Month: June 2024
FTC Mandates Vendors Notify Patients of Breaches
The Federal Trade Commission (FTC) has amended its Health Breach Notification Rule to require vendors of personal health records (PHR) and related entities not covered by HIPAA to notify individuals, the FTC, and, at times, the media, when a breach in protected health information (PHI) occurs. The change will take effect July 29.
Physicians do not have to notify patients if their PHI is leaked via a PHR vendor that is not a business associate of the physician. That responsibility falls to the vendors themselves.
Smart Edits are Going Away
Smart Edits were introduced in July of 2023 to analyze claim data and will be removed effective June 28th. No action is needed. The removal of these edits will not impact your electronic billing routine. The typical workday using electronic billing will remain the same.
Network Adequacy Waiver Hearings
TDI will hold virtual public hearings to consider insurers' requests to waive network adequacy standards. Health care providers and consumers can share information for TDI's consideration.
Digital Claim Correspondence for Cigna
Beginning today, registered users with the Claim Search entitlement have access to digital claim correspondence via the Messaging Center on CignaforHCP.com.
HHSC: Star+Plus Webinars
HHSC is transitioning contracts for the STAR+PLUS program effective September 1, 2024.
They will be conducting webinars to assist with the STAR+PLUS transition as this change will affect both members and providers.
ONLY TWO SESSIONS LEFT
Saturday June 22nd, 9:00-10:00 AM
Monday June 24th, 1:00-2:00 PM
G-Code Frustration
Deepening ongoing physician concerns over the implementation of Medicare’s add-on code for complex care, two major payers have either reduced payment for G2211 claims or announced plans to stop paying certain claims associated with the code altogether for particular plan members.
Cigna Provider Newsroom
WEBINAR SCHEDULE FOR DIGITAL SOLUTIONS: You’re invited to join interactive, web-based demonstrations of the Cigna for Health Care Professionals website (CignaforHCP.com). Learn how to navigate the site and perform time-saving […] Read more >
CLINICAL, REIMBURSEMENT, AND ADMINISTRATIVE POLICY UPDATES: To support access to quality, cost-effective care for your patients with a medical plan administered by Cigna Healthcare, we routinely review clinical, reimbursement, and administrative […] Read more >
COORDINATION OF CARE: Coordination of care is the process by which a patient’s team of providers cooperatively help coordinate care management and ensure access to quality, cost-effective care. […] Read more >
New Option to Report Violations of the Emergency Medical Treatment and Labor Act
“Health and Human Services (HHS) is committed to protecting access to emergency medical care for everyone in America.”
“We will continue to uphold the law and the right to emergency care, to inform people of their rights under EMTALA, and to make it easier for someone denied care to file a complaint.”
For more information, please visit: https://www.cms.gov/priorities/your-patient-rights/emergency-room-rights.
UHC Responsible for Breach Notifications
The Health and Human Services (HHS) Department announced Friday (May 31, 2024), United HealthCare must take responsibility for informing people about privacy breaches resulting for the the Change Healthcare cyberattack.
UnitedHealth Group previously disclosed that the ransomware attack exposed personal information of a “substantial portion” of Americans.
That “substantial portion” turns out to be 1 in 3 Americans.
“OCR must affirm its position that the breach was perpetrated upon Change Healthcare, whose status as a healthcare clearinghouse makes them a covered entity under HIPAA and thus responsible for the breach of any [protected health information] which it processes or facilitates the processing of,”
Under HIPAA, UnitedHealth Group must provide affected individuals with descriptions of the incident, what data were compromised, how the company responded to the attack, how the company can be reached and what individuals can do to protect themselves.
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