HIPAA Articles and Resources

News and Important Information

HIPAA Violation Penalties Revised

Are HIPAA Changes Coming?

A summary of the HIPAA law is included in Find-A-Code's specialty specific Reimbursement Guides as well as the ChiroCode DeskBook

A more thorough explanation can be found in the Complete & Easy HIPAA Compliance book which also includes editable and sample forms

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How CMS Determines Which Telehealth Services are Risk Adjustable

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Medicare Advantage Organizations (MAOs) have gone back and forth on whether or not to use data collected from telehealth, virtual Care, and telephone (audio-only) encounters with Medicare beneficiaries for risk adjustment reporting, but the following published documents from CMS cleared that up once and for all by providing an answer to a question specifically related to this question.

The 'Big 2' HIPAA Rules Medical Billing Companies Must Follow

by  Find-A-Code™

HIPAA covers nearly every aspect of how medical and personal information is collected, utilized, shared, and stored within the healthcare industry. Title II of the rules is applied directly to medical billing companies and independent coders. The 'Big 2' rules that medical billing companies must adhere to revolve around privacy and security.

New Audio-Only Telehealth Guidance to Meet HIPAA Rules

by  U.S. Department of Health & Human Services

Covered entities (healthcare providers and health plans) can use remote communications, called telehealth, to provide services to patients as long as they follow certain guidelines. Because certain populations may have difficulty using audio-video telehealth, HHS is now issuing this guidance on audio-only telehealth. This guidance will help ensure that individuals can continue to benefit from audio-only telehealth by clarifying how covered entities can provide telehealth services and improve public confidence that covered entities are protecting the privacy and security of patients' health information.

2022-06-16-MLNC - ICD-10-CM Diagnosis Codes: Fiscal Year 2023

by  CMS - MLNConnects

News - Comprehensive Error Rate Testing Program Report: Sample Reduced for Reporting Year 2023 - Men’s Health: Talk to Your Patients About Preventive Services - Compliance - Implanted Spinal Neurostimulators: Document Medical Records - Claims, Pricers, & Codes - ICD-10-CM Diagnosis Codes: Fiscal...

Using Health IT to Support Safer Use and Management of Controlled Substance Prescriptions

by  Chelsea Richwine  and  Christian Johnson

New ONC data show that, as of 2021, nearly all non-federal acute care hospitals were enabled to electronically prescribe controlled substances (EPCS). According to the American Hospital Association (AHA) Information Technology (IT) Supplement Survey, the proportion of non-federal acute care hospitals enabled for EPCS increased from 67% in...

Substance Use Disorder Treatment Incentive Program Receives Go Ahead From the OIG

by  Raquel Shumway

DynamiCare Health Inc. has developed a contingency management program for those dealing with substance use disorders. DynamiCare Health Inc. has developed a contingency management program for those dealing with substance use disorders. CM “addresses the brain’s reward response in ways that conventional counseling and medications often cannot.” Over a course of 50 years, it has shown that this program is effective. The OIG, upon analysis, has determined that there is low risk for fraud and abuse and has offered their opinion at the request of DynamiCare Health, Inc.

Cybersecurity & Ransomware Warnings

by  Wyn Staheli, Director of Content - innoviHealth

Although HIPAA Security protocols have been in effect for some time, as technology advances, if we are not diligent, gaps can be left available for intruders. On top of that, on February 23, 2022, the American Hospital Association issued a cybersecurity advisory. They stated, “there is concern that Russia may retaliate against the U.S. and allied nations with disruptive cyberattacks.”

HIPAA Penalty Changes

by  Wyn Staheli, Director of Content - innoviHealth

On January 5, 2021, H.R. 7898 was signed into law by President Trump. This new law modifies the HITECH Act such that when an organization experiences a breach, fines and/or penalties may be reduced if (for at least a year) they have instituted “recognized security practices” as defined within the law.

New ABN Form is Here

by  Wyn Staheli, Director of Content - innoviHealth

The anticipated changes to the Advanced Beneficiary Notice of Non-coverage (ABN) Form (CMS-R-131) have arrived. This important form is issued to the patient or client by providers, physicians, practitioners, and suppliers in situations where Medicare payment is expected to be denied. You can begin using the new ABN immediately if you so wish. However, it becomes mandatory on August 31, 2020.

HIPAA Final Rule Eliminates HPID and OEID

by  Wyn Staheli, Director of Content - innoviHealth

Final rule eliminates the requirement for health plans to obtain a unique health plan identifier (HPID) and also eliminates the voluntary use of the other entity identifier (OEID). This change becomes effective December 27, 2019.

Why is HIPAA So Important?

by  NAMAS

Why is HIPAA So Important? Some may think that what they do to protect patient information may be a bit extreme. Others in specialty medical fields and research understand its importance a little more. Most of that importance lies in the information being protected. Every patient has a unique set of ...

Small Breaches Can Be Subject to Large Penalties

by  NAMAS

Small Breaches Can Be Subject to Large Penalties    We may have heard about the large fines issued by the Office for Civil Rights (OCR) against big organizations like Anthem or the University of Texas MD Anderson Cancer Center. These organizations have been in the news due to privacy breaches that constituted violations ...

HIPAA Violation Penalties Revised

by  Wyn Staheli, Director of Content - innoviHealth

On April 30, 2019 The Department of Health and Human Services (HHS) announced that “HHS will apply a different cumulative annual CMP limit for each of the four penalties tiers in the HITECH Act.” Unlike other notices which require a proposed rule with a comment period, this notice will take ...

Watch out for People-Related ‘Gotchas’

by  Wyn Staheli, Director of Content - innoviHealth

In Chapter 3 — Compliance of the ChiroCode DeskBook, we warn about the dangers of disgruntled people (pages 172-173). Even if we think that we are a wonderful healthcare provider and office, there are those individuals who can and will create problems. As frustrating as it may be, there are ...

Truncated ICD-10-CM Official Guidelines for Coding and Reporting

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS

Adherence to ICD-10-CM official guideline's are required under HIPAA and adopted for all healthcare settings. We have made it easy to access guidelines and made them available on the code information page, either on the page you are viewing or view more information by selecting the ICD-10-CM Chapter Section/Guidelines and ...

Are HIPAA Changes Coming?

by  Wyn Staheli, Director of Content - innoviHealth

On December 14, 2018, the Office for Civil Rights (OCR) issued a Request for Information (RFI). They are considering making changes to some of the HIPAA regulations. Earlier this year at the HIMSS (Healthcare Information and Management Systems Society) meeting, Roger Severino, the head of the Office for Civil Rights ...

Q/A: Do I Have to Accept Any New Patient?

by  Wyn Staheli, Director of Content - innoviHealth

Question: Is it legal for us to not allow a patient to be seen in our office if their parents have bad debt with us?

Finalized Confidentiality of Alcohol and Drug Abuse Patient Records Regulations

by  Wyn Staheli, Director of Content - innoviHealth

In January, the U.S. Department of Health and Human Services (HHS) issued updates to the privacy regulations regarding the confidentiality of patient information of substance use disorder patients (42 CFR Part 2).  This notice included references to better alignment with HIPAA regulations, but did state that Part 2 is more protective ...

Q/A: Is it Legal to Shred Archived Patient Records After a Certain Amount of Time?

by  Wyn Staheli, Director of Content - innoviHealth

Shredding patient records. When is it appropriate? Read more to find out.

Medicare Claim Submission Exceptions

by  Wyn Staheli, Director of Content - innoviHealth

There are several exceptions to the Medicare "Mandatory Claim Submission Rule." What are they?
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Do Minor Procedures Feel like Major Work? 

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Reporting Telemedicine Services by Aimee Wilcox 

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

HIPAA Has New Requirements (New as of 2013-11-07) 

by  Wyn Staheli, Director of Content - innoviHealth

HIPAA Has New Requirements ...

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