decisionhealth Newsletters, Part B News - 2016 Issue 5 (May)
Prepare for nondiscrimination rule compliance now, expect changes from payers
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Article Overview
This article reviews the federal nondiscrimination rule for health programs and activities commonly referred to as Section 1557. It explains the broad compliance implications for providers and health plans, highlights the categories of entities affected, and discusses the kinds of operational and coverage-policy updates organizations may need to evaluate as the rule takes effect. It is intended for practice managers, compliance staff, and billing/coding professionals who need a high-level understanding of the rule’s scope and timing.
Why This Topic Matters
Organizations that participate in federal health programs may need to assess whether they are covered by the rule and whether their current policies, workflows, or payer interactions could be affected. Early review can help practices prepare for compliance obligations and anticipate administrative or coverage-related changes.
What You Will Learn
- The general scope of the nondiscrimination rule and the compliance issue it addresses.
- Which types of providers and health plans may be covered by the rule.
- How the rule’s timing differs for providers and payers.
- What kinds of operational review a practice may need to perform before the effective date.
Who Should Read This
- Practice managers
- Compliance officers
- Revenue cycle staff
- Medical billing and coding professionals
- Healthcare administrators
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