The healthcare industry is known for its strict regulations, and it is crucial for healthcare organizations to stay up-to-date on the latest legislation, legal settlements, and best practices to ensure compliance. In this article, we will provide a brief overview of the latest developments in the healthcare industry that organizations need to be aware of in 2023.
- HIPAA Right of Access Initiative The HIPAA Right of Access Initiative, launched in 2019, focuses on a patient’s right to prompt access to their medical records without incurring excessive fees. The current regulations require a covered entity to provide access within 30 days, with the possibility of a 30-day extension. However, proposed modifications to the HIPAA Privacy Rule would shorten the response time to 15 calendar days and require the covered entity to establish policies for prioritizing urgent requests.
- The No Surprises Act The No Surprises Act aims to protect patients from receiving surprise medical bills from out-of-network providers at in-network facilities. It also establishes a federal independent dispute resolution process for payment disputes between plans and providers. The act went into effect on January 1, 2022, but legal challenges have arisen, and the final rule issued in August 2022 removed the original presumption of the qualifying payment amount. The IDR entities are now required to provide a written decision with their rationale and information considered in their decision-making.
- HIPAA Privacy Rule & The Dobbs Decision The Supreme Court’s Dobbs vs. Jackson Women’s Health Organization decision created confusion around the HIPAA Privacy Rule and the disclosure of protected health information (PHI) without patient authorization. The Department of Health and Human Services issued guidance in June 2022 to clarify the restrictions on disclosure of PHI related to abortion and other sexual and reproductive healthcare. The guidance reminds covered entities that PHI can only be used and disclosed as permitted by the Privacy Rule and outlines the restrictions on disclosure for law enforcement purposes.
In conclusion, the healthcare industry is constantly changing, and it is essential for organizations to stay informed and up-to-date on the latest regulations and compliance best practices. By staying informed, organizations can ensure that they are providing quality care while avoiding financial penalties and negative media attention.
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