA), aiming to reduce the timeline to immediate or 72 hours for Medicare Advantage, Medicaid, or Qualified Health Plan enrollees. Patients benefit from faster authorizations, reduced wait times, and improved decision transparency, ensuring timely and appropriate care. PA transformation offers a high return on investment, making it a strategic business initiative rather than just a compliance requirement.
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
