HIPAA Final Rule: Enforcement–Factors for Determining Civil Money Penalties for HIPAA Violations

February 25, 2013.  Today, we examine factors considered in determining the amount of a civil money penalty for a HIPAA violation that are modified in the Final Rule:  Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules Under the Health Information Technology for Economic and Clinical Health Act [HITECH Act] and the Genetic Information Nondiscrimination Act; Other Modifications of the HIPAA Rules, which was published in the Federal Register on January 25, 2013.  The effective date of the Final Rule is March 26, 2013, and covered entities and business associates must comply by September 23, 2013. The Department of Health and Human Services (HHS) identified “five general factors”…

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HIPAA Final Rule: Enforcement: Willful Neglect

February 20, 2013.  Today, we begin examination of HITECH Act modifications of HIPAA Enforcement, focusing on the meaning and consequences of willful neglect in the Final Rule:  Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules Under the Health Information Technology for Economic and Clinical Health Act [HITECH Act] and the Genetic Information Nondiscrimination Act; Other Modifications of the HIPAA Rules, which was published in the Federal Register on January 25, 2013.  The effective date of the Final Rule is March 26, 2013, and covered entities and business associates must comply by September 23, 2013. Willful neglect is defined as “conscious, intentional failure or reckless indifference to the…

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Final Administrative Simplification Rules for Plan ID, NPI Addition, and ICD-10 Code Set Compliance Delay Published in Federal Register

September 5, 2012.  Today, the Federal Register published the Centers for Medicare & Medicaid Services (CMS) Final Rule:  Administrative Simplification:  Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier [NPI] Requirements; and a Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets.  We provided the detailed “Executive Summary” in our August 24, 2012, posting, based on the preview posting at the Federal Register’s Electronic Public Inspection Desk.  Below we provide the shorter publication “Summary” [p.54664]: “This final rule adopts the standard for a national unique health plan identifier (HPID) and establishes requirements…

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CMS Issues Final Administrative Simplification Final Rules Regarding Identifiers and ICD-10 Code Set Compliance Delay

August 24, 2012.  Today, the Office of Management and Budget (OMB) completed review and sent to the Federal Register for publication on September 5, 2012, the Centers for Medicare & Medicaid Services (CMS) Final Rule:  Administrative Simplification:  Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets.  The effective date of the Rule is November 5, 2012.  Prior to publication, the Final Rule may be examined at or downloaded from the Office of the Federal Register’s Electronic Public Inspection Desk. Here…

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Five HIPAA Compliance Activities Your Organization Must Undertake

HIPAA Administrative Simplification was enacted on August 21, 1996 as Subtitle F of Title II of Public Law 104-191. The so-called HITECH Act “Omnibus” regulation that modifies HIPAA privacy and security provisions will be published in the Federal Register by the end of this summer, according to the head of HHS’ National Coordinator for Health Information Technology, Farzad Mostashari, M.D. Based on the timeline in the Notice of Proposed Rule Making, compliance by all covered entities and their business associates would be required 240 days after publication, most likely sometime in May 2013, assuming the end-of-summer deadline is met.  All covered entities and their business associates will be required to comply with provisions of…

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EFT and RA Transaction Operating Rules IFC Published in Federal Register August 10

August 10, 2012.  Today, the Interim Final Rule with comment period (IFC):  Administrative Simplification:  Adoption of Operating Rules for Electronic Funds Transfers (EFT) and Remittance Advice Transactions, was published in the Federal Register.  The effective date of the IFC is the date of publication, August 10, 2012.   Comments on the IFC may be submitted to the Department of Health and Human Services (HHS) on or before October 9, 2012, with submission instructions included on page 48008 of the IFC.    The Executive Summary (without footnotes) from the IFC follows: “A.  Purpose of the Regulatory Action.  Health care spending in the United States constitutes nearly 18 percent of the US…

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HHS Publishes NPRM for HIPAA Health Plan Identifier and Delay for ICD-10 Compliance Date

April 17, 2012.  The Office of the Secretary of the Department of Health and Human Services (HHS) published today in the Federal Register its Notice of Proposed Rule Making (NPRM):  Administrative Simplification:  Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for ICD-10-CM and (CD-10-PCS Medical Data Code Sets. From the NPRM is the Summary of the Major Provisions: “a. HPID.  This rule proposes the adoption of the HPID [national unique health plan identifier] as the standard for the unique identifier for health plans and definitions for ‘Controlling Health Plan’ and ‘Subhealth Plan.’ The proposed…

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HHS Issues HIPAA NPRM for Unique Health Plan Identifier and One Year Delay for ICD-10 Code Set Compliance

April 10, 2012.  Yesterday, the Office of the Secretary of the Department of Health and Human Services (HHS) promulgated a notice of proposed rule making (NPRM) entitled:  Administrative Simplification:  Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for ICD-10-CM and ICD-10-PCS Medical Data Code Sets. The NPRM will be published in the Federal Register on April 17, 2012. Here is the NPRM summary:  “This proposed rule would implement section 1104 of the Patient Protection and Affordable Care Act (hereinafter referred to as the Affordable Care Act) by establishing new requirements for administrative transactions that…

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IFR for HIPAA EFT Standard to be Published in Federal Register January 10, 2012

HIPAA.com discussed in its preceding posting this Interim Final Rule (IFR) for “adoption of standards and operating rules for Electronic Funds Transfers (EFT) and operating rules for remittance advice…”, as required by the Patient Protection and Affordable Care Act of 2010 (Public Law 111-148).  [124 STAT. 153] The Office of Management and Budget (OMB) completed its regulatory review on January 3, 2012, and the IFR is available for pre-publication review prior to January 10, 2012, when it will be published in the Federal Register.  The title of the IFR is: Administrative Simplification:  Adoption of Standards for Health Care Electronic Funds Transfers (EFTs) and Remittance Advice. The Summary in the pre-publication…

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IFR for EFT at OMB

The Centers for Medicare & Medicaid Services (CMS) of the Department of Health and Human Services (HHS) has sent to the Office of Management and Budget (OMB) its Interim Final Rule (IFR) for “adoption of standards and operating rules for Electronic Funds Transfers (EFT) and operating rules for remittance advice….” Following the December 15 receipt and subsequent review of the IFR by OMB, the IFR is expected to be published in the Federal Register before January 1, 2012, as required by the Affordable Care Act of 2010 (Public Law 111-148). [124 STAT. 153] The legal authority for the IFR is Section 1104 (Administrative Simplification) of the Affordable Care Act.  Section 1104…

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