Stimulus Bill Includes Important Changes to HIPAA Requirements
The American Recovery and Reinvestment Act of 2009 (the “Stimulus Bill”), which President Obama signed on Feb. 17, 2009, changes several requirements related to the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
HIPAA is intended to protect the privacy of protected health information (PHI). To accomplish this, HIPAA regulates how covered entities and their business associates use and disclose PHI. A covered entity is either a health plan, a health care provider who conducts certain transactions in electronic form or a health care clearinghouse.
Doctors of chiropractic and their staff members should be aware of the following dates and requirements:
Beginning Wednesday, Feb. 17, 2010, Business Associates of Covered Entities must comply with the “Security Standards for the Protection of Electronic Protected Health Information,” commonly known as the Security Rule. This rule was adopted to implement provisions of HIPAA. Section 13401 of Subtitle D (Privacy) of the HITECH Act (42 USC 17931) states that “[t]he additional requirements of this title that related to security and that are made applicable with respect to Covered Entities shall also be applicable to such a Business Associate and shall be incorporated into the business associate agreement between the business associate and the covered entity.” [Public Law 111-5, p.260] In addition, penalties that apply to Covered Entities also will apply to Business Associates for noncompliance with the provisions of the Security Rule. To learn more about the Security Rule, please click here.
Beginning Thursday, Feb. 18, 2010, a health care provider is required to honor a patient request to restrict disclosure of PHI to a health plan for purposes other than carrying out treatment (specifically, payment or health care operations) if the patient pays the health care provider out of pocket in full. [Section 13405 of Subtitle D of the HITECH Act (42 USC 17935)]
Lastly, on Monday, Feb. 22, 2010, enforcement of the Breach Notification Rule goes into effect for “failure to provide the required notifications for breaches” of unsecured PHI discovered on or after the Feb. 22 date. [74 Federal Register 42757, August 24, 2009]. The Breach Notification Rule provides obligations concerning collection and reporting of information pertaining to a breach, and requires “incorporation [of those obligations] into the Business Associate Agreement between the Business Associate and the Covered Entity.” [42 USC 17934]
For any questions concerning these changes, please contact Maura Barnes, ACA's paralegal at [email protected].
ACT NOW: Still Time Left to Help Stop 21% Medicare Fee Cut Proposed for 2010
As ACA previously reported in Week in Review, Congress delayed the 21% fee cuts that had been proposed for 2010 until March 1. Congress must take action prior to March 1 to address this decrease for the remainder of the year. Please contact your state representatives today to urge them to block the implementation of these drastic fee cuts. Simply visit the ACA Legislative Action Center and create an e-mail message using a template we’ve created for your convenience.
CMS Delays PECOS Enrollment Requirement
The Centers for Medicare and Medicaid Services (CMS) has delayed the requirement to enroll in PECOS for providers who order or refer for services until Jan. 3, 2011. As CMS considers accurate and current provider enrollment information an important part of its program integrity, providers should stay informed about Medicare enrollment requirements. For a list of frequently asked questions about Medicare enrollment, click here.
Chronic Conditions Account for Increased Medicare Spending
A study published today in Health Affairs discussed the causes for increased Medicare spending from 1987 to 2006. Researchers discovered that treatment for chronic conditions such as diabetes, arthritis, hypertension and kidney disease were the main causes of the spending hikes. In concluding their study, the researchers indicate that more preventive care and care coordination is needed to address these conditions. Read more…
NALC Physical Therapy Benefit Clarified
ACA’s Insurance Relations department has recently fielded a number of member questions surrounding the National Association of Letter Carriers (NALC) physical therapy benefits. Details regarding the benefit for physical therapy services when performed by a doctor of chiropractic have been clarified in their 2010 Benefit Plan Brochure. The benefit states “We cover physical therapy services rendered by a chiropractor in a medically underserved area when the services performed are within the scope of his/her license.” According the brochure, the states that are considered medically underserved by OPM designation are Ala., Ariz., Idaho, Ill., Ky., La., Miss., Mo., N.M., N.D., S.C., S.D., and Wyo. In recent years, the NALC has expanded the chiropractic benefit to acknowledge doctors of chiropractic as physicians and added an initial office visit to the benefit.
Should you have any questions regarding this or any other insurance-related matter, please contact us at [email protected].
