Posts Tagged ‘hipaa’

Medicare Parts A and B Medicare Administrative Contractors (A/B MACs) for jurisdictions 10 and 14 have been instructed to begin implementing Health Insurance Portability and Accountability Act (HIPAA) Version 5010. This will affect all physicians, providers and suppliers who bill these two A/B MACs. Read more »

Health care providers, health plans, and other entities covered under the Health Insurance Portability and Accountability Act (HIPAA) will soon be required to notify individuals in the event their unsecured personal health information (PHI) is breached. The U.S. Department of Health and Human Services (HHS) published an interim final rule with comment period Aug. 24 providing new regulations regarding the HIPAA notice of breach requirements. Read more »

Health and Human Services (HHS) Secretary Kathleen Sebelius announced Aug. 3 that the Office for Civil Rights (OCR) is the new authority for the administration and enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule.

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By Angela “Annie” Boynton RHIT, CPC, CCS, CPC-H, CCS-P, CPC-P, CPC-I

All of those involved in the health care industry are working in a revolutionary time, an exciting time and a stressful time!  Current workers will see a major code set change and see our country overhaul its health care infrastructure in order to support a nationwide electronic health record environment.  With ICD-10 taking over so much of the limelight recently, it is easy to overlook some of the vitally significant steps along the way.  Equally important, but much less famous, is the conversion to the ASC X12 version 5010 architecture, more commonly known as 5010, and the NCPDP versions D.0 and 3.0. Read more »

By Jillian Harrington, MHA, CPC, CPC-P, CPC-I, CCS-P

A question often heard in discussions about ICD-10 is “Why do we need to start preparing already?”  Many who work in the health care sector are wary of potential changes in the rules prior to the October 2013 compliance date.  Others are concerned about whether or not the code set will even be implemented in 2013, due to potential changes in the industry before that date.  Obviously there will also be changes in the code set itself before that date, and some feel that waiting until closer to the deadline will result in fewer changes in the code set over the time leading to implementation. Read more »

CMS held a conference call presentation on 5010 Implementation with Chris Stahlecker and Lorraine Doo, CMS, Office of Information Services, as the speakers. During their presentations they made the following main points.

Need for 5010 Conversion

• More than 5 years since initial implementation, but 8 years since balloting of the current version
• Many situational and required rules did not fit business practices of the industry
• Industry relied too extensively on companion guides, limiting value of standards
• Many transactions were not implemented at all because of limited utility and value.

Why 5010 is an Improvement over 4010

• Includes structural and content oriented changes
• Incorporates more than 500 change requests
• Resolves ambiguities in situational rules
• Provides more consistency across transactions – most rules are the same throughout the suite
• Shortcomings have been addressed to increase value of transactions such as referrals and authorizations. Read more »

Recently, the Office of the National Coordinator for Health Information Technology (ONC) released the implementation plan relative to the Health Information Technology for Economic and Clinical Health Act (HITECH) Act. The plan is titled “The Health Information Technology American Recovery and Reinvestment Act Implementation Plan” (the Implementation Plan).

The HITECH Act, a component of the American Recovery and Reinvestment Act of 2009 (ARRA), authorized $2 billion in spending to expand usage of electronic health records (EHRs) capable of sharing data between systems. The Implementation Plan addresses the need to meet the short implementation deadlines created by the ARRA, as well as the need to achieve long-term improvements in health and health care through adoption of information technology. The ONC will continue to hold hearings to develop additional policies and procedures necessary to achieve the goals of the ARRA.

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The Department of Health and Human Services (HHS) seeks your input on final guidelines regulating the handling of unsecured protected health information (PHI) breaches by May 21. The rules are mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act. Read more »

CVS, the nation’s largest retail pharmacy chain, will pay the U.S. government a $2.25 million settlement and take corrective action to ensure it does not violate privacy when disposing of patient information, such as identifying information on pill bottle labels.

The settlement, which applies to all of CVS’ more than 6,000 retail pharmacies, follows an extensive investigation by the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) for potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule.

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A Long Island mother and son are charged with stealing patient information in New York and Florida and using that information to get credit cards. Some alleged victims were deceased.

The mother, who worked in a physician’s office and had access to personal health information, and her son, a painter, are charged with three counts of second-degree identity theft, first-degree scheming to defraud, third-degree assault, and fourth-degree crminal possession of a weapon. Read more »