Medicare Compliance & Reimbursement
Understand the Nuances Between HIPAA and State-Mandated Privacy Disclosures
Question: Is it a violation of the HIPAA Privacy Rule if we comply with our state’s disclosure law requirements? We weren’t sure whether the federal provisions trump the state mandates. California Subscriber Answer: The HIPAA Privacy Rule actually contains an exception specifically involving disclosures required by state law. Common state-law disclosure obligations include reporting cases of child abuse, reporting cases of vulnerable adult abuse, and reporting to law enforcement if an individual has certain types of wounds like a bullet wound. HIPAA’s “required by state law” disclosure exception makes reviewing and understanding your state’s mandatory reporting laws absolutely essential. Focusing only on the federal HIPAA regulations to inform your disclosure obligations is a mistake. Bottom line: Learning the types of health information disclosures that HIPAA prohibits and encourages will facilitate the proper flow of information, improve patient experience, and help avoid costly federal investigations and fines.
Medicare Compliance & Reimbursement
- Balance Billing:
CMS Updates CAA Data With No Surprises Act Enforcement Letters
Review your state’s letter — and specific state regulations. As the feds continue to roll [...] - Compliance:
Fend Off Chart Blunders With Stellar Documentation
Ensure notes prove medical necessity to thwart MAC ire. If you utilize certain unique codes [...] - Quiz:
Test Your Knowledge of These Fraud & Abuse Basics
Find out where you stand on these regulations. To avoid federal scrutiny and the watchful [...] - Healthcare Tops 2021 FCA Settlement Numbers
Not that you need another reason to promote False Claims Act (FCA) compliance, but last [...] - Reader Questions:
Understand the Nuances Between HIPAA and State-Mandated Privacy Disclosures
Question: Is it a violation of the HIPAA Privacy Rule if we comply with our state’s [...] - Reader Questions:
Pocket These Global Day Facts
Question: We often need to know the global days of a procedure to help us determine [...] - Reader Questions:
Know These MUE Appeals Options
Question: We’ve been hit with a few Part B denials due to medically unlikely edit (MUE) [...] - Industry Notes:
Boost Medicare Claims Success With Helpful Compliance Data
If you’re confused by the HIPAA Simplification rules and how they apply to electronic healthcare [...] - Industry Notes:
HHS Taps Past FDA Commissioner to Head Agency Again
The U.S. Food and Drug Administration (FDA) has been critical to the success of the [...] - Industry Notes:
CMS Updates MVP Resource Offerings
If you want to get a head start and acclimate yourself with the Merit-based Incentive [...]
