Health Care Law Blog

Health Plans Take Notice: Compliance with HIPAA Administrative Simplification Rules is still Required

On Jan. 2, 2014, the Department of Health and Human Services (“HHS”) issued a proposed rule related to the Administrative Simplification requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).  Specifically, it delayed the date by which health plans must certify compliance with certain operating rules imposed by the Affordable Care Act (“ACA”).   

The ACA required the Secretary of HHS to adopt operating rules related to claims status, eligibility, electronic funds transfers ("EFT") and health care payment and remittance advice transactions ("ERA").  Health plans (and other covered entities) were required to comply with the claims status and eligibility operating rules by Jan. 1, 2013 and the EFT and ERA operating rules by Jan. 1, 2014.  Additionally, health plans were required to file a statement with HHS certifying that the health plan is in compliance with the operating rules.  This certification statement was due by Dec. 31, 2013.  Read More ›

Categories: Billing/Payment, Compliance, Health Care Reform, HIPAA, Insurance, Privacy, Providers

Posted by: Mindi M. Johnson

  |  Contact Author

Share  | 

Pivotal Question for 2014: Are you a Large Employer?

While originally scheduled to start in 2014, now beginning in 2015, "large employers" will be required to provide adequate health care coverage to their full time employees or pay a penalty. This requirement is known as health care reform’s Employer Mandate. In order to assess whether your company is subject to the Employer Mandate, you must first determine whether your company is a "large employer." Read More ›

Categories: Employee Benefits, Employment, Health Care Reform

Posted by: Mindi M. Johnson

  |  Contact Author

Share  | 

Final Rules Published in the Federal Register Extend Protections of Electronic Health Record Donations

On Dec. 27, 2013, final rules were published in the Federal Register by the Office of Inspector General and the Centers for Medicare & Medicaid Services. These rules amend regulations protecting certain arrangements involving the donation of electronic health records (EHR) software or information technology and training services related to such EHR software from the Anti-Kickback Statute and Stark law. The final rules are nearly identical to one another and make five primary changes to the EHR provisions: Read More ›

Categories: Electronic Health Records, Providers

Contact Author

Share  | 

A Rare Reversal of a Licensing Sanctions by The Michigan Court Of Appeals Offers Hope to Disciplined Health Professionals

A recent Michigan Court of Appeals decision offers a glimmer of hope to health professionals who face the unenviable prospect of appealing adverse decisions made by licensing boards. Since 1994, the Public Health Code has required that appeals by licensed health professionals from adverse licensing decisions be filed in the Michigan Court of Appeals. Over the past two decades, there have been very few cases where the Court of Appeals held that a decision by a licensing board was legally incorrect or factually unsupported. Read More ›

Categories: Licensing, Physicians, Providers

Contact Author

Share  |